Outcomes of Elderly Patients Hospitalized with the SARS-CoV-2 Omicron B.1.1.529 Variant: A Systematic Review

Abstract

The Omicron (B.1.1.529) variant of the severe acute respiratory syndrome Coronavirus 2 (SARS-CoV-2) had an increased rate of spreading among the general population. Although this virus mutation resulted in milder symptoms, those on the vulnerable side of the population are still in danger of developing severe symptoms. Thus, this systematic review focused on identifying the clinical outcomes of older age patients (>65) that are hospitalized with the SARS-CoV-2 Omicron variant. The research was conducted using four electronic databases (PubMed, Scopus, Web of Science, and ProQuest Central), with a search query in December 2022 that comprised the duration of the COVID-19 pandemic. The inclusion criteria comprised (1) a population of patients older than 65 years, (2) a history of hospitalization for SARS-CoV-2 infection, and (3) infection with Omicron B.1.1.529 variant. The initial search generated 295 articles, out of which six were included in the systematic review, and a total of 7398 patients. The main findings were that when looking at the elderly population, the mortality and hospitalization rates remained high. This is because older people are more vulnerable and have more comorbidities that interfere with the virus’s progress. However, there is inconsistency in mortality rates, since the data reported by the included studies had different selection criteria based on the severity of the COVID-19 infection. Although no statistically significant differences were found between the unvaccinated and vaccinated groups, patients who got booster doses of vaccination had a lower likelihood of developing severe symptoms, serving as a protective factor for this population.

Age, comorbidities, c-reactive protein and procalcitonin as predictors of severity in confirmed COVID-19 patients in the Philippines

“…The emergence of new virus variants that differ in their genotype and phenotype from the first SARS-CoV-2 detected in this study, particularly the Omicron and its subvariants, can cause changes in their pathogenicity and transmissibility [ 64 ], which may in turn led to different clinical outcomes in COVID-19 patients. As the Omicron strains appear to be more transmissible and less pathogenic that the majority of the Omicron-infected cases tended to exhibit less severe or milder clinical manifestation than those infected with other variants, therefore a high-severity group would be narrowed down to the patient's characteristics of old age and having comorbidities [ 65 , 66 ]. Additionally, the introduction of COVID-19 vaccines to the Philippines during the time period of data collected [ 67 ] could have an impact on the immune characteristics of patients across different age groups [ 68 ].…”

Association of SARS-CoV-2 viral load with abnormal laboratory characteristics and clinical outcomes in hospitalised COVID-19 patients

“…Although the Omicron variant is more transmissible, data and many studies have shown that unlike the previous variants, the Omicron variant is less virulent and causes less severe illness and mortality [10][11][12][13][14]. However, it was worthy to note that Omicron cases in paediatric and elderly patients had a higher admission frequency [15][16][17][18]. Moreover, elderly populations with comorbidities such as diabetes, hypertension, cardiovascular disease, and chronic lung disease were more likely to develop severe symptoms [17,19].…”

“…However, it was worthy to note that Omicron cases in paediatric and elderly patients had a higher admission frequency [15][16][17][18]. Moreover, elderly populations with comorbidities such as diabetes, hypertension, cardiovascular disease, and chronic lung disease were more likely to develop severe symptoms [17,19].…”

Genome-wide association study suggests that CPQ influences the Omicron variant COVID-19 severity

“…The identi ed genes include JAK1, PDE4A, SLC2A5, AK5, TMPRSS2 and RAB2A that all constitute as potentially therapeutic targets in multiple physiological systems. However, the patients in these studies were mostly recruited during 2020-2022 and therefore, infected with a mixture of several SARS-CoV-2 variants, resulting in heterogenous immune responses and symptoms 10 . Moreover, the majority of these studies are based on European ancestry, yielding results with uncertain translation to non-European populations.…”