A diagnostic model for serious COVID-19 infection among older adults in Shanghai during the Omicron wave

Abstract

BackgroundThe Omicron variant is characterized by striking infectivity and antibody evasion. The analysis of Omicron variant BA.2 infection risk factors is limited among geriatric individuals and understanding these risk factors would promote improvement in the public health system and reduction in mortality. Therefore, our research investigated BA.2 infection risk factors for discriminating severe/critical from mild/moderate geriatric patients.MethodsBaseline characteristics of enrolled geriatric patients (aged over 60 years) with Omicron infections were analyzed. A logistic regression analysis was conducted to evaluate factors correlated with severe/critical patients. A receiver operating characteristic (ROC) curve was constructed for predicting variables to discriminate mild/moderate patients from severe/critical patients.ResultsA total of 595 geriatric patients older than 60 years were enrolled in this study. Lymphocyte subset levels were significantly decreased, and white blood cells (WBCs) and D-dimer levels were significantly increased with disease progression from a mild/moderate state to a severe/critical state. Univariate and multivariate logistic regression analyses identified a panel of WBCs, CD4+ T cell, and D-dimer values that were correlated with good diagnostic accuracy for discriminating mild/moderate patients from severe/critical patients with an area under the curve of 0.962.ConclusionSome key baseline laboratory indicators change with disease development. A panel was identified for discriminating mild/moderate patients from severe/critical patients, suggesting that the panel could serve as a potential biomarker to enable physicians to provide timely medical services in clinical practice.

Prehospital physiological parameters related illness severity scores can accurately discriminate the severe/critical state in adult patients with COVID-19

“…Even patients with lower prehospital NEWS2 may experience exacerbation if combined with other risk factors. Compared with predictive models and markers composed of laboratory results [ 4 , 5 , 39 ], NEWS2 can be obtained by measuring physiological parameters without blood or bronchoalveolar lavage test and can be used in risk stratification to predict serious patients quickly and cheaply. This study also suggested that NEWS2 has positive correlations with prehospital care workload and consumption of medical human resources, and it is an important independent predictor for severe/critical categories of COVID-19.…”

“…The diagnostic model composed of white blood cells, CD4 positive T cells, and D-dimer can effectively discriminate the severe/critical state from the mild/moderate state in COVID-19 caused by SARS-CoV-2 Omicron variant BA.2 infection. This model shows a C-statistic of 0.962, a sensitivity of 97.14%, and a specificity of 90.27% [ 5 ]. However, such diagnostic models and biomarkers must be obtained by laboratory testing, which are inconvenient, time consuming, and uneconomical.…”

The antiviral activity of a small molecule drug targeting the NSP1-ribosome complex against Omicron, especially in elderly patients

“…1.5 may further undermine the efficacy of the current COVID-19 vaccine and lead to a surge in breakthrough infections and re-infections. At the same time, on October 14, 2022, studies suggested that age over 80, suffering from a variety of underlying diseases, the use of immunosuppressants, chronic kidney disease, and other factors are the risk factors for developing severe disease after novel coronavirus infection, so these people need additional vaccination ( Agrawal et al., 2022 ; Bao et al., 2022 ).…”

COVID-19 or seasonal influenza? How to distinguish in people younger than 65 years old — — A retrospective observational cohort study comparing the 2009 pandemic influenza A H1N1 with 2022 SARS-CoV-2 Omicron BA.2 outbreaks in China

“…In the current environment where most countries cancel normalized nucleic acid testing, it is of great significance for clinicians to understand the identification of the above two diseases. Besides, most of the previous studies focused on elderly patients [12,13] , and the difference between Omicron and H1N1 influenza in young patients is rarely reported. Although young patients are often mild [14] , they should also be noticed.…”