Differential Characteristics of Patients for Hospitalized Severe COVID-19 Infected by the Omicron Variants and Wild Type of SARS-CoV-2 in China

Wei, Yuansong; Wang, Ruirui; Zhang, Da-Wei; Chen, S.; Tan, Yuanyuan; Zhang, Wenting; Han, Mingyong; Fei, Guanghe

doi:10.2147/jir.s420721

Cited by 6 publications

(5 citation statements)

References 41 publications

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“…Our previous multicentre study in Saudi Arabia demonstrated the prognostic value of the NLR in detecting severe COVID-19 cases, i.e., admitted to the ICU, compared to both non-severe cases and non-COVID-19 patients [9]. Such a finding was later confirmed and was found to be applicable to other cohorts locally [15,16] and internationally [17][18][19]. More recently, the works of Regolo et al demonstrated the value of the NLR as an independent predictor of mortality in separate studies including over 1000 patients with COVID-19 [20,21].…”

Section: Discussionmentioning

confidence: 71%

Assessing the Diagnostic Values of the Neutrophil-to-Lymphocyte Ratio (NLR) and Systematic Immunoinflammatory Index (SII) as Biomarkers in Predicting COVID-19 Severity: A Multicentre Comparative Study

Sayed

2024

Medicina

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COVID-19 has been notoriously unpredictable in its clinical course. Such unpredictability poses a challenge to clinicians in predicting patients who will develop severe cases and possibly die from the infection. This study aims to assess and compare the diagnostic value of the NLR and SII as biomarkers in predicting COVID-19 severity, represented by mortality, with a multicentre comparative study including 855 patients in Saudi Arabia. Descriptive and analytical statistics were used to compare haematological indices between survivors and non-survivors. The median age of patients included was 41 years old, with an almost equal ratio of men to women. Most participants were Saudis, and the mortality rate in the study cohort was 13.22%. Non-survivors, as compared to survivors, were significantly older, had lower RBC counts, haemoglobin and haematocrit levels, as well as significantly higher WBC and neutrophil counts. Both the NLR and SII were capable of differentiating between survivors and non-survivors, with the latter having significantly higher values. However, the NLR was superior to the SII in such differentiation, as it had a larger area under the curve. This study further confirms the diagnostic values of the NLR and SII as biomarkers in predicting COVID-19 severity and mortality, with the NLR being more sensitive and specific. Clinical guidelines on managing COVID-19 cases should benefit from these findings by harnessing the value of the NLR in COVID-19 management.

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Section: Discussionmentioning

confidence: 71%

Assessing the Diagnostic Values of the Neutrophil-to-Lymphocyte Ratio (NLR) and Systematic Immunoinflammatory Index (SII) as Biomarkers in Predicting COVID-19 Severity: A Multicentre Comparative Study

Sayed

2024

Medicina

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“…Our previous multicentre study demonstrated the prognostic value of NLR in detecting severe COVID-19 cases, i.e., admitted to the ICU, compared to both non-severe cases and non-COVID-19 patients [11]. Several studies confirmed such findings both locally [20,21] and internationally [12,22]. In more recent studies, Regolo and colleagues demonstrated the value of NLR as an independent predictor of mortality in separate studies including over 1000 patients with COVID-19 [23,24].…”

Section: Discussionmentioning

confidence: 90%

Developing a COVID-19 Mortality Prediction (CoMPred) Indicator for ICU Diabetic Patients Treated with Tocilizumab in Saudi Arabia: A Proof-of-Concept Study

Sayed,

Al Nozha

2023

Biomedicines

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Since the beginning of the COVID-19 pandemic, efforts have been made to underline its discourse and identify factors contributing to its severe forms. Clinically, many physicians depended on subjective criteria to determine its severe forms, which varied significantly between practices. However, they did not rely on objective laboratory findings. This study aimed to present a novel and objective laboratory-based indicator to predict mortality among COVID-19 patients. The study included 249 COVID-19 patients who were admitted to the ICU, of which 80 did not survive. The COVID-19 Mortality Prediction (CoMPred) indicator was developed by including the age and the following lab investigations: neutrophil-to-lymphocyte ratio (NLR), D-Dimer, PT, aPTT, ESR, CRP, and urea levels. A CoMPred score of 7.5 or higher carries a sensitivity of 81.10% in predicting mortality, i.e., a patient with a CoMPred score of 7.5 or higher has an 81.10% chance of dying. The CoMPred indicator score directly correlates with mortality, i.e., the higher the score, the higher the possibility of the patient dying. In conclusion, the CoMPred indicator is an objective tool that is affordable and widely available, will assist physicians, and limit the burden on clinical decisions on an unpredicted course of COVID-19 in patients.

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“…With the increased coinfection rate during the Omicron period, routine measurement of procalcitonin was suggested at our institution, and a signi cantly higher procalcitonin level was found in patients during this period. Similarly, the proportion of patients with an increased procalcitonin level on admission was signi cantly higher in patients with the Omicron variant than in those with the wild-type variant (37.2% versus 2.6%) [7].…”

Section: Discussionmentioning

confidence: 91%

“…When the Omicron variant became prevalent [7], patients were more likely to be hospitalized with rather than for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection [8,9]. Wei et al [7] found that patients with the Omicron variant were more likely to be older and to have more comorbidities and bacterial coinfections on admission than were patients with the wild-type strain or other variants.…”

Section: Introductionmentioning

confidence: 99%

Difference in impact of coinfections on antibiotic use in patients hospitalized with COVID- 19 between the Omicron-dominant period and the pre-Omicron period

Murakami,

Nozaki,

Morosawa

et al. 2023

Preprint

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Background Excessive antibiotic use in patients with coronavirus disease 2019 (COVID-19) can cause an increase in multidrug-resistant (MDR) organisms. This study evaluated antibiotic stewardship during the COVID-19 pandemic. Methods Antibiotic use in patients with COVID-19 was compared in a community hospital between 2022 when the Omicron variant was prevalent (n = 225) and 2021 when previous variants were prevalent (n = 257). Antibiotics were categorized as antibiotics predominantly used for community-acquired infections (CAIs) and antibiotics predominantly used for health care-associated infections (HAIs), and days of therapy per 100 bed days (DOT) was evaluated. Results Patients during the Omicron period were older and had more comorbidities. The rate of critically ill patients was around 10% in both periods. During the pre-Omicron period, > 90% of hospitalized patients were unvaccinated, whereas 41.8% of patients received a booster dose during the Omicron period. Ground-glass opacities, bilateral shadows, and a peripheral distribution on CT were observed in most patients in the pre-Omicron period and there were significant differences in comparison with the Omicron period. Although only 0.9% of patients had bacterial coinfection on admission in the pre-Omicron period, 38.9% of patients had the coinfection during the Omicron period and were less likely to receive COVID-19-directed therapy. Coinfection before /after admission was an independent risk factor for composite adverse events in both periods (odds ratio [OR] 3.77, 95% confidence interval [CI] 1.13–12.59, and OR 9.15, 95% CI 3.85–21.74). DOT in antibiotics for CAIs were significantly fewer in the COVID-19 ward than in general wards in the pre-Omicron period but increased in the Omicron period (from 3.60 ± 3.15 to 17.83 ± 10.00). Numerically lower DOT of antibiotics for HAIs was demonstrated in the COVID-19 ward than in the general wards (pre-Omicron, 3.33 ± 6.09 versus 6.37 ± 1.10; Omicron, 3.84 ± 2.93 versus 5.22 ± 0.79). No MDR gram-negative organisms were isolated in the COVID-19 ward. Conclusions Antibiotic use on admission was limited in the pre-Omicron period but increased in the Omicron period because of a high coinfection rate on admission. Excessive use of antibiotics for HAIs was avoided during both periods.

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Differential Characteristics of Patients for Hospitalized Severe COVID-19 Infected by the Omicron Variants and Wild Type of SARS-CoV-2 in China

Cited by 6 publications

References 41 publications

Assessing the Diagnostic Values of the Neutrophil-to-Lymphocyte Ratio (NLR) and Systematic Immunoinflammatory Index (SII) as Biomarkers in Predicting COVID-19 Severity: A Multicentre Comparative Study

Assessing the Diagnostic Values of the Neutrophil-to-Lymphocyte Ratio (NLR) and Systematic Immunoinflammatory Index (SII) as Biomarkers in Predicting COVID-19 Severity: A Multicentre Comparative Study

Developing a COVID-19 Mortality Prediction (CoMPred) Indicator for ICU Diabetic Patients Treated with Tocilizumab in Saudi Arabia: A Proof-of-Concept Study

Difference in impact of coinfections on antibiotic use in patients hospitalized with COVID- 19 between the Omicron-dominant period and the pre-Omicron period

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