Distinct Clinical Presentations and Outcomes of Hospitalized Adults with the SARS-CoV-2 Infection Occurring during the Omicron Variant Surge

• Published in: Healthcare (Basel) Vol. 11; no. 12; p. 1703
• Main Authors: Niu, Jianli, Kim, Myeongji, Jalal, Ayesha T, Goldberg, Jessica E, Acevedo Martinez, Elsa M, Suarez Moscoso, Nathalie P, Rubio-Gomez, Heysu, Mayer, Daniel, Visbal, Alvaro, Sareli, Candice, Eckardt, Paula A, Sareli, Aharon E
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 01.06.2023; MDPI
• Subjects: Classification; Clinical outcomes; COVID-19; COVID-19 vaccines; Data collection; Drug dosages; Electronic health records; Health care policy; Hospital patients; Hospitalization; hospitalizations; in-hospital mortality; incidental COVID-19; Infections; Intensive care; intensive care services; Laboratories; Mortality; Omicron variant; Patients; Public health; Regression analysis; Severe acute respiratory syndrome coronavirus 2; Statistics; United States; Florida; United States > US; COVID-19; in-hospital mortality; Omicron variant; incidental COVID-19; intensive care services; hospitalizations
• ISSN: 2227-9032; 2227-9032
• DOI: 10.3390/healthcare11121703

The COVID-19 Omicron variant has imposed a tremendous burden on healthcare services. We characterized the types of the Omicron variant-associated hospitalizations and their associations with clinical outcomes. Consecutive adults hospitalized with COVID-19 during the Omicron variant surge period of 1-14 January 2022, were classified into one of three groups based on their clinical presentations on admission: Group 1-primary COVID-19; Group 2-extrapulmonary manifestations of COVID-19; and Group 3-incidental COVID-19. Of the 500 patients who were hospitalized, 51.4% fell into Group 1, 16.4% into Group 2, and 32.2% into Group 3. The patients in Groups 1 and 2 were older, with higher proportions of comorbidities than patients in Group 3. The Group 1 patients had the highest mortality rate (15.6%), followed by Group 2 (8.5%), and Group 3 (0.6%), with adjusted odds ratios (OR) of 22.65 (95% confidence interval [CI], 2.75-239.46; = 0.004) and 10.95 (95% CI, 1.02-117.28; = 0.048), respectively, compared to Group 3. Those in Group 1 showed a greater utilization of intensive care services (15.9%), followed by Group 2 (10.9%), and Group 3 (2.5%), with adjusted ORs of 7.95 (95% CI, 2.52-25.08; < 0.001) and 5.07 (95% CI, 1.34-19.15; = 0.017), respectively, compared to Group 3. The patients in Groups 1 and 2 had longer hospitalization stays than the patients in Group 3 ( < 0.001 and = 0.002, respectively). Older age (≥65 years) was an independent factor associated with longer hospital stays (OR = 1.72, 95% CI, 1.07-2.77). These findings can help hospitals prioritize patient care and service planning for future SARS-CoV-2 variants.