Journal Article

Higher in-hospital mortality in SARS-CoV-2 omicron variant infection compared to influenza infection—Insights from the CORONA Germany study

Bergmann, Martin W., Schreiber, Ruediger, Gesierich, Wolfgang, Bachmann, Martin, Sheikhzadeh, Sara, Dickow, Jannis, Gunawardene, Melanie A., Feldhege, Johannes, Wohlmuth, Peter, Wirtz, Sebastian, Pape, Ulrich-Frank, Nowak, Lorenz, Willems, Stephan, Twerenbold, Raphael, Gessler, Nele

2023

Overview

With the emergence of new subvariants, the disease severity of Severe Acute Respiratory Syndrome Coronavirus-2 has attenuated. This study aimed to compare the disease severity in patients hospitalized with omicron variant infection to those with influenza infection. We compared data from the multicenter observational, prospective, epidemiological \"CORONA Germany\" (Clinical Outcome and Risk in hospitalized COVID-19 patients) study on patients infected with Severe Acute Respiratory Syndrome Coronavirus-2 to retrospective data on influenza infection cases from November 2016 to August 2022. Severe Acute Respiratory Syndrome Coronavirus-2 cases were classified as wild-type/delta variant before January 2022, or omicron variant from January 2022 onward. The primary outcome was in-hospital mortality, adjusted for age, gender, and comorbidities. The study included 35,806 patients from 53 hospitals in Germany, including 4,916 patients (13.7%) with influenza infection, 16,654 patients (46.5%) with wild-type/delta variant infection, and 14,236 patients (39.8%) with omicron variant infection. In-hospital mortality was highest in patients with wild-type/delta variant infection (16.8%), followed by patients with omicron variant infection (8.4%) and patients with influenza infection (4.7%). In the adjusted analysis, higher age was the strongest predictor for in-hospital mortality (age 80 years vs. age 50 years: OR 4.25, 95% CI 3.10-5.83). Both, patients with wild-type/delta variant infection (OR 3.54, 95% CI 3.02-4.15) and patients with omicron variant infection (OR 1.56, 95% CI 1.32-1.84) had a higher risk for in-hospital mortality than patients with influenza infection. After adjusting for age, gender and comorbidities, patients with wild-type/delta variant infection had the highest risk for in-hospital mortality compared to patients with influenza infection. Even for patients with omicron variant infection, the adjusted risk for in-hospital mortality was higher than for patients with influenza infection. The adjusted risk for in-hospital mortality showed a strong age dependency across all virus types and variants. NCT04659187.

• Publisher: Public Library of Science,Public Library of Science (PLoS)
• Subject: Adult / Age / Aged / Aged, 80 and over / Biology and life sciences / Cardiovascular disease / Cerebrovascular disease / Chronic obstructive pulmonary disease / Comorbidity / Comparative analysis / Corona / Coronaviruses / COVID-19 / COVID-19 - epidemiology / COVID-19 - mortality / COVID-19 - virology / Diabetes / Epidemiology / Evaluation / Female / Gender / Germany / Germany - epidemiology / Heart failure / Hospital Mortality / Hospitalization / Hospitals / Humans / Infections / Influenza / Influenza, Human - epidemiology / Influenza, Human - mortality / Influenza, Human - virology / Ischemia / Lipids / Liver cirrhosis / Male / Medical research / Medicine and Health Sciences / Medicine, Experimental / Metabolic disorders / Middle Aged / Mortality / Obesity / Pandemics / Patient outcomes / Patients / Pneumonia / Prospective Studies / Public health / Regression analysis / Respiratory diseases / Retrospective Studies / Risk / SARS-CoV-2 - genetics / SARS-CoV-2 - isolation & purification / Severe acute respiratory syndrome / Severe acute respiratory syndrome coronavirus 2 / Severity of Illness Index / Viral diseases