Journal article
Changing Severity and Epidemiology of Adults Hospitalized With Coronavirus Disease 2019 (COVID-19) in the United States After Introduction of COVID-19 Vaccines, March 2021-August 2022
Clinical infectious diseases, Vol.77(4), pp.547-557
08/2023
DOI: 10.1093/cid/ciad276
PMCID: PMC10526883
PMID: 37255285
Abstract
Understanding the changing epidemiology of adults hospitalized with coronavirus disease 2019 (COVID-19) informs research priorities and public health policies.
Among adults (≥18 years) hospitalized with laboratory-confirmed, acute COVID-19 between 11 March 2021, and 31 August 2022 at 21 hospitals in 18 states, those hospitalized during the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Omicron-predominant period (BA.1, BA.2, BA.4/BA.5) were compared to those from earlier Alpha- and Delta-predominant periods. Demographic characteristics, biomarkers within 24 hours of admission, and outcomes, including oxygen support and death, were assessed.
Among 9825 patients, median (interquartile range [IQR]) age was 60 years (47-72), 47% were women, and 21% non-Hispanic Black. From the Alpha-predominant period (Mar-Jul 2021; N = 1312) to the Omicron BA.4/BA.5 sublineage-predominant period (Jun-Aug 2022; N = 1307): the percentage of patients who had ≥4 categories of underlying medical conditions increased from 11% to 21%; those vaccinated with at least a primary COVID-19 vaccine series increased from 7% to 67%; those ≥75 years old increased from 11% to 33%; those who did not receive any supplemental oxygen increased from 18% to 42%. Median (IQR) highest C-reactive protein and D-dimer concentration decreased from 42.0 mg/L (9.9-122.0) to 11.5 mg/L (2.7-42.8) and 3.1 mcg/mL (0.8-640.0) to 1.0 mcg/mL (0.5-2.2), respectively. In-hospital death peaked at 12% in the Delta-predominant period and declined to 4% during the BA.4/BA.5-predominant period.
Compared to adults hospitalized during early COVID-19 variant periods, those hospitalized during Omicron-variant COVID-19 were older, had multiple co-morbidities, were more likely to be vaccinated, and less likely to experience severe respiratory disease, systemic inflammation, coagulopathy, and death.
Details
- Title: Subtitle
- Changing Severity and Epidemiology of Adults Hospitalized With Coronavirus Disease 2019 (COVID-19) in the United States After Introduction of COVID-19 Vaccines, March 2021-August 2022
- Creators
- Noah Kojima - Centers for Disease Control and PreventionKatherine Adams - Centers for Disease Control and PreventionWesley H Self - Vanderbilt University Medical CenterManjusha Gaglani - Baylor Scott & White HealthTresa McNeal - Texas A&M UniversityShekhar Ghamande - Texas A&M UniversityJay S Steingrub - Baystate Medical CenterNathan I Shapiro - Beth Israel Deaconess Medical CenterAbhijit Duggal - Cleveland ClinicLaurence W Busse - Emory UniversityMatthew E Prekker - Hennepin County Medical CenterIthan D Peltan - University of UtahSamuel M Brown - University of UtahDavid N Hager - Johns Hopkins MedicineHarith Ali - Johns Hopkins MedicineMichelle N Gong - Albert Einstein College of MedicineAmira Mohamed - Albert Einstein College of MedicineMatthew C Exline - The Ohio State UniversityAkram Khan - Oregon Health & Science UniversityJennifer G Wilson - Stanford UniversityNida Qadir - University of California, Los AngelesSteven Y Chang - University of California, Los AngelesAdit A Ginde - University of Colorado DenverCori A Withers - University of Colorado DenverNicholas M Mohr - University of IowaChristopher Mallow - University of MiamiEmily T Martin - University of MichiganAdam S Lauring - University of MichiganNicholas J Johnson - University of WashingtonJonathan D Casey - Vanderbilt University Medical CenterWilliam B Stubblefield - Vanderbilt University Medical CenterKevin W Gibbs - Wake Forest UniversityJennie H Kwon - Washington University in St. LouisAdrienne Baughman - Vanderbilt University Medical CenterJames D Chappell - Vanderbilt University Medical CenterKimberly W Hart - Vanderbilt University Medical CenterIan D Jones - Vanderbilt University Medical CenterJillian P Rhoads - Vanderbilt University Medical CenterSydney A Swan - Vanderbilt University Medical CenterKelsey N Womack - Vanderbilt University Medical CenterYuwei Zhu - Vanderbilt University Medical CenterDiya Surie - Centers for Disease Control and PreventionMeredith L McMorrow - Centers for Disease Control and PreventionManish M Patel - Centers for Disease Control and PreventionMark W Tenforde - Centers for Disease Control and Prevention
- Contributors
- Investigating Respiratory Viruses in the Acutely Ill (IVY) Network (Contributor)Kay I Zepeski (Contributor) - University of Iowa, Pharmacy Practice and Science
- Resource Type
- Journal article
- Publication Details
- Clinical infectious diseases, Vol.77(4), pp.547-557
- DOI
- 10.1093/cid/ciad276
- PMID
- 37255285
- PMCID
- PMC10526883
- NLM abbreviation
- Clin Infect Dis
- ISSN
- 1058-4838
- eISSN
- 1537-6591
- Grant note
- NIH HHS NCATS NIH HHS
- Language
- English
- Electronic publication date
- 05/31/2023
- Date published
- 08/2023
- Academic Unit
- Epidemiology; Emergency Medicine; Pharmacy Practice and Science; Anesthesia; Injury Prevention Research Center
- Record Identifier
- 9984421705602771
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