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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

2023; Oxford University Press; Volume: 77; Issue: 4 Linguagem: Inglês

10.1093/cid/ciad276

1537-6591

Noah Kojima, Katherine Adams, Wesley H. Self, Manjusha Gaglani, Tresa McNeal, Shekhar Ghamande, Jay S. Steingrub, Nathan I. Shapiro, Abhijit Duggal, Laurence W. Busse, Matthew E. Prekker, Ithan D. Peltan, Samuel M. Brown, David N. Hager, Harith Ali, Michelle N. Gong, Amira Mohamed, Matthew C. Exline, Akram Khan, Jennifer G. Wilson, Nida Qadir, Steven Y. Chang, Adit A. Ginde, Cori Withers, Nicholas M. Mohr, Christopher Mallow, Emily T. Martin, Adam S. Lauring, Nicholas J. Johnson, Jonathan D. Casey, William B. Stubblefield, Kevin W. Gibbs, Jennie H. Kwon, Adrienne Baughman, James D. Chappell, Kimberly W. Hart, Ian D. Jones, Jillian P. Rhoads, Sydney A. Swan, Kelsey N. Womack, Yuwei Zhu, Diya Surie, Meredith McMorrow, Manish M. Patel, Mark W. Tenforde, Manjusha Gaglani, Tresa McNeal, Shekhar Ghamande, Nicole Calhoun, Kempapura Murthy, Judy Herrick, Amanda McKillop, Eric Hoffman, Martha Zayed, Michael J. Smith, Jay S. Steingrub, Lori-Ann Kozikowski, Lesley De Souza, Scott Ouellette, Nathan I. Shapiro, Michael Bolstad, Brianna Coviello, Robert A. Ciottone, Arnaldo deVilla, Ana Grafals, Conor Higgins, Carlo Ottanelli, Kimberly Redman, Douglas Scaffidi, Alexander Weingart, Diya Surie, Meredith McMorrow, Jennifer DeCuir, Natalie J. Thornburg, Brendan Flannery, Nathaniel M. Lewis, Mark W. Tenforde, Katherine Adams, Manish M. Patel, Omar Mehkri, Megan Mitchell, Zachary Griffith, Connery Brennan, Kiran Ashok, Bryan Poynter, Abhijit Duggal, Laurence W. Busse, Caitlin ten Lohuis, Nicholas Stanley, Sophia Zhang, Matthew E. Prekker, Heidi L. Erickson, Anne Frosch, Audrey Hendrickson, Sean Caspers, Walker Tordsen, Olivia Kaus, Tyler Scharber, Ithan D. Peltan, Samuel M. Brown, Jenna Lumpkin, Cassie Smith, Hunter Marshall, David N. Hager, Harith Ali, Richard E. Rothman, Michelle N. Gong, Amira Mohamed, R. Nair, Jen-Ting Chen, Matthew C. Exline, Sarah Karow, Emily Robart, Paulo Nunes Maldonado, Maryiam Khan, Preston So, Madison So, Elizabeth Schwartz, Mena Botros, Akram Khan, Catherine L. Hough, Hae‐Un Jung, Jesus Martinez, Andrea Luong, Bao Huynh, Habiba Ibrahim, Cynthia Villanueva-Vargas, Juliana Villanueva-Vargas, Suha Quadri, Jennifer G. Wilson, Alexandra June Gordon, Cynthia Pérez, Lily Lau, Ismail Bekiroglu, Nida Qadir, Steven Y. Chang, Trevor Frankel, Omai B. Garner, Sukantha Chandrasekaran, Adit A. Ginde, David J. Douin, Kelly Jensen, David Huynh, Aimee Steinwand, Cori Withers, Nicholas M. Mohr, Anne Zepeski, Paul Nassar, Shannon R. Landers, Karin Nielsen, Noble Briggs, Cathy Fairfield, Chris Mallow, Carolina Rivas, Emily T. Martin, Arnold S. Monto, Adam S. Lauring, EJ McSpadden, Rachel Truscon, Anne Kaniclides, Lara Thomas, Ramsay Bielak, Weronika Damek Valvano, Rebecca Fong, William J. Fitzsimmons, Christopher Blair, Julie Gilbert, Leigh Baker, Nicholas J. Johnson, Vasisht Srinivasan, Christine D Crider, Kyle A Steinbock, Thomas C Paulsen, Layla A. Anderson, Wesley H. Self, H. Keipp Talbot, Carlos G. Grijalva, Ian Rees Jones, Natasha Halasa, James D. Chappell, Kelsey N. Womack, Jillian P. Rhoads, Adrienne Baughman, Christy Kampe, Jakea Johnson, Kim Hart, Todd W. Rice, Jonathan D. Casey, William B. Stubblefield, Yuwei Zhu, Laura Short, Lauren J Ezzell, Margaret E Whitsett, Rendie McHenry, Samarian J Hargrave, Marcia Blair, Jennifer L Luther, Claudia Guevara Pulido, Bryan P M Peterson, D. Clark Files, Kevin W. Gibbs, Mary LaRose, Leigha Landreth, Madeline Hicks, Lisa Parks, Hilary M. Babcock, Jennie H. Kwon, Jahnavi Bongu, David W. McDonald, Candice Cass, Sondra Seiler, David Park, Tiffany Hink, Meghan A. Wallace, Carey‐Ann D. Burnham, Olivia Arter,

COVID-19 epidemiological studies

Abstract Introduction Understanding the changing epidemiology of adults hospitalized with coronavirus disease 2019 (COVID-19) informs research priorities and public health policies. Methods 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. Results 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. Conclusions 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.