Clinical Progression and Outcome of Hospitalized Patients Infected with SARS-CoV-2 Omicron Variant in Shanghai, China
Abstract
:1. Introduction
2. Methods
2.1. Study Designs and Participants
2.2. Procedures
2.3. Laboratory Confirmation
2.4. Statistical Analysis
3. Results
3.1. Clinical and Laboratory Characteristics of Participants on Admission
3.2. Clinical Outcomes of the Study Population
3.3. Duration of Fever in the Study Population
3.4. Imaging Changes in Disease Progression
3.5. Viral Eradication in the Upper Respiratory Tract
3.6. Factors Related to the Severity of the Infection
4. Discussion
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Characteristics | All Patients (n = 226) | Disease Severity | p-Value | |||
---|---|---|---|---|---|---|
Asymptomatic (n = 4) | Mild (n = 180) | Moderate (n = 41) | Severe (n = 1) | |||
Age | ||||||
Median (IQR), y | 52.0 (32.0–68.0) | 51.5 (43.5–58.5) | 48.0 (28.5–62.5) | 71.0 (57.0–78.0) | 78.0 (78.0–78.0) | <0.001 |
Distribution—No./total No. (%) | <0.001 | |||||
0–14 y | 28 (12.4) | 0 (0.0) | 28 (15.6) | 0 (0.0) | 0 | |
15–49 y | 73 (32.4) | 1 (25.0) | 66 (36.9) | 6 (14.6) | 0 | |
50–64 y | 52 (23.1) | 2 (50.0) | 42 (23.5) | 8 (19.5) | 0 | |
≥65 y | 72 (32.0) | 1 (25.0) | 43 (24.0) | 27 (65.9) | 1 (100) | |
Female sex—No./total No. (%) | 118 (52.2) | 2 (50.0) | 99 (55.0) | 17 (41.5) | 0 | 0.251 |
Smoking history—No./total No. (%) | 0.245 | |||||
Smoker | 27 (11.9) | 0 (0.0) | 21 (11.7) | 6 (14.3) | ||
Non-smoker | 199 (88.1) | 4 (100.0) | 159 (88.3) | 36 (85.7) | ||
Median days from onset of symptoms to admission | 3.0 (2.0–3.0) | / | 3.0 (2.0–3.0) | 3.0 (2.0–4.0) | 2.0 (2.0–2.0) | 0.608 |
Median vaccination doses (IQR) | 2.0 (0.0–3.0) | 3.0 (2.0–3.0) | 2.0 (0.0–3.0) | 0.0 (0.0–2.0) | 0.0 (0.0–0.0) | 0.009 |
Fever—No./total No. (%) | 103 (45.6) | 0 (0.0) | 83 (46.1) | 20 (48.8) | 0 (0.0) | 0.226 |
Median temperature (IQR)—°C | 38.4 (38.0–39.0) | / | 38.4 (38.0–39.0) | 38.4 (37.9–38.8) | 0.444 | |
Duration of fever | 5.0 (4.0–6.0) | / | 5.0 (4.0–6.0) | 6.5 (6.0–8.3) | 14.0 (12.0–16.0) | <0.001 |
Distribution of Temperature—No./total No. (%) | 0.280 | |||||
<37.5 °C | 123 (54.4) | 4 (100.0) | 97 (53.9) | 21 (51.2) | 1 (100.0) | |
37.5–38.0 °C | 35 (15.5) | 0 (0.0) | 28 (15.6) | 7 (17.1) | 0 (0.0) | |
38.1–39.0 °C | 51 (22.6) | 0 (0.0) | 38 (21.1) | 13 (31.7) | 0 (0.0) | |
>39.0 °C | 17 (7.52) | 0 (0.0) | 17 (9.4) | 0 (0.0) | 0 (0.0) | |
Symptoms—No. (%) | ||||||
Cough | 168 (74.3) | 0 (0.0) | 133 (73.9) | 34 (82.9) | 1 (100.0) | 0.005 |
Sputum production | 111 (49.1) | 0 (0.0) | 85 (47.2) | 25 (61.0) | 1 (100.0) | 0.031 |
Loss of olfaction | 16 (7.1) | 0 (0.0) | 14 (7.8) | 2 (4.9) | 0 (0.0) | 0.822 |
Fatigue | 33 (14.6) | 0 (0.0) | 27 (15.0) | 6 (14.6) | 0 (0.0) | 1.000 |
Dizziness and headache | 28 (12.4) | 0 (0.0) | 22 (12.2) | 6 (14.6) | 0 (0.0) | 0.801 |
Shortness of breath | 4 (1.8) | 0 (0.0) | 3 (1.67) | 1 (2.44) | 0 (0.0) | 0.600 |
Rhinorrhea | 18 (8.0) | 0 (0.0) | 16 (8.89) | 2 (4.88) | 0 (0.0) | 0.696 |
Sore throat | 44 (19.5) | 0 (0.0) | 40 (22.2) | 4 (9.76) | 0 (0.0) | 0.212 |
Diarrhea | 6 (2.7) | 0 (0.0) | 3 (1.67) | 3 (7.32) | 0 (0.0) | 0.196 |
Myalgia/arthralgia | 11 (4.9) | 0 (0.0) | 8 (4.44) | 3 (7.32) | 0 (0.0) | 0.559 |
Comorbidity—No. (%) | ||||||
Respiratory system diseases | 6 (2.7) | 0 (0.0) | 4 (2.2) | 2 (4.9) | 0 (0.0) | 0.396 |
Type 2 diabetes | 30 (13.3) | 0 (0.0) | 18 (10.0) | 12 (29.3) | 0 (0.0) | 0.012 |
Hypertension | 76 (33.6) | 1 (25.0) | 50 (27.8) | 24 (58.5) | 1 (100.0) | <0.001 |
Non-hypertension cardiovascular disease | 13 (5.8) | 0 (0.0) | 10 (5.6) | 3 (7.3) | 0 (0.0) | 0.787 |
Cerebrovascular disease | 22 (9.7) | 0 (0.0) | 9 (5.00) | 13 (31.7) | 0 (0.0) | <0.001 |
Hepatitis B virus infection | 1 (0.4) | 0 (0.0) | 1 (0.6) | 0 (0.0) | 0 (0.0) | 1.000 |
Cancer | 14 (6.2) | 0 (0.0) | 6 (3.3) | 7 (17.1) | 1 (100.0) | 0.001 |
Chronic renal disease | 2 (0.9) | 0 (0.0) | 2 (1.1) | 0 (0.0) | 0 (0.0) | 1.000 |
Endocrine disorder | 2 (0.9) | 0 (0.0) | 2 (1.1) | 0 (0.0) | 0 (0.0) | 1.000 |
Asthma | 2 (0.9) | 0 (0.0) | 1 (0.6) | 1 (2.4) | 0 (0.0) | 1.000 |
Parkinson’s disease | 2 (0.9) | 0 (0.0) | 1 (0.6) | 1 (2.4) | 0 (0.0) | 0.366 |
Immunodeficiency | 1 (0.4) | 0 (0.0) | 0 (0.0) | 0 (0.0) | 1 (100.0) | 0.204 |
Laboratory Findings | Reference Range | Median (IQR), on Hospital Admission (n = 226) | Median (IQR) | p-Value | |||
---|---|---|---|---|---|---|---|
Disease Severity | |||||||
Asymptomatic (n = 4) | Mild (n = 180) | Moderate (n = 41) | Severe (n = 1) | ||||
WBC (×109/L) | 3.5–9.5 | 4.6 (3.7–6.0) | 5.4 (4.6–6.1) | 4.5 (3.7–5.9) | 5.20 (3.7–6.2) | 3.30 (3.3–3.3) | 0.432 |
Hb (g/L) | 130–175 | 130.0 (121.0–141.0) | 138.0 (131.0–143.0) | 130.0 (122.0–141.0) | 124.0 (116.0–135.0) | 103.0 (103.0–103.0) | 0.052 |
PLT (×109/L) | 125–350 | 188.0 (139.0–227.0) | 180.0 (154.0–192.0) | 188.0 (140.0–232.0) | 174.0 (138.0–224.0) | 196.0 (196.0–196.0) | 0.618 |
Lymphocyte (×109/L) | 1.1–3.2 | 1.3 (0.9–1.7) | 1.1 (0.9–1.6) | 1.3 (1.0–1.7) | 1.1 (0.9–1.4) | 0.6 (0.6–0.6) | 0.034 |
Ferritin (ng/mL) | 4.63–204 | 111.0 (47.0–218.0) | 122.0 (81.8–203.0) | 99.3 (40.2–187.0) | 238.0 (142.0–336.0) | 296.0 (296.0–296.0) | <0.001 |
ESR (mm/h) | <15 | 11.0 (8.0–15.0) | 8.0 (7.3–10.8) | 10.0 (8.0–12.0) | 20.0 (14.0–29.0) | 24.0 (24.0–24.0) | <0.001 |
CRP (mg/L) | 0–8 | 2.9 (0.4–7.0) | 3.4 (0.7–7.7) | 2.0 (0.4–5.5) | 9.7 (3.8–24.6) | 71.7 (71.7–71.7) | <0.001 |
PCT (ng/mL) | ≤0.25 | 0.0 (0.0–0.1) | 0.1 (0.0–0.1) | 0.0 (0.0–0.1) | 0.1 (0.0–0.2) | 1.3 (1.3–1.3) | <0.001 |
IL-6 (pg/mL) | 0–10 | 4.7 (3.6–8.5) | 6.6 (3.9–10.1) | 4.2 (3.3–6.4) | 13.8 (5.9–24.5) | 23.6 (23.6–23.6) | <0.001 |
D-dimer (mg/L) | 0–0.5 | 0.3 (0.2–0.6) | 0.2 (0.2–0.3) | 0.3 (0.2–0.5) | 0.6 (0.3–1.2) | 1.4 (1.4–1.4) | <0.001 |
TG (mmol/L) | 0–1.8 | 1.2 (0.9–1.5) | 1.0 (1.0–1.2) | 1.2 (0.9–1.5) | 1.2 (0.8–1.8) | 1.1 (1.1–1.1) | 0.841 |
TC (mmol/L) | 2.84–6.2 | 3.8 (3.2–4.4) | 3.6 (3.5–3.9) | 3.8 (3.1–4.3) | 4.1 (3.7–4.6) | 3.1 (3.1–3.1) | 0.370 |
HDL (mmol/L) | 1.04–1.68 | 1.1 (0.9–1.4) | 1.4 (1.1–1.5) | 1.2 (1.0–1.5) | 1.0 (0.9–1.1) | 1.1 (1.1–1.1) | 0.004 |
LDL (mmol/L) | ≤3.3 | 2.3 (1.9–2.7) | 2.1 (1.8–2.4) | 2.3 (1.9–2.8) | 2.3 (1.8–2.7) | 1.4 (1.4–1.4) | 0.500 |
Total bilirubin (umol/L) | 3.4–20.5 | 8.3 (6.3–12.8) | 11.8 (9.8–17.8) | 7.9 (6.3–11.7) | 9.3 (7.3–15.4) | 17.6 (17.6–17.6) | 0.031 |
Pro-BNP (pg/mL) | ≤589 | 36.9 (27.5–93.0) | 35.6 (27.7–40.5) | 33.5 (25.5–57.0) | 89.8 (47.9–222.0) | 255.0 (255.0–255.0) | <0.001 |
ALT (IU/L) | <50 | 15.0 (12.0–23.0) | 11.5 (8.0–16.2) | 16.0 (12.0–23.0) | 15.0 (12.0–25.0) | 11.0 (11.0–11.0) | 0.404 |
AST (IU/L) | 17–59 | 23.0 (18.0–30.0) | 17.0 (14.8–21.0) | 22.0 (18.0–30.0) | 24.0 (18.0–29.0) | 45.0 (45.0–45.0) | 0.222 |
Albumin (g/L) | 35–53 | 39.0 (37.0–41.0) | 41.0 (40.2–41.2) | 40.0 (38.0–41.0) | 36.0 (33.0–39.0) | 28.0 (28.0–28.0) | <0.001 |
LDH (IU/L) | 50–240 | 157.0 (132.0–201.0) | 156.0 (131.0–183.0) | 154.0 (129.0–194.0) | 198.0 (156.0–255.0) | 675.0 (675.0–675.0) | <0.001 |
Lactate (mmol/L) | 0.7–2.1 | 1.1 (0.9–1.3) | 1.1 (0.9–1.3) | 1.0 (0.8–1.2) | 1.4 (1.2–1.7) | 2.0 (2.0–2.0) | <0.001 |
e-GFR (mL/min/1.73 m2) | 46–92 | 99.6 (87.5–117.0) | 98.5 (87.3–109.0) | 103.0 (90.9–121.0) | 85.4 (76.1–97.2) | 92.2 (92.2–92.2) | <0.001 |
Potassium (mmol/L) | 3.5–5.1 | 4.0 (3.7–4.3) | 3.8 (3.8–3.9) | 4.0 (3.7–4.3) | 3.9 (3.5–4.4) | 3.7 (3.7–3.7) | 0.552 |
Sodium (mmol/L) | 135–147 | 139.0 (137.0–141.0) | 139.0 (139.0–140.0) | 139.0 (137.0–141.0) | 139.0 (137.0–141.0) | 139.0 (139.0–139.0) | 0.969 |
Chloride (mmol/L) | 98–107 | 104.0 (101.0–106.0) | 105.0 (103.0–106.0) | 104.0 (101.0–107.0) | 105.0 (102.0–106.0) | 103.0 (103.0–103.0) | 0.905 |
Univariate Logistic Regression | Multivariate Logistic Regression | |||||
---|---|---|---|---|---|---|
OR | 95%CI | p-Value | OR | 95%CI | p-Value | |
Age | 1.06 | 1.03–1.08 | <0.001 | 1.03 | 0.99–1.08 | 0.138 |
Female | 0.58 | 0.29–1.15 | 0.120 | 0.51 | 0.20–1.24 | 0.143 |
Fever | 1.11 | 0.56–2.19 | 0.757 | 1.97 | 0.75–5.35 | 0.172 |
Comorbidity | 5.46 | 2.46–12.12 | <0.001 | 1.11 | 0.33–3.69 | 0.867 |
WBC | 1.09 | 0.94–1.26 | 0.266 | 0.95 | 0.74–1.20 | 0.674 |
Lymphocytes | 0.48 | 0.25–0.91 | 0.025 | 0.70 | 0.27–1.65 | 0.459 |
CRP | 1.03 | 1.01–1.05 | 0.004 | 0.99 | 0.96–1.02 | 0.387 |
ESR | 1.08 | 1.04–1.13 | <0.001 | 1.05 | 1.02–1.10 | 0.007 |
Albumin | 0.81 | 0.73–0.89 | <0.001 | 0.95 | 0.84–1.07 | 0.363 |
ALT | 1.00 | 0.99–1.01 | 0.861 | 1.00 | 0.97–1.04 | 0.908 |
AST | 1.00 | 0.99–1.00 | 0.920 | 1.00 | 0.97–1.02 | 0.703 |
Lactate | 6.51 | 2.72–15.58 | <0.001 | 2.34 | 0.67–8.25 | 0.180 |
e-GFR | 0.97 | 0.95–0.98 | <0.001 | 0.99 | 0.97–1.02 | 0.606 |
Dose of vaccinations | ||||||
0 | 1.00 | 1.00 | ||||
1 | 1.46 | 0.25–8.49 | 0.676 | 2.43 | 0.17–28.85 | 0.492 |
2 | 0.63 | 0.28–1.46 | 0.282 | 0.71 | 0.21–2.25 | 0.571 |
3 | 0.28 | 0.11–0.73 | 0.009 | 0.52 | 0.15–1.73 | 0.296 |
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Shao, J.; Fan, R.; Hu, J.; Zhang, T.; Lee, C.; Huang, X.; Wang, F.; Liang, H.; Jin, Y.; Jiang, Y.; et al. Clinical Progression and Outcome of Hospitalized Patients Infected with SARS-CoV-2 Omicron Variant in Shanghai, China. Vaccines 2022, 10, 1409. https://doi.org/10.3390/vaccines10091409
Shao J, Fan R, Hu J, Zhang T, Lee C, Huang X, Wang F, Liang H, Jin Y, Jiang Y, et al. Clinical Progression and Outcome of Hospitalized Patients Infected with SARS-CoV-2 Omicron Variant in Shanghai, China. Vaccines. 2022; 10(9):1409. https://doi.org/10.3390/vaccines10091409
Chicago/Turabian StyleShao, Jiasheng, Rong Fan, Jianrong Hu, Tiejun Zhang, Catherine Lee, Xuyuan Huang, Fei Wang, Haiying Liang, Ye Jin, Ying Jiang, and et al. 2022. "Clinical Progression and Outcome of Hospitalized Patients Infected with SARS-CoV-2 Omicron Variant in Shanghai, China" Vaccines 10, no. 9: 1409. https://doi.org/10.3390/vaccines10091409
APA StyleShao, J., Fan, R., Hu, J., Zhang, T., Lee, C., Huang, X., Wang, F., Liang, H., Jin, Y., Jiang, Y., Gu, Y., & Huang, G. (2022). Clinical Progression and Outcome of Hospitalized Patients Infected with SARS-CoV-2 Omicron Variant in Shanghai, China. Vaccines, 10(9), 1409. https://doi.org/10.3390/vaccines10091409