Outcomes of SARS-CoV-2 Omicron Variant Infections Compared With Seasonal Influenza and Respiratory Syncytial Virus Infections in Adults Attending the Emergency Department: A Multicenter Cohort Study

被引:19
作者
Hedberg, Pontus [1 ,6 ]
Valik, John Karlsson [3 ]
Abdel-Halim, Lina [2 ,3 ]
Alfven, Tobias [2 ,4 ,5 ]
Naucler, Pontus [2 ,3 ,7 ]
机构
[1] Karolinska Inst, Dept Med Huddinge, Stockholm, Sweden
[2] Karolinska Inst, Dept Med, Div Infect Dis, Stockholm, Sweden
[3] Karolinska Univ Hosp, Dept Infect Dis, Stockholm, Sweden
[4] Karolinska Inst, Dept Global Publ Hlth, Stockholm, Sweden
[5] Sachs Children & Youth Hosp, Stockholm, Sweden
[6] H7 Infekt & Hud Sonnerborg, PH7 Med, Dept Med Huddinge, Infect Dis & Dermatol Unit, S-17177 Stockholm, Sweden
[7] K2 Infekt Naucler P, Dept Med Solna, Div Infect Dis, K2 Med, S-17177 Stockholm, Sweden
基金
瑞典研究理事会;
关键词
SARS-CoV-2; Omicron; influenza; respiratory syncytial virus; emergency department; VACCINE;
D O I
10.1093/cid/ciad660
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
100102 ;
摘要
Background There is a controversy over the impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections in an era of less virulent variants and an increasing population immunity. We compared outcomes in adults attending the emergency department (ED) with an Omicron, influenza, or respiratory syncytial virus (RSV) infection.Methods Retrospective multicenter cohort study including adults attending the ED in 6 acute care hospitals in Stockholm County, Sweden, with an Omicron, influenza, or RSV infection during 2021-2022 and 2015-2019. During 2021-2022, patients were tested for all 3 viruses by multiplex polymerase chain reaction (PCR) testing. The primary outcome was 30-day all-cause mortality. Secondary outcomes were 90-day all-cause mortality, hospitalization, and intensive care unit (ICU) admission.Results A total of 6385 patients from 2021-2022 were included in the main analyses: 4833 Omicron, 1099 influenza, and 453 RSV. The 30-day mortality was 7.9% (n = 381) in the Omicron, 2.5% (n = 28) in the influenza, and 6.0% (n = 27) in the RSV cohort. Patients with Omicron had an adjusted 30-day mortality odds ratio (OR) of 2.36 (95% confidence interval [CI] 1.60-3.62) compared with influenza and 1.42 (95% CI .94-2.21) compared with RSV. Among unvaccinated Omicron patients, stronger associations were observed compared with both influenza (OR 5.51 [95% CI 3.41-9.18]) and RSV (OR 3.29 [95% CI 2.01-5.56]). Similar trends were observed for secondary outcomes. Findings were consistent in comparisons with 5709 pre-pandemic influenza 995 RSV patients.Conclusions In patients attending the ED, infections with Omicron were both more common and associated with more severe outcomes compared with influenza and RSV, in particular among unvaccinated patients. Adults attending the emergency department with an Omicron infection had more severe outcomes compared with patients with influenza, particularly among unvaccinated individuals. For respiratory syncytial virus, differences were less evident, but clear when restricting the Omicron cohort to unvaccinated individuals.
引用
收藏
页码:900 / 907
页数:8
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