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Journal Article Epublish 15 citations

PubMed: 37907849 DOI: 10.1186/s12879-023-08714-x

Comparison of the clinical characteristics of SARS-CoV-2 Delta (B.1.617.2) and Omicron (B.1.1.529) infected patients from a single hospitalist service.

BMC Infect Dis 23(1):747

Authors: N Radhakrishnan, M Liu, B Idowu, A Bansari, K Rathi, S Magar, L Mundhra, J Sarmiento, U Ghaffar, J Kattan, R Jones, J George, Y Yang, F Southwick

Affiliations

  • Division of Hospital Medicine, Department of Medicine, University of Florida College of Medicine, 6362 NW 41st Ave, Gainesville, FL, 32606, USA.
  • Department of Biostatistics, College of Public Health and Health Professions, University of Florida, Gainesville, FL, USA.
  • Department of Statistics, Franklin College of Arts and Sciences, University of Georgia, 310 Herty Drive, Athens, GA, 30602, Greece.
  • Division of Hospital Medicine, Department of Medicine, University of Florida College of Medicine, 6362 NW 41st Ave, Gainesville, FL, 32606, USA.

Abstract

BACKGROUND

While existing evidence suggests less severe clinical manifestations and lower mortality are associated with the Omicron variant as compared to the Delta variant. However, these studies fail to control for differences in health systems facilities and providers. By comparing patients hospitalized on a single medical service during the Delta and Omicron surges we were able to conduct a more accurate comparison of the two varaints' clinical manifestations and outcomes.

METHODS

We conducted a prospective study of 364 Omicron (BA.1) infected patients on a single hospitalist service and compared these findings to a retrospective analysis of 241 Delta variant infected patients managed on the same service. We examined differences in symptoms, laboratory measures, and clinical severity between the two variants and assessed potential risk drivers for case mortality.

FINDINGS

Patients infected with Omicron were older and had more underlying medical conditions increasing their risk of death. Although they were less severely ill and required less supplemental oxygen and dexamethasone, in-hospital mortality was similar to Delta cases, 7.14% vs. 4.98% for Delta (q-value = 0.38). Patients older than 60 years or with immunocompromised conditions had much higher risk of death during hospitalization, with estimated odds ratios of 17.46 (95% CI: 5.05, 110.51) and 2.80 (1.03, 7.08) respectively. Neither vaccine history nor variant type played a significant role in case fatality. The Rothman score, NEWS-2 score, level of neutrophils, level of care, age, and creatinine level at admission were highly predictive of in-hospital death.

INTERPRETATION

In hospitalized patients, the Omicron variant is less virulent than the Delta variant but is associated with a comparable mortality. Clinical and laboratory features at admission are informative about the risk of death.

MeSH

Risk, Communicable Diseases, Hospitalists, Laboratories, Hospital Mortality, Sars Virus, Covid-19, Sars-Cov-2

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