An international observational study to assess the impact of the Omicron variant emergence on the clinical epidemiology of COVID-19 in hospitalised patients
An international observational study to assess the impact of the Omicron variant emergence on the clinical epidemiology of COVID-19 in hospitalised patients
Abstract BackgroundWhilst timely clinical characterisation of infections caused by novel SARS-CoV-2 variants is necessary for evidence-based policy response, individual-level data on infecting variants are typically only available for a minority of patients and settings. MethodsHere, we propose an innovative approach to study changes in COVID-19 hospital presentation and outcomes after the Omicron variant emergence using publicly available population-level data on variant relative frequency to infer SARS-CoV-2 variants likely responsible for clinical cases. We apply this method to data collected by a large international clinical consortium before and after the emergence of the Omicron variant in different countries. ResultsOur analysis, that includes more than 100,000 patients from 28 countries, suggests that in many settings patients hospitalised with Omicron variant infection less often presented with commonly reported symptoms compared to patients infected with pre-Omicron variants. Patients with COVID-19 admitted to hospital after Omicron variant emergence had lower mortality compared to patients admitted during the period when Omicron variant was responsible for only a minority of infections (odds ratio in a mixed-effects logistic regression adjusted for likely confounders, 0.67 [95% confidence interval 0.61 – 0.75]). Qualitatively similar findings were observed in sensitivity analyses with different assumptions on population-level Omicron variant relative frequencies, and in analyses using available individual-level data on infecting variant for a subset of the study population. ConclusionsAlthough clinical studies with matching viral genomic information should remain a priority, our approach combining publicly available data on variant frequency and a multi-country clinical characterisation dataset with more than 100,000 records allowed analysis of data from a wide range of settings and novel insights on real-world heterogeneity of COVID-19 presentation and clinical outcome.
Dunning Jake、Balan Valeria、Baillie J. Kenneth、Hashmi Madiha、Carson Gail、Wils Evert-Jan、Olliaro Piero L.、ISARIC Clinical Characterisation Group、Chow Yock Ping、Thwin Soe Soe、Jassat Waasila、Kartsonaki Christiana、Semple Malcolm G.、Rojek Amanda、Baruch Joaqu¨an、Reyes Luis Felipe、Pritchard Mark、Mart¨an-Quiros Alejandro、Angheben Andrea、Caoili Janice、Rashan Aasiyah、Douglas James Joshua、Aryal Diptesh、Diaz Janet、G¨?mez-Junyent Joan、Rishu Asgar、Bertagnolio Silvia、Citarella Barbara Wanjiru、Horby Peter、Streinu-Cercel Anca、Kraemer Moritz U.G.、Fowler Rob、Rangappa Rajavardhan、Wong Xin Ci、Nor Mohd Basri Mat、Hall Matthew、Figueiredo-Mello Claudia、Murthy Srinivas、Ong David S.Y.、Carrier Fran?ois Martin、Salazar Leonardo、Harrison Ewen M.、Dasgupta Abhishek、Arabi Yaseen、Merson Laura、Gon?alves Bronner P.、Sili Uluhan
ISARIC, Pandemic Sciences Institute, University of OxfordISARIC, Pandemic Sciences Institute, University of OxfordRoslin Institute, University of Edinburgh||Intensive Care Unit, Royal Infirmary of EdinburghCritical Care Asia and Ziauddin UniversityISARIC, Pandemic Sciences Institute, University of OxfordDepartment of Intensive CareISARIC, Pandemic Sciences Institute, University of OxfordClinical Research Centre, Sunway Medical CentreWorld Health OrganizationNational Institute for Communicable DiseasesMRC Population Health Research Unit, Clinical Trials Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of OxfordInstitute of Infection, Veterinary and Ecological Sciences, Faculty of Health and Life Sciences, University of Liverpool||Respiratory Medicine, Alder Hey Children?ˉs Hospital, University of LiverpoolISARIC, Pandemic Sciences Institute, University of Oxford||Royal Melbourne Hospital||Centre for Integrated Critical Care, University of MelbourneISARIC, Pandemic Sciences Institute, University of OxfordISARIC, Pandemic Sciences Institute, University of Oxford||Universidad de La Sabana||Clinica Universidad de La SabanaISARIC, Pandemic Sciences Institute, University of OxfordEmergency Department. Hospital Universitario La PazDepartment of Infectious, Tropical Diseases and Microbiology (DITM), IRCCS Sacro Cuore Don Calabria HospitalMakati Medical CenterCritical Care AsiaLions Gate HospitalCritical Care and Anesthesia, Nepal Mediciti HospitalWorld Health OrganizationDepartment of Infectious Diseases, Hospital del Mar, Infectious Pathology and Antimicrobial Research Group (IPAR), Institut Hospital del Mar d?ˉInvestigacions M¨¨diques (IMIM)Critical Care Research Unit, Sunnybrook Health Sciences CentreWorld Health OrganizationISARIC, Pandemic Sciences Institute, University of OxfordISARIC, Pandemic Sciences Institute, University of OxfordCarol Davila University of Medicine and Pharmacy||National Institute for Infectious Diseases ?°Prof. Dr. Matei Bals?±Department of Biology, University of Oxford||Pandemic Sciences Institute, University of OxfordDepartment of Critical Care Medicine, Sunnybrook Health Sciences CentreDepartment of Critical Care Medicine, Manipal Hospital WhitefieldDigital Health Research and Innovation Unit, Institute for Clinical Research, National Institutes of Health (NIH), Ministry of Health MalaysiaInternational Islamic UniversityBig Data Institute, Nuffield Department of Medicine, University of OxfordInstituto de Infectologia Em¨alio RibasFaculty of Medicine, University of British ColumbiaDepartment of Medical Microbiology and Infection ControlDepartment of Anesthesiology, Centre hospitalier de l?ˉUniversit¨| de Montr¨|al||Department of Medicine, Critical Care Division, Centre hospitalier de l?ˉUniversit¨| de Montr¨|al||Carrefour de l?ˉinnovation et sant¨| des populations, Centre de recherche du Centre hospitalier de l?ˉUniversit¨| de Montr¨|al (CRCHUM)||Department of Anesthesiology and Pain Medicine, Universit¨| de Montr¨|alFundaci¨?n Cardiovascular de Colombia,Centre for Medical Informatics, The University of Edinburgh, Usher Institute of Population Health Sciences and InformaticsDepartment of Computer Science, University of Oxford||Department of Biology, University of OxfordKing Abdullah International Medical Research Center and King Saud Bin Abdulaziz University for Health SciencesISARIC, Pandemic Sciences Institute, University of Oxford||Infectious Diseases Data Observatory, Centre for Tropical Medicine and Global Health, University of OxfordISARIC, Pandemic Sciences Institute, University of OxfordDepartment of Infectious Disease and Clinical Microbiology, Marmara University Pendik Training and Research Hospital
医学研究方法医药卫生理论临床医学
Dunning Jake,Balan Valeria,Baillie J. Kenneth,Hashmi Madiha,Carson Gail,Wils Evert-Jan,Olliaro Piero L.,ISARIC Clinical Characterisation Group,Chow Yock Ping,Thwin Soe Soe,Jassat Waasila,Kartsonaki Christiana,Semple Malcolm G.,Rojek Amanda,Baruch Joaqu¨an,Reyes Luis Felipe,Pritchard Mark,Mart¨an-Quiros Alejandro,Angheben Andrea,Caoili Janice,Rashan Aasiyah,Douglas James Joshua,Aryal Diptesh,Diaz Janet,G¨?mez-Junyent Joan,Rishu Asgar,Bertagnolio Silvia,Citarella Barbara Wanjiru,Horby Peter,Streinu-Cercel Anca,Kraemer Moritz U.G.,Fowler Rob,Rangappa Rajavardhan,Wong Xin Ci,Nor Mohd Basri Mat,Hall Matthew,Figueiredo-Mello Claudia,Murthy Srinivas,Ong David S.Y.,Carrier Fran?ois Martin,Salazar Leonardo,Harrison Ewen M.,Dasgupta Abhishek,Arabi Yaseen,Merson Laura,Gon?alves Bronner P.,Sili Uluhan.An international observational study to assess the impact of the Omicron variant emergence on the clinical epidemiology of COVID-19 in hospitalised patients[EB/OL].(2025-03-28)[2025-04-28].https://www.medrxiv.org/content/10.1101/2022.06.22.22276764.点此复制
评论