Clinical and laboratory profiles of the SARS-CoV-2 Delta variant compared with pre-Delta variants

Bhakta, Shivang; Sanghavi, Devang; Johnson, Patrick W.; Kunze, Katie L.; Neville, Matthew R.; Wadei, Hani M.; Bosch, Wendelyn; Carter, Rickey E.; Shah, Sadia; Pollock, Benjamin D.; Oman, Sven P.; Speicher, Leigh; Siegel, Jason; Libertin, Claudia R.; Matson, Mark W; Franco, Pablo Moreno; Cowart, Jennifer B.

doi:10.1016/j.ijid.2022.04.050

Cited by 8 publications

(12 citation statements)

References 19 publications

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“…Furthermore, the results of our study regarding the milder course of the disease during the Omicron-dominant period, as manifested by a significantly lower percentage of patients requiring oxygen therapy and mechanical ventilation compared to both of the previous periods analyzed, are consistent with reports from other researchers [ 15 , 24 , 28 ]. It should be noted that, according to the results of our analysis, the highest rate of patients requiring oxygen supplementation and invasive mechanical ventilation was documented during the period of dominance of the Delta variant, which is consistent with observations from other studies [ 6 , 28 , 32 , 35 ]. The fact that during the dominance of BA.2 compared to BA.1, patients were older, more likely to have chronic diseases, but nevertheless were discharged from the hospital sooner and died less, generally indicates that BA.2 infections were milder.…”

Section: Discussionsupporting

confidence: 93%

“…We documented that on admission to the hospital, patients in the Omicron wave showed a significantly better clinical condition compared to the previous pandemic periods; meanwhile, the highest percentage of those presenting the most severe clinical condition was recorded for the Delta wave, which supported other reports [ 6 , 25 , 28 , 34 , 35 ]. Omicron-infected patients significantly less frequently demonstrated cough, fever, shortness of breath, fatigue, headache, and only occasionally loss of smell and taste, i.e., symptoms considered at the beginning of the pandemic to be typical for COVID-19.…”

Section: Discussionsupporting

confidence: 87%

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Variability in the Clinical Course of COVID-19 in a Retrospective Analysis of a Large Real-World Database

Flisiak

Rzymski

Zarębska-Michaluk

et al. 2023

Viruses

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The COVID-19 pandemic proceeds in waves, with variable characteristics of the clinical picture resulting from the evolution of the SARS-CoV-2 virus. This study aimed to compare the epidemiological characteristics, symptomatology, and outcomes of the disease in patients hospitalized for COVID-19 during periods of different variants dominance. Comparing the periods of dominance of variants preceding the Delta variant, the Delta period was characterized by a higher share of hospitalized females, less frequent comorbidities among patients, and a different age distribution. The lowest need for oxygen therapy and mechanical ventilation was observed under Omicron dominance. The triad of classic COVID-19 symptoms, cough, fever, dyspnoea, and fatigue, were most prevalent during the Delta period, and significantly less common under the Omicron dominance. During the Omicron period, nearly twice as many patients as in the previous periods could be discharged from the hospital within 7 days; the overall 28-day mortality was significantly lower compared to that of the Delta period. It also did not differ between periods that were dominated by the BA.1 and BA.2 subvariants. The study indicates that the Omicron SARS-CoV-2 variant that dominated between January and June 2022 caused a disease which resembled the common cold, and was caused by seasonal alpha and beta-coronaviruses with a low pathogenicity for humans. However, one should note that this effect may not only have been related to biological features of the Omicron lineage, but may additionally have been driven by the increased levels of immunization through natural infections and vaccinations, for which we could not account for due to a lack of sufficient data.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionsupporting

confidence: 87%

Variability in the Clinical Course of COVID-19 in a Retrospective Analysis of a Large Real-World Database

Flisiak

Rzymski

Zarębska-Michaluk

et al. 2023

Viruses

View full text Add to dashboard Cite

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“…The limitations of our study are: (1) a monocentric study design, (2) the small patient sample, despite being the largest published cohort in the literature, (3) the lack of external validation, and (4) the span of the study, covering different COVID-19 waves and SARS-CoV2 variants. Indeed, during each wave, the dominant variant presented distinct clinical and biological characteristics, including inflammatory response profile [ 31 , 32 ]. Hence, the prognostic accuracy of MR-proADM for each variant may have differed, but this has not been evaluated due to an insufficient patient sample.…”

Section: Discussionmentioning

confidence: 99%

Mid-Regional Pro-Adrenomedullin as a Prognostic Factor for Severe COVID-19 ARDS

et al. 2022

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Mid-regional proadrenomedullin (MR-proADM) protects against endothelial permeability and has been associated with prognosis in bacterial sepsis. As endothelial dysfunction is central in the pathophysiology of severe SARS-CoV-2 infection, we sought to evaluate MR-proADM both as a prognostic biomarker and as a marker of bacterial superinfection. Consecutive patients admitted to the ICU for severe SARS-CoV-2 pneumonia were prospectively included and serum was bio-banked on days 1, 3, and 7. MR-proADM levels were measured blindly from clinical outcomes in batches at the end of follow-up. Among the 135 patients included between April 2020 and May 2021, 46 (34.1%) had died at day 60. MR-proADM levels on days 1, 3, and 7 were significantly higher in day-60 non-survivors. The area under the curve (AUC) of the receiver operating characteristic (ROC) curve (0.744, p < 0.001) of day-1 MR-proADM compared favorably with the AUC ROC curve of day-1 procalcitonin (0.691, p < 0.001). Serial MR-proADM measurements on days 3 and 7 may add prognostic information. After adjusting for CRP, LDH, and lymphocyte values, day-1 MR-proADM remained significantly associated with day-60 mortality. MR-proADM concentrations were significantly higher in patients with respiratory superinfections (on days 3 and 7) and bloodstream infections (on days 1, 3, and 7) than in patients without infection. Our results suggest that MR-proADM is a good predictor of outcome in severe SARS-CoV-2 infection and could be a useful tool to assess bacterial superinfection in COVID-19 patients.

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“…A wave was defined as a period correlated with the predominance (detection rate ≥50%) of each variant circulating in South Korea. 3 , 10 , 11 …”

Section: Methodsmentioning

confidence: 99%

Distinct Clinical and Laboratory Features of COVID-19 in Children During the Pre-Delta, Delta and Omicron Wave

Han

Kim

et al. 2023

Pediatric Infectious Disease Journal

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Background: The SARS-CoV-2 variants of concern exhibit distinct features in terms of transmissibility and virulence. This study compared the clinical characteristics of COVID-19 in children during pre-Delta, Delta and Omicron waves. Methods: Medical records of 1163 children <19 years of age with COVID-19 admitted to a designated hospital in Seoul, South Korea, were analyzed. Clinical and laboratory findings during the pre-Delta (March 1, 2020, to June 30, 2021; 330 children), Delta (July 1, 2021, to December 31, 2021; 527 children) and Omicron (January 1, 2022, to May 10, 2022; 306 children) waves were compared. Results: Children during the Delta wave were older and had a higher proportion of fever ≥5 days and pneumonia than children during the pre-Delta and Omicron waves. The Omicron wave was characterized by younger age and a higher proportion of fever ≥39.0 °C, febrile seizure and croup. More children <2 years of age and adolescents aged 10 to <19 years experienced neutropenia and lymphopenia, respectively, during the Delta wave. Children aged 2 to <10 years had a higher incidence of leukopenia and lymphopenia during the Omicron wave. Conclusions: Distinct features of COVID-19 were observed in children during the Delta and Omicron surges. Continuous scrutiny of the manifestations of variants of concern is needed for appropriate public health response and management.

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Clinical and laboratory profiles of the SARS-CoV-2 Delta variant compared with pre-Delta variants

Cited by 8 publications

References 19 publications

Variability in the Clinical Course of COVID-19 in a Retrospective Analysis of a Large Real-World Database

Variability in the Clinical Course of COVID-19 in a Retrospective Analysis of a Large Real-World Database

Mid-Regional Pro-Adrenomedullin as a Prognostic Factor for Severe COVID-19 ARDS

Distinct Clinical and Laboratory Features of COVID-19 in Children During the Pre-Delta, Delta and Omicron Wave

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