Hospital Outcomes of Community-Acquired SARS-CoV-2 Omicron Variant Infection Compared With Influenza Infection in Switzerland

Medientyp: E-Artikel
Titel: Hospital Outcomes of Community-Acquired SARS-CoV-2 Omicron Variant Infection Compared With Influenza Infection in Switzerland
Beteiligte: Portmann, Lea; de Kraker, Marlieke E. A.; Fröhlich, Georg; Thiabaud, Amaury; Roelens, Maroussia; Schreiber, Peter W.; Troillet, Nicolas; Iten, Anne; Widmer, Andreas; Harbarth, Stephan; Sommerstein, Rami; Tschudin-Sutter, Sarah; Heininger, Ulrich; Jent, Philipp; Büttcher, Michael; Nussbaumer, Yvonne; Vuichard Gysin, Danielle; Berger, Christoph; Flury, Domenica; Zanella Terrier, Marie-Céline
Erschienen: American Medical Association (AMA), 2023
Erschienen in: JAMA Network Open, 6 (2023) 2, Seite e2255599
Sprache: Englisch
DOI: 10.1001/jamanetworkopen.2022.55599
ISSN: 2574-3805
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Beschreibung: <jats:sec id="ab-zoi221575-4"><jats:title>Importance</jats:title><jats:p>With the ongoing COVID-19 pandemic, it is crucial to assess the current burden of disease of community-acquired SARS-CoV-2 Omicron variant in hospitalized patients to tailor appropriate public health policies. Comparisons with better-known seasonal influenza infections may facilitate such decisions.</jats:p></jats:sec><jats:sec id="ab-zoi221575-5"><jats:title>Objective</jats:title><jats:p>To compare the in-hospital outcomes of patients hospitalized with the SARS-CoV-2 Omicron variant with patients with influenza.</jats:p></jats:sec><jats:sec id="ab-zoi221575-6"><jats:title>Design, Setting, and Participants</jats:title><jats:p>This cohort study was based on a national COVID-19 and influenza registry. Hospitalized patients aged 18 years and older with community-acquired SARS-CoV-2 Omicron variant infection who were admitted between January 15 and March 15, 2022 (when B.1.1.529 Omicron predominance was &amp;gt;95%), and hospitalized patients with influenza A or B infection from January 1, 2018, to March 15, 2022, where included. Patients without a study outcome by August 30, 2022, were censored. The study was conducted at 15 hospitals in Switzerland.</jats:p></jats:sec><jats:sec id="ab-zoi221575-7"><jats:title>Exposures</jats:title><jats:p>Community-acquired SARS-CoV-2 Omicron variant vs community-acquired seasonal influenza A or B.</jats:p></jats:sec><jats:sec id="ab-zoi221575-8"><jats:title>Main Outcomes and Measures</jats:title><jats:p>Primary and secondary outcomes were defined as in-hospital mortality and admission to the intensive care unit (ICU) for patients with the SARS-CoV-2 Omicron variant or influenza. Cox regression (cause-specific and Fine-Gray subdistribution hazard models) was used to account for time-dependency and competing events, with inverse probability weighting to adjust for confounders with right-censoring at day 30.</jats:p></jats:sec><jats:sec id="ab-zoi221575-9"><jats:title>Results</jats:title><jats:p>Of 5212 patients included from 15 hospitals, 3066 (58.8%) had SARS-CoV-2 Omicron variant infection in 14 centers and 2146 patients (41.2%) had influenza A or B in 14 centers. Of patients with the SARS-CoV-2 Omicron variant, 1485 (48.4%) were female, while 1113 patients with influenza (51.9%) were female (<jats:italic>P</jats:italic> = .02). Patients with the SARS-CoV-2 Omicron variant were younger (median [IQR] age, 71 [53-82] years) than those with influenza (median [IQR] age, 74 [59-83] years; <jats:italic>P</jats:italic> &amp;lt; .001). Overall, 214 patients with the SARS-CoV-2 Omicron variant (7.0%) died during hospitalization vs 95 patients with influenza (4.4%; <jats:italic>P</jats:italic> &amp;lt; .001). The final adjusted subdistribution hazard ratio (sdHR) for in-hospital death for SARS-CoV-2 Omicron variant vs influenza was 1.54 (95% CI, 1.18-2.01; <jats:italic>P</jats:italic> = .002). Overall, 250 patients with the SARS-CoV-2 Omicron variant (8.6%) vs 169 patients with influenza (8.3%) were admitted to the ICU (<jats:italic>P</jats:italic> = .79). After adjustment, the SARS-CoV-2 Omicron variant was not significantly associated with increased ICU admission vs influenza (sdHR, 1.08; 95% CI, 0.88-1.32; <jats:italic>P</jats:italic> = .50).</jats:p></jats:sec><jats:sec id="ab-zoi221575-10"><jats:title>Conclusions and Relevance</jats:title><jats:p>The data from this prospective, multicenter cohort study suggest a significantly increased risk of in-hospital mortality for patients with the SARS-CoV-2 Omicron variant vs those with influenza, while ICU admission rates were similar.</jats:p></jats:sec>
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