Changing Severity and Epidemiology of Adults Hospitalized With Coronavirus Disease 2019 (COVID-19) in the United States After Introduction of COVID-19 Vaccines, March 2021–August 2022

Details

• Alternative Title:
  Clin Infect Dis
• Personal Author:
  Kojima, Noah ; Adams, Katherine ; Self, Wesley H. ; Gaglani, Manjusha ; McNeal, Tresa ; Ghamande, Shekhar ; Steingrub, Jay S. ; Shapiro, Nathan I. ; Duggal, Abhijit ; Busse, Laurence W. ; Prekker, Matthew E. ; Peltan, Ithan D. ; Brown, Samuel M. ; Hager, David N. ; Ali, Harith ; Gong, Michelle N. ; Mohamed, Amira ; Exline, Matthew C. ; Khan, Akram ; Wilson, Jennifer G. ; Qadir, Nida ; Chang, Steven Y. ; Ginde, Adit A. ; Withers, Cori A. ; Mohr, Nicholas M. ; Mallow, Christopher ; Martin, Emily T. ; Lauring, Adam S. ; Johnson, Nicholas J. ; Casey, Jonathan D. ; Stubblefield, William B. ; Gibbs, Kevin W. ; Kwon, Jennie H. ; Baughman, Adrienne ; Chappell, James D. ; Hart, Kimberly W. ; Jones, Ian D. ; Rhoads, Jillian P. ; Swan, Sydney A. ; Womack, Kelsey N. ; Zhu, Yuwei ; Surie, Diya ; McMorrow, Meredith L. ; Patel, Manish M. ; Tenforde, Mark W.
• Corporate Authors:
  Investigating Respiratory Viruses in the Acutely Ill (IVY) Network
• Description:
  Introduction.
  
  Understanding the changing epidemiology of adults hospitalized with coronavirus disease 2019 (COVID-19) informs research priorities and public health policies.
  
  Methods.
  
  Among adults (≥18 years) hospitalized with laboratory-confirmed, acute COVID-19 between 11 March 2021, and 31 August 2022 at 21 hospitals in 18 states, those hospitalized during the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Omicron-predominant period (BA.1, BA.2, BA.4/BA.5) were compared to those from earlier Alpha- and Delta-predominant periods. Demographic characteristics, biomarkers within 24 hours of admission, and outcomes, including oxygen support and death, were assessed.
  
  Results.
  
  Among 9825 patients, median (interquartile range [IQR]) age was 60 years (47–72), 47% were women, and 21% non-Hispanic Black. From the Alpha-predominant period (Mar–Jul 2021; N = 1312) to the Omicron BA.4/BA.5 sublineage-predominant period (Jun–Aug 2022; N = 1307): the percentage of patients who had ≥4 categories of underlying medical conditions increased from 11% to 21%; those vaccinated with at least a primary COVID-19 vaccine series increased from 7% to 67%; those ≥75 years old increased from 11% to 33%; those who did not receive any supplemental oxygen increased from 18% to 42%. Median (IQR) highest C-reactive protein and D-dimer concentration decreased from 42.0 mg/L (9.9–122.0) to 11.5 mg/L (2.7–42.8) and 3.1 mcg/mL (0.8–640.0) to 1.0 mcg/mL (0.5–2.2), respectively. In-hospital death peaked at 12% in the Delta-predominant period and declined to 4% during the BA.4/BA.5-predominant period.
  
  Conclusions.
  
  Compared to adults hospitalized during early COVID-19 variant periods, those hospitalized during Omicron-variant COVID-19 were older, had multiple co-morbidities, were more likely to be vaccinated, and less likely to experience severe respiratory disease, systemic inflammation, coagulopathy, and death.
  
  
• Subjects:
  Adult Aged COVID-19 COVID-19 Vaccines Female Hospital Mortality Humans Male Middle Aged Oxygen SARS-CoV-2 United States

  More +
• Keywords:
  Death Hospitalization Severe Disease
• Source:
  Clin Infect Dis. 77(4):547-557
• Pubmed ID:
  37255285
• Pubmed Central ID:
  PMC10526883
• Document Type:
  Journal Article
• Funding:
  CC999999/ImCDC/Intramural CDC HHSUnited States/ ; K08 AI141761/AI/NIAID NIH HHSUnited States/ ; K23 GM129661/GM/NIGMS NIH HHSUnited States/ ; K23 HL153584/HL/NHLBI NIH HHSUnited States/
• Volume:
  77
• Issue:
  4
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha-512:9171a4917e580b4cc912cdc7819045e5c278a7c157bb74facdc2a7ebc15b495e3c1798dce604c5f9032feeacebf086ba489e6872a79e400f0aa8d26d2f788516
• Download URL:
  https://stacks.cdc.gov/view/cdc/133489/cdc_133489_DS1.pdf
• File Type:
  [PDF - 1.37 MB ]