Comparison of Patients Infected With Delta Versus Omicron COVID-19 Variants Presenting to Paris Emergency Departments : A Retrospective Cohort Study.

Adult COVID-19 Emergency Service, Hospital Female Humans Male Middle Aged Paris / epidemiology Retrospective Studies SARS-CoV-2 / genetics

Journal

Annals of internal medicine
ISSN: 1539-3704
Titre abrégé: Ann Intern Med
Pays: United States
ID NLM: 0372351

Informations de publication

Date de publication:
06 2022
Historique:
pubmed: 15 3 2022
medline: 23 6 2022
entrez: 14 3 2022
Statut: ppublish

Résumé

At the end of 2021, the B.1.1.529 SARS-CoV-2 variant (Omicron) wave superseded the B.1.617.2 variant (Delta) wave. To compare baseline characteristics and in-hospital outcomes of patients with SARS-CoV-2 infection with the Delta variant versus the Omicron variant in the emergency department (ED). Retrospective chart reviews. 13 adult EDs in academic hospitals in the Paris area from 29 November 2021 to 10 January 2022. Patients with a positive reverse transcriptase polymerase chain reaction (RT-PCR) test result for SARS-CoV-2 and variant identification. Main outcome measures were baseline clinical and biological characteristics at ED presentation, intensive care unit (ICU) admission, mechanical ventilation, and in-hospital mortality. A total of 3728 patients had a positive RT-PCR test result for SARS-CoV-2 during the study period; 1716 patients who had a variant determination (818 Delta and 898 Omicron) were included. Median age was 58 years, and 49% were women. Patients infected with the Omicron variant were younger (54 vs. 62 years; difference, 8.0 years [95% CI, 4.6 to 11.4 years]), had a lower rate of obesity (8.0% vs. 12.5%; difference, 4.5 percentage points [CI, 1.5 to 7.5 percentage points]), were more vaccinated (65% vs. 39% for 1 dose and 22% vs. 11% for 3 doses), had a lower rate of dyspnea (26% vs. 50%; difference, 23.6 percentage points [CI, 19.0 to 28.2 percentage points]), and had a higher rate of discharge home from the ED (59% vs. 37%; difference, 21.9 percentage points [-26.5 to -17.1 percentage points]). Compared with Delta, Omicron infection was independently associated with a lower risk for ICU admission (adjusted difference, 11.4 percentage points [CI, 8.4 to 14.4 percentage points]), mechanical ventilation (adjusted difference, 3.6 percentage points [CI, 1.7 to 5.6 percentage points]), and in-hospital mortality (adjusted difference, 4.2 percentage points [CI, 2.0 to 6.5 percentage points]). Patients with COVID-19 illness and no SARS-CoV-2 variant determination in the ED were excluded. Compared with the Delta variant, infection with the Omicron variant in patients in the ED had different clinical and biological patterns and was associated with better in-hospital outcomes, including higher survival. None.

Sections du résumé

BACKGROUND
At the end of 2021, the B.1.1.529 SARS-CoV-2 variant (Omicron) wave superseded the B.1.617.2 variant (Delta) wave.
OBJECTIVE
To compare baseline characteristics and in-hospital outcomes of patients with SARS-CoV-2 infection with the Delta variant versus the Omicron variant in the emergency department (ED).
DESIGN
Retrospective chart reviews.
SETTING
13 adult EDs in academic hospitals in the Paris area from 29 November 2021 to 10 January 2022.
PATIENTS
Patients with a positive reverse transcriptase polymerase chain reaction (RT-PCR) test result for SARS-CoV-2 and variant identification.
MEASUREMENTS
Main outcome measures were baseline clinical and biological characteristics at ED presentation, intensive care unit (ICU) admission, mechanical ventilation, and in-hospital mortality.
RESULTS
A total of 3728 patients had a positive RT-PCR test result for SARS-CoV-2 during the study period; 1716 patients who had a variant determination (818 Delta and 898 Omicron) were included. Median age was 58 years, and 49% were women. Patients infected with the Omicron variant were younger (54 vs. 62 years; difference, 8.0 years [95% CI, 4.6 to 11.4 years]), had a lower rate of obesity (8.0% vs. 12.5%; difference, 4.5 percentage points [CI, 1.5 to 7.5 percentage points]), were more vaccinated (65% vs. 39% for 1 dose and 22% vs. 11% for 3 doses), had a lower rate of dyspnea (26% vs. 50%; difference, 23.6 percentage points [CI, 19.0 to 28.2 percentage points]), and had a higher rate of discharge home from the ED (59% vs. 37%; difference, 21.9 percentage points [-26.5 to -17.1 percentage points]). Compared with Delta, Omicron infection was independently associated with a lower risk for ICU admission (adjusted difference, 11.4 percentage points [CI, 8.4 to 14.4 percentage points]), mechanical ventilation (adjusted difference, 3.6 percentage points [CI, 1.7 to 5.6 percentage points]), and in-hospital mortality (adjusted difference, 4.2 percentage points [CI, 2.0 to 6.5 percentage points]).
LIMITATION
Patients with COVID-19 illness and no SARS-CoV-2 variant determination in the ED were excluded.
CONCLUSION
Compared with the Delta variant, infection with the Omicron variant in patients in the ED had different clinical and biological patterns and was associated with better in-hospital outcomes, including higher survival.
PRIMARY FUNDING SOURCE
None.

Identifiants

DOI: 10.7326/M22-0308 PMID: 35286147 PMC: PMC8941485
pubmed: 35286147
doi: 10.7326/M22-0308
pmc: PMC8941485
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

831-837

Investigateurs

Maud Salmona (M)
Jérôme Le Goff (J)
David Veyer (D)
Richard Chocron (R)
Clément Augustin (C)
Flore Rozenberg (F)
Jean-François Meritet (JF)
Aurélie Schnuriger (A)
Slim Fourati (S)
Mehdi Khellaf (M)
Audrey Coulomb (A)
Frédéric Gindre (F)
Khouloud Aloui (K)
Hervé Jacquier (H)
Xavier Eyer (X)
Christophe Choquet (C)
Vittiaroat Ing (V)
Thomas Pavlovsky (T)
Nadhira Houhou-Fidouh (N)
Valentine Ferré (V)
Luce Landraud (L)
Hélène Goulet (H)
Youri Yordanov (Y)
Laurence Berard (L)
Alexandra Rousseau (A)
Théophile Morel (T)
Theophile Vieux (T)
Simon Cahen (S)
Melkir Saib (M)

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Auteurs

Donia Bouzid (D)

Emergency Department, Hôpital Bichat, Assistance Publique - Hôpitaux de Paris, and Université Paris Cité, IAME (Infection, Antimicrobial, Modelisation, Evolution), Inserm, Paris, France (D.B.).
ORCID: 0000-0002-7538-3320

Benoit Visseaux (B)

Virology Department, Hôpital Bichat, Assistance Publique - Hôpitaux de Paris, and Université Paris Cité, IAME (Infection, Antimicrobial, Modelisation, Evolution), Inserm, Paris, France (B.V.).
ORCID: 0000-0002-9279-5538

Christian Kassasseya (C)

Emergency Department, Hôpital Henri, Mondor, Assistance Publique - Hôpitaux de Paris, Créteil, France (C.K.).
ORCID: 0000-0003-2045-4985

Asma Daoud (A)

Emergency Department, Hôpital Avicenne, Assistance Publique-Hôpitaux de Paris, Bobigny, France (A.D.).

Florent Fémy (F)

Emergency Department, Hôpital Européen Georges Pompidou, Assistance Publique-Hôpitaux de Paris, Université Paris Cité, Paris, and Toxicology and Chemical Risks Department, French Armed Forces Biomedical Institute, Bretigny-Sur-Orges, France (F.F.).

Christelle Hermand (C)

Emergency Department, Hôpital Saint-Antoine, Assistance Publique - Hôpitaux de Paris, Paris, France (C.H.).
ORCID: 0000-0003-3673-5837

Jennifer Truchot (J)

Emergency Department, Hôpital Cochin, Assistance Publique - Hôpitaux de Paris, Université Paris Cité, Paris, France (J.T.).

Sebastien Beaune (S)

Emergency Department, Hôpital Ambroise Paré, Assistance Publique - Hôpitaux de Paris, Université Versailles - Saint Quentin en Yvelines, Boulogne, France (S.B.).

Nicolas Javaud (N)

Emergency Department, Hôpital Louis-Mourier, Assistance Publique - Hôpitaux de Paris, Reference Center for bradykinin angiœdema (CRéAk), Université Paris Cité, Colombes, France (N.J.).

Olivier Peyrony (O)

Emergency Department, Hôpital Saint-Louis, Assistance Publique - Hôpitaux de Paris, Paris, France (O.P.).
ORCID: 0000-0001-6831-0054

Anthony Chauvin (A)

Emergency Department, Hôpital Lariboisière, Assistance Publique - Hôpitaux de Paris, Université Paris Cité, Paris, France (A.C.).
ORCID: 0000-0001-8819-0061

Prabakar Vaittinada Ayar (P)

Emergency Department, Hôpital Beaujon, Assistance Publique - Hôpitaux de Paris, Clichy, France (P.V.A.).
ORCID: 0000-0003-2043-3391

Arthur Bourg (A)

Emergency Department, Hôpital Tenon, Assistance Publique - Hôpitaux de Paris, Paris, France (A.B.).

Bruno Riou (B)

Sorbonne Université, UMR Inserm 1166, IHU ICAN, and Emergency Department, Hôpital Pitié-Salpêtrière, Assistance Publique - Hôpitaux de Paris, Paris, France (B.R., Y.F.).
ORCID: 0000-0003-1205-4738

Stephane Marot (S)

Virology Department, Hôpital Pitié-Salpêtrière, Assistance Publique - Hôpitaux de Paris, Paris, France (S.M.).

Ben Bloom (B)

Emergency Department, Royal London Hospital, London, United Kingdom (B.B.).
ORCID: 0000-0002-3016-4925

Marine Cachanado (M)

Department of Clinical Pharmacology and Clinical Research Platform Paris-East (URCEST-CRC-CRB), Hôpital Saint-Antoine, Assistance Publique-Hôpitaux de Paris, Paris, France (M.C.).
ORCID: 0000-0002-9739-7950

Tabassome Simon (T)

Department of Clinical Pharmacology and Clinical Research Platform Paris-East (URCEST-CRC-CRB), Hôpital Saint-Antoine, Assistance Publique-Hôpitaux de Paris, and Sorbonne Université, Paris, France (T.S.).
ORCID: 0000-0002-4550-0450

Yonathan Freund (Y)

Sorbonne Université, UMR Inserm 1166, IHU ICAN, and Emergency Department, Hôpital Pitié-Salpêtrière, Assistance Publique - Hôpitaux de Paris, Paris, France (B.R., Y.F.).

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Classifications MeSH

questionsmedicales.fr › Personnes › Tranches d'âge › Adulte › Comparison of Patients Infected With Delta...
questionsmedicales.fr › Maladies de l'appareil respiratoire › Infections de l'appareil respiratoire › Pneumopathie infectieuse › Pneumopathie virale › COVID-19 › Comparison of Patients Infected With Delta...
questionsmedicales.fr › Administration des services de santé › Organisation et administration › Administration d'établissement de santé › Administration hospitalière › Services hospitaliers › Service hospitalier d'urgences › Comparison of Patients Infected With Delta...
questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Comparison of Patients Infected With Delta...
questionsmedicales.fr › Personnes › Tranches d'âge › Adulte › Adulte d'âge moyen › Comparison of Patients Infected With Delta...
questionsmedicales.fr › Régions géographiques › Europe › France › Paris › Comparison of Patients Infected With Delta...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Caractéristiques des études épidémiologiques › Études épidémiologiques › Études de cohortes › Études rétrospectives › Comparison of Patients Infected With Delta...
questionsmedicales.fr › Virus › Virus à ARN › Virus à ARN à brin positif › Nidovirales › Coronaviridae › Coronavirus › Betacoronavirus › Virus du SRAS › SARS-CoV-2 › Comparison of Patients Infected With Delta...