TY - JOUR

T1 - Clinical progression, disease severity, and mortality among adults hospitalized with COVID-19 caused by the Omicron and Delta SARS-CoV-2 variants

T2 - A population-based, matched cohort study

AU - Harboe, Zitta Barrella

AU - Roed, Casper

AU - Holler, Jon Gitz

AU - Khan, Fahim Iqbal

AU - Abdulrahman, Aya Nihad Abdulrahman

AU - Mulverstedt, Stefan Lundby

AU - Lindgaard-Jensen, Betina

AU - Bertelsen, Barbara Bonnesen

AU - Søborg, Christian

AU - Nielsen, Thyge Lynghøj

AU - Hansen, Line Vinum

AU - Madsen, Birgitte Lindegaard

AU - Browatzki, Andrea

AU - Eiberg, Mads

AU - Bernhard, Peter Haahr

AU - Pedersen, Emilie Marie Juelstorp

AU - Egelund, Gertrud Baunbaek

AU - Dungu, Arnold Matovu

AU - Sejdic, Adin

AU - Mathiesen, Inger Hee Mabuza

AU - Jespersen, Naja Z.

AU - Petersen, Pelle Trier

AU - Nielsen, Lars

AU - Jepsen, Micha Phill Grønholm

AU - Pedersen, Thomas Ingemann

AU - Eriksson, Robert

AU - Seitz-Rasmussen, Hans Eric Sebastian

AU - Bestle, Morten

AU - Andersen, Henrik

AU - Skram, Ulrik

AU - Skøtt, Mads Rømer

AU - Altaraihi, Sarah

AU - Sivapalan, Pradeesh

AU - Jensen, Jens Ulrik Stæhr

AU - Bagge, Kristian

AU - Jørgensen, Kristina Melbardis

AU - Knudsen, Maja Johanne Søndergaard

AU - Leineweber, Thomas

AU - Schneider, Uffe Vest

AU - Ahlstrom, Magnus Glindvad

AU - Rytter, Sofie

AU - Le Dous, Nina

AU - Ravn, Pernille

AU - Reiter, Nanna

AU - Podlekareva, Daria

AU - Knudsen, Andreas

AU - Johnsen, Stine

AU - Kristensen, Lars Erik

AU - Leding, Cæcilie

AU - Hertz, Bastian Bryan

AU - Benfield, Thomas

AU - Kirk, Ole

AU - Holler, Jon Gitz

AU - Ostrowski, Sisse Rye

AU - Sigurdsson, Sigurdur Thor

AU - Perner, Anders

AU - Kirkby, Nikolai

AU - Pedersen, Martin Schou

AU - Van Wijhe, Maarten

AU - Simonsen, Lone

AU - Bager, Peter Michael

AU - Krause, Tyra Grove

AU - Voldstedlund, Marianne

AU - Christiansen, Lasse Engbo

AU - Stegger, Marc

AU - Cohen, Arieh

AU - Fonager, Jannik

AU - Fomsgaard, Anders

AU - Legarth, Rebecca

AU - Rasmussen, Morten

AU - Gubbels, Sophie

AU - Wohlfahrt, Jan

AU - Lillebæk, Troels

AU - Johannesen, Caroline Klint

AU - Van Wijhe, Maarten

AU - Fischer, Thea K.

N1 - Publisher Copyright: © 2023 COVID-19 Omicron Delta study group. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

PY - 2023

Y1 - 2023

N2 - Background To compare the intrinsic virulence of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) omicron variant with the delta variant in hospitalized adults with coronavirus disease 2019 (COVID-19). Methods All adults hospitalized in the Capital Region of Copenhagen with a positive reverse transcription polymerase chain reaction test for SARS-CoV-2 and an available variant determination from 1 September 2021 to 11 February 2022. Data from health registries and patient files were used. Omicron and Delta patients were matched (1:1) by age, sex, comorbidities, and vaccination status. We calculated crude and adjusted hazard ratios (aHRs) for severe hypoxemia and mortality at 30 and 60 days. Results 1,043 patients were included. Patients with Omicron were older, had more comorbidities, were frailer, and more often had three vaccine doses than those with Delta. Fewer patients with Omicron developed severe hypoxemia than those with Delta (aHR, 0.55; 95% confidence interval, 0.38 0.78). Omicron patients exhibited decreased aHR for 30- day mortality compared to Delta (aHR, 0.61; 0.39 0.95). Omicron patients who had received three vaccine doses had lower mortality compared to Delta patients who received three doses (aHR, 0.31;0.16 0.59), but not among those who received two or 0 1 doses (aHR, 0.86; 0.41 1.84 and 0.94; 0.49 1.81 respectively). Similar findings were observed for mortality at 60 days. Similar outcomes were obtained in the analyses of 316 individually matched patients. Conclusions Among adults hospitalized with COVID-19, those with Omicron had less severe hypoxemia and nearly 40% higher 30- and 60-day survival, as compared with those with Delta, mainly driven by a larger proportion of Omicron patients vaccinated with three doses of an mRNA vaccine.

AB - Background To compare the intrinsic virulence of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) omicron variant with the delta variant in hospitalized adults with coronavirus disease 2019 (COVID-19). Methods All adults hospitalized in the Capital Region of Copenhagen with a positive reverse transcription polymerase chain reaction test for SARS-CoV-2 and an available variant determination from 1 September 2021 to 11 February 2022. Data from health registries and patient files were used. Omicron and Delta patients were matched (1:1) by age, sex, comorbidities, and vaccination status. We calculated crude and adjusted hazard ratios (aHRs) for severe hypoxemia and mortality at 30 and 60 days. Results 1,043 patients were included. Patients with Omicron were older, had more comorbidities, were frailer, and more often had three vaccine doses than those with Delta. Fewer patients with Omicron developed severe hypoxemia than those with Delta (aHR, 0.55; 95% confidence interval, 0.38 0.78). Omicron patients exhibited decreased aHR for 30- day mortality compared to Delta (aHR, 0.61; 0.39 0.95). Omicron patients who had received three vaccine doses had lower mortality compared to Delta patients who received three doses (aHR, 0.31;0.16 0.59), but not among those who received two or 0 1 doses (aHR, 0.86; 0.41 1.84 and 0.94; 0.49 1.81 respectively). Similar findings were observed for mortality at 60 days. Similar outcomes were obtained in the analyses of 316 individually matched patients. Conclusions Among adults hospitalized with COVID-19, those with Omicron had less severe hypoxemia and nearly 40% higher 30- and 60-day survival, as compared with those with Delta, mainly driven by a larger proportion of Omicron patients vaccinated with three doses of an mRNA vaccine.

UR - http://www.scopus.com/inward/record.url?scp=85158948700&partnerID=8YFLogxK

U2 - 10.1371/journal.pone.0282806

DO - 10.1371/journal.pone.0282806

M3 - Journal article

C2 - 37104488

AN - SCOPUS:85158948700

VL - 18

JO - PLoS ONE

JF - PLoS ONE

SN - 1932-6203

IS - 4

M1 - e0282806

ER -