tetano
Editor, Senior Moderator
Clin Infect Dis
. 2023 May 31;ciad276.
doi: 10.1093/cid/ciad276. Online ahead of print. Changing Severity and Epidemiology of Adults Hospitalized With Coronavirus Disease 2019 (COVID-19) in the United States After Introduction of COVID-19 Vaccines, March 2021-August 2022
Noah Kojima[SUP] 1 [/SUP], Katherine Adams[SUP] 1 [/SUP], Wesley H Self[SUP] 2 [/SUP], Manjusha Gaglani[SUP] 3 [/SUP], Tresa McNeal[SUP] 4 [/SUP], Shekhar Ghamande[SUP] 4 [/SUP], Jay S Steingrub[SUP] 5 [/SUP], Nathan I Shapiro[SUP] 6 [/SUP], Abhijit Duggal[SUP] 7 [/SUP], Laurence W Busse[SUP] 8 [/SUP], Matthew E Prekker[SUP] 9 [/SUP], Ithan D Peltan[SUP] 10 [/SUP], Samuel M Brown[SUP] 10 [/SUP], David N Hager[SUP] 11 [/SUP], Harith Ali[SUP] 11 [/SUP], Michelle N Gong[SUP] 12 [/SUP], Amira Mohamed[SUP] 13 [/SUP], Matthew C Exline[SUP] 14 [/SUP], Akram Khan[SUP] 15 [/SUP], Jennifer G Wilson[SUP] 16 [/SUP], Nida Qadir[SUP] 17 [/SUP], Steven Y Chang[SUP] 17 [/SUP], Adit A Ginde[SUP] 18 [/SUP], Cori A Withers[SUP] 18 [/SUP], Nicholas M Mohr[SUP] 19 [/SUP], Christopher Mallow[SUP] 20 [/SUP], Emily T Martin[SUP] 21 [/SUP], Adam S Lauring[SUP] 22 23 [/SUP], Nicholas J Johnson[SUP] 24 [/SUP], Jonathan D Casey[SUP] 25 [/SUP], William B Stubblefield[SUP] 26 [/SUP], Kevin W Gibbs[SUP] 27 [/SUP], Jennie H Kwon[SUP] 28 [/SUP], Adrienne Baughman[SUP] 26 [/SUP], James D Chappell[SUP] 29 [/SUP], Kimberly W Hart[SUP] 30 [/SUP], Ian D Jones[SUP] 26 [/SUP], Jillian P Rhoads[SUP] 31 [/SUP], Sydney A Swan[SUP] 30 [/SUP], Kelsey N Womack[SUP] 31 [/SUP], Yuwei Zhu[SUP] 30 [/SUP], Diya Surie[SUP] 32 [/SUP], Meredith L McMorrow[SUP] 32 [/SUP], Manish M Patel[SUP] 1 [/SUP], Mark W Tenforde[SUP] 1 [/SUP]; Investigating Respiratory Viruses in the Acutely Ill (IVY) Network
Collaborators, Affiliations
Introduction: Understanding the changing epidemiology of adults hospitalized with coronavirus disease 2019 (COVID-19) informs research priorities and public health policies.
Methods: Among adults (≥18 years) hospitalized with laboratory-confirmed, acute COVID-19 between 11 March 2021, and 31 August 2022 at 21 hospitals in 18 states, those hospitalized during the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Omicron-predominant period (BA.1, BA.2, BA.4/BA.5) were compared to those from earlier Alpha- and Delta-predominant periods. Demographic characteristics, biomarkers within 24 hours of admission, and outcomes, including oxygen support and death, were assessed.
Results: Among 9825 patients, median (interquartile range [IQR]) age was 60 years (47-72), 47% were women, and 21% non-Hispanic Black. From the Alpha-predominant period (Mar-Jul 2021; N = 1312) to the Omicron BA.4/BA.5 sublineage-predominant period (Jun-Aug 2022; N = 1307): the percentage of patients who had ≥4 categories of underlying medical conditions increased from 11% to 21%; those vaccinated with at least a primary COVID-19 vaccine series increased from 7% to 67%; those ≥75 years old increased from 11% to 33%; those who did not receive any supplemental oxygen increased from 18% to 42%. Median (IQR) highest C-reactive protein and D-dimer concentration decreased from 42.0 mg/L (9.9-122.0) to 11.5 mg/L (2.7-42.8) and 3.1 mcg/mL (0.8-640.0) to 1.0 mcg/mL (0.5-2.2), respectively. In-hospital death peaked at 12% in the Delta-predominant period and declined to 4% during the BA.4/BA.5-predominant period.
Conclusions: Compared to adults hospitalized during early COVID-19 variant periods, those hospitalized during Omicron-variant COVID-19 were older, had multiple co-morbidities, were more likely to be vaccinated, and less likely to experience severe respiratory disease, systemic inflammation, coagulopathy, and death.
Keywords: COVID-19; SARS-CoV-2; death; hospitalization; severe disease.
. 2023 May 31;ciad276.
doi: 10.1093/cid/ciad276. Online ahead of print. Changing Severity and Epidemiology of Adults Hospitalized With Coronavirus Disease 2019 (COVID-19) in the United States After Introduction of COVID-19 Vaccines, March 2021-August 2022
Noah Kojima[SUP] 1 [/SUP], Katherine Adams[SUP] 1 [/SUP], Wesley H Self[SUP] 2 [/SUP], Manjusha Gaglani[SUP] 3 [/SUP], Tresa McNeal[SUP] 4 [/SUP], Shekhar Ghamande[SUP] 4 [/SUP], Jay S Steingrub[SUP] 5 [/SUP], Nathan I Shapiro[SUP] 6 [/SUP], Abhijit Duggal[SUP] 7 [/SUP], Laurence W Busse[SUP] 8 [/SUP], Matthew E Prekker[SUP] 9 [/SUP], Ithan D Peltan[SUP] 10 [/SUP], Samuel M Brown[SUP] 10 [/SUP], David N Hager[SUP] 11 [/SUP], Harith Ali[SUP] 11 [/SUP], Michelle N Gong[SUP] 12 [/SUP], Amira Mohamed[SUP] 13 [/SUP], Matthew C Exline[SUP] 14 [/SUP], Akram Khan[SUP] 15 [/SUP], Jennifer G Wilson[SUP] 16 [/SUP], Nida Qadir[SUP] 17 [/SUP], Steven Y Chang[SUP] 17 [/SUP], Adit A Ginde[SUP] 18 [/SUP], Cori A Withers[SUP] 18 [/SUP], Nicholas M Mohr[SUP] 19 [/SUP], Christopher Mallow[SUP] 20 [/SUP], Emily T Martin[SUP] 21 [/SUP], Adam S Lauring[SUP] 22 23 [/SUP], Nicholas J Johnson[SUP] 24 [/SUP], Jonathan D Casey[SUP] 25 [/SUP], William B Stubblefield[SUP] 26 [/SUP], Kevin W Gibbs[SUP] 27 [/SUP], Jennie H Kwon[SUP] 28 [/SUP], Adrienne Baughman[SUP] 26 [/SUP], James D Chappell[SUP] 29 [/SUP], Kimberly W Hart[SUP] 30 [/SUP], Ian D Jones[SUP] 26 [/SUP], Jillian P Rhoads[SUP] 31 [/SUP], Sydney A Swan[SUP] 30 [/SUP], Kelsey N Womack[SUP] 31 [/SUP], Yuwei Zhu[SUP] 30 [/SUP], Diya Surie[SUP] 32 [/SUP], Meredith L McMorrow[SUP] 32 [/SUP], Manish M Patel[SUP] 1 [/SUP], Mark W Tenforde[SUP] 1 [/SUP]; Investigating Respiratory Viruses in the Acutely Ill (IVY) Network
Collaborators, Affiliations
- PMID: 37255285
- DOI: 10.1093/cid/ciad276
Introduction: Understanding the changing epidemiology of adults hospitalized with coronavirus disease 2019 (COVID-19) informs research priorities and public health policies.
Methods: Among adults (≥18 years) hospitalized with laboratory-confirmed, acute COVID-19 between 11 March 2021, and 31 August 2022 at 21 hospitals in 18 states, those hospitalized during the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Omicron-predominant period (BA.1, BA.2, BA.4/BA.5) were compared to those from earlier Alpha- and Delta-predominant periods. Demographic characteristics, biomarkers within 24 hours of admission, and outcomes, including oxygen support and death, were assessed.
Results: Among 9825 patients, median (interquartile range [IQR]) age was 60 years (47-72), 47% were women, and 21% non-Hispanic Black. From the Alpha-predominant period (Mar-Jul 2021; N = 1312) to the Omicron BA.4/BA.5 sublineage-predominant period (Jun-Aug 2022; N = 1307): the percentage of patients who had ≥4 categories of underlying medical conditions increased from 11% to 21%; those vaccinated with at least a primary COVID-19 vaccine series increased from 7% to 67%; those ≥75 years old increased from 11% to 33%; those who did not receive any supplemental oxygen increased from 18% to 42%. Median (IQR) highest C-reactive protein and D-dimer concentration decreased from 42.0 mg/L (9.9-122.0) to 11.5 mg/L (2.7-42.8) and 3.1 mcg/mL (0.8-640.0) to 1.0 mcg/mL (0.5-2.2), respectively. In-hospital death peaked at 12% in the Delta-predominant period and declined to 4% during the BA.4/BA.5-predominant period.
Conclusions: Compared to adults hospitalized during early COVID-19 variant periods, those hospitalized during Omicron-variant COVID-19 were older, had multiple co-morbidities, were more likely to be vaccinated, and less likely to experience severe respiratory disease, systemic inflammation, coagulopathy, and death.
Keywords: COVID-19; SARS-CoV-2; death; hospitalization; severe disease.