Severity predictors of COVID-19 in SARS-CoV-2 variant, delta and omicron period; single center study

• Published in: PloS one Vol. 17; no. 10; p. e0273134
• Main Authors: Ogawa, Fumihiro, Oi, Yasufumi, Honzawa, Hiroshi, Misawa, Naho, Takeda, Tomoaki, Kikuchi, Yushi, Fukui, Ryosuke, Tanaka, Katsushi, Kano, Daiki, Kato, Hideaki, Abe, Takeru, Takeuchi, Ichiro
• Format: Journal Article
• Language: English
• Published: San Francisco Public Library of Science 25.10.2022; Public Library of Science (PLoS)
• Subjects: Age; Antiviral drugs; Biology and life sciences; Biomarkers; Blood; Body mass; Body mass index; Body size; Classification; Comorbidity; Coronaviruses; COVID-19; COVID-19 vaccines; Dyspnea; Health aspects; Health services; Hemodialysis; Hospitalization; Hospitals; Immunization; Intensive care; Laboratories; Medical case management; Medicine and Health Sciences; Pandemics; Patients; Pharyngitis; Physical Sciences; Pneumonia; Regression analysis; Renal function; Respiration; Respiratory diseases; Services; Severe acute respiratory syndrome coronavirus 2; Signs and symptoms; Smokers; Smoking; Social Sciences; Vaccination; Ventilators; Viral diseases; China
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0273134

Background The outcomes of coronavirus disease 2019 (COVID-19) treatment have improved due to vaccination and the establishment of better treatment regimens. However, the emergence of variants of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which causes COVID-19, and the corresponding changes in the characteristics of the disease present new challenges in patient management. This study aimed to analyze predictors of COVID-19 severity caused by the delta and omicron variants of SARS-CoV-2. Methods We retrospectively analyzed the data of patients who were admitted for COVID-19 at Yokohama City University Hospital from August 2021 to March 2022. Results A total of 141 patients were included in this study. Of these, 91 had moderate COVID-19, whereas 50 had severe COVID-19. There were significant differences in sex, vaccination status, dyspnea, sore throat symptoms, and body mass index (BMI) (p <0.0001, p <0.001, p <0.001, p = 0.02, p< 0.0001, respectively) between the moderate and severe COVID-19 groups. Regarding comorbidities, smoking habit and renal dysfunction were significantly different between the two groups (p = 0.007 and p = 0.01, respectively). Regarding laboratory data, only LDH level on the first day of hospitalization was significantly different between the two groups (p<0.001). Multiple logistic regression analysis revealed that time from the onset of COVID-19 to hospitalization, BMI, smoking habit, and LDH level were significantly different between the two groups (p<0.03, p = 0.039, p = 0.008, p<0.001, respectively). The cut-off value for the time from onset of COVID-19 to hospitalization was four days (sensitivity, 0.73; specificity, 0.70). Conclusions Time from the onset of COVID-19 to hospitalization is the most important factor in the prevention of the aggravation of COVID-19 caused by the delta and omicron SARS-CoV-2 variants. Appropriate medical management within four days after the onset of COVID-19 is essential for preventing the progression of COVID-19, especially in patients with smoking habits.