Clinical features of and severity risk factors for COVID-19 in adults during the predominance of SARS-CoV-2 XBB variants in Okinawa, Japan.


Journal

PloS one
ISSN: 1932-6203
Titre abrégé: PLoS One
Pays: United States
ID NLM: 101285081

Informations de publication

Date de publication:
2024
Historique:
received: 26 04 2024
accepted: 20 08 2024
medline: 1 11 2024
pubmed: 1 11 2024
entrez: 31 10 2024
Statut: epublish

Résumé

Since 2023, COVID-19 induced by SARS-CoV-2 XBB variants have been a global epidemic. The XBB variant-induced epidemic was largest in the Okinawa Prefecture among areas in Japan, and healthcare institutions have been burdened by increased COVID-19 hospitalizations. This study aimed to evaluate the clinical features of XBB variant-induced COVID-19 and risk factors for severe COVID-19. This retrospective study included adult patients hospitalized for COVID-19 between May and July 2023 at four tertiary medical institutions in Okinawa, Japan. Patients with bacterial infection-related complications were excluded. According to oxygen supplementation and intensive care unit admission, patients were divided into two groups, mild and severe. Patient backgrounds, symptoms, and outcomes were compared between both groups, and the risk factors for severe COVID-19 were analyzed using a multivariate logistic regression model. In total of 367 patients included, the median age was 75 years, with 18.5% classified into the severe group. The all-cause mortality rate was 4.9%. Patients in the severe group were more older, had more underlying diseases, and had a higher mortality rate (13.2%) than those in the mild group (3.0%). Multivariate logistic regression analysis showed that diabetes mellitus was an independent risk factor for severe COVID-19 (95% confidence interval [CI], 1.002-3.772), whereas bivalent omicron booster vaccination was an independent factor for less severe COVID-19 (95% CI, 0.203-0.862). This study implies that assessing risk factors in older adults is particularly important in the era of omicron variants.

Sections du résumé

BACKGROUND AND OBJECTIVE OBJECTIVE
Since 2023, COVID-19 induced by SARS-CoV-2 XBB variants have been a global epidemic. The XBB variant-induced epidemic was largest in the Okinawa Prefecture among areas in Japan, and healthcare institutions have been burdened by increased COVID-19 hospitalizations. This study aimed to evaluate the clinical features of XBB variant-induced COVID-19 and risk factors for severe COVID-19.
METHODS METHODS
This retrospective study included adult patients hospitalized for COVID-19 between May and July 2023 at four tertiary medical institutions in Okinawa, Japan. Patients with bacterial infection-related complications were excluded. According to oxygen supplementation and intensive care unit admission, patients were divided into two groups, mild and severe. Patient backgrounds, symptoms, and outcomes were compared between both groups, and the risk factors for severe COVID-19 were analyzed using a multivariate logistic regression model.
RESULTS RESULTS
In total of 367 patients included, the median age was 75 years, with 18.5% classified into the severe group. The all-cause mortality rate was 4.9%. Patients in the severe group were more older, had more underlying diseases, and had a higher mortality rate (13.2%) than those in the mild group (3.0%). Multivariate logistic regression analysis showed that diabetes mellitus was an independent risk factor for severe COVID-19 (95% confidence interval [CI], 1.002-3.772), whereas bivalent omicron booster vaccination was an independent factor for less severe COVID-19 (95% CI, 0.203-0.862).
CONCLUSION CONCLUSIONS
This study implies that assessing risk factors in older adults is particularly important in the era of omicron variants.

Identifiants

pubmed: 39480756
doi: 10.1371/journal.pone.0309808
pii: PONE-D-24-16162
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

e0309808

Informations de copyright

Copyright: © 2024 Ideguchi et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Déclaration de conflit d'intérêts

The authors have declared that no competing interests exist.

Auteurs

Shuhei Ideguchi (S)

Division of Infectious, Respiratory, and Digestive Medicine, First Department of Internal Medicine, University of the Ryukyus Graduate School of Medicine, Okinawa, Japan.

Kazuya Miyagi (K)

Division of Infectious, Respiratory, and Digestive Medicine, First Department of Internal Medicine, University of the Ryukyus Graduate School of Medicine, Okinawa, Japan.

Wakaki Kami (W)

Department of Respiratory Medicine, Ohama Dai-ichi Hospital, Okinawa, Japan.

Daisuke Tasato (D)

Department of Respiratory and Infectious Diseases, Okinawa North Medical Association Hospital, Okinawa, Japan.

Futoshi Higa (F)

Department of Respiratory Medicine, NHO Okinawa Hospital, Okinawa, Japan.

Noriyuki Maeshiro (N)

Research Center for Infectious Diseases, Okinawa Prefectural Institute of Health and Environment, Okinawa, Japan.

Shota Nagamine (S)

Research Center for Infectious Diseases, Okinawa Prefectural Institute of Health and Environment, Okinawa, Japan.

Hideta Nakamura (H)

Division of Infectious, Respiratory, and Digestive Medicine, First Department of Internal Medicine, University of the Ryukyus Graduate School of Medicine, Okinawa, Japan.

Takeshi Kinjo (T)

Division of Infectious, Respiratory, and Digestive Medicine, First Department of Internal Medicine, University of the Ryukyus Graduate School of Medicine, Okinawa, Japan.

Masashi Nakamatsu (M)

Department of Infection Control, University of the Ryukyus Hospital, Okinawa, Japan.

Shusaku Haranaga (S)

University of the Ryukyus Comprehensive Health Professions Education Center, University Hospital, Okinawa, Japan.

Akihiro Tokushige (A)

Department of Clinical Pharmacology and Therapeutics, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan.

Shinichiro Ueda (S)

Department of Clinical Pharmacology and Therapeutics, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan.

Jiro Fujita (J)

Department of Respiratory Medicine, Ohama Dai-ichi Hospital, Okinawa, Japan.

Kazuko Yamamoto (K)

Division of Infectious, Respiratory, and Digestive Medicine, First Department of Internal Medicine, University of the Ryukyus Graduate School of Medicine, Okinawa, Japan.

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