Abstract
Background: At the end of 2021, the B.1.1.529 SARS-CoV-2 variant (Omicron) wave superseded the B.1.617.2 variant (Delta) wave.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.
【초록키워드】 SARS-CoV-2, intensive care, mechanical ventilation, SARS-COV-2 infection, obesity, hospital, variant, SARS-CoV-2 variant, Infection, intensive care unit, Delta, B.1.617.2, outcome, omicron, delta variant, RT-PCR, ICU, emergency department, outcomes, polymerase chain reaction, survival, Characteristics, Dyspnea, Patient, ICU admission, Omicron variant, age, B.1.1.529, women, PCR test, Admission, in-hospital mortality, positive RT-PCR, dose, reverse transcriptase, test result, Chain Reaction, In-hospital, 95% CI, baseline characteristics, median age, study period, Paris, outcome measure, lower risk, COVID-19 illness, doses, positive, transcriptase, positive reverse transcriptase polymerase chain reaction, polymerase chain, discharge home, adjusted, baseline, biological pattern, patients with SARS-CoV-2, were excluded, with COVID-19, 【제목키워드】 COVID-19, Delta, omicron, Emergency, Paris, Department,