2021年12月至2022年1月法国出现症状性感染新冠病毒奥密克戎和德尔塔变异株后的严重住院事件：一项基于人群的回顾性配对队列研究。
Severe hospital events following symptomatic infection with Sars-CoV-2 Omicron and Delta variants in France, December 2021-January 2022: A retrospective, population-based, matched cohort study.
作者信息
Auvigne Vincent, Vaux Sophie, Strat Yann Le, Schaeffer Justine, Fournier Lucie, Tamandjou Cynthia, Montagnat Charline, Coignard Bruno, Levy-Bruhl Daniel, Parent du Châtelet Isabelle
机构信息
Santé publique France, 12 rue du Val d'Osne, Saint-Maurice 94415 France.
Sully Group, 3 av. Doyen Louis Weil, Grenoble 38000 France.
出版信息
EClinicalMedicine. 2022 Jun;48:101455. doi: 10.1016/j.eclinm.2022.101455. Epub 2022 May 20.
BACKGROUND
A rapid increase in incidence of the SARS-CoV-2 Omicron variant (sub-lineage BA.1) occurred in France in December 2021, while the Delta variant was prevailing since July 2021. We aimed to determine whether the risk of a severe hospital event following symptomatic SARS-CoV-2 infection differs for Omicron versus Delta.
METHODS
We conducted a retrospective cohort study to compare severe hospital events (admission to intensive care unit or death) between Omicron and Delta symptomatic cases matched according to week of virological diagnosis and age. The analysis was adjusted for age, sex, vaccination status, presence of comorbidities and region of residence, using Cox proportional hazards model.
FINDINGS
Between 06/12/2021-28/01/2022, 184 364 cases were included, of which 931 had a severe hospital event (822 Delta, 109 Omicron). The risk of severe event was lower among Omicron versus Delta cases; the difference in severity between the two variants decreased with age (adjusted Hazard Ratio (aHR)=0·13 95%CI: 0·08-0·20 among 40-64 years, aHR=0·50 95%CI: 0·26-0.98 among 80+ years). The risk of severe event increased with the presence of comorbidities (for very-high-risk comorbidity, aHR=4·15 95%CI: 2·86-6·01 among 40-64 years) and in males (aHR=2·28 95%CI: 1·82-2·85among 40-64 years) and was higher in unvaccinated compared to primo-vaccinated (aHR=7·29 95%CI: 5·58-9·54 among 40-64 years). A booster dose reduced the risk of severe hospital event in 80+ years infected with Omicron (aHR=0·29; 95%CI: 0·12-0·69).
INTERPRETATION
This study confirms the lower severity of Omicron compared to Delta. However, the difference in disease severity is less marked in the elderly. Further studies are needed to better understand the interactions between age and severity of variants.
FUNDING
The study was performed as part of routine work at Public Health France.
背景
2021年12月，法国SARS-CoV-2奥密克戎变种（谱系BA.1）的发病率迅速上升，而自2021年7月以来，德尔塔变种一直占主导地位。我们旨在确定有症状的SARS-CoV-2感染后发生严重住院事件的风险在奥密克戎和德尔塔变种之间是否存在差异。
方法
我们进行了一项回顾性队列研究，以比较根据病毒学诊断周数和年龄匹配的奥密克戎和德尔塔有症状病例之间的严重住院事件（入住重症监护病房或死亡）。使用Cox比例风险模型对年龄、性别、疫苗接种状况、合并症的存在情况和居住地区进行了分析调整。
研究结果
在2021年12月6日至2022年1月28日期间，共纳入184364例病例，其中931例发生了严重住院事件（822例德尔塔，109例奥密克戎）。奥密克戎病例发生严重事件的风险低于德尔塔病例；两个变种之间的严重程度差异随年龄增长而减小（40-64岁人群中，调整后风险比（aHR）=0·13，95%置信区间：0·08-0·20；80岁及以上人群中，aHR=0·50，95%置信区间：0·26-0.98）。严重事件的风险随着合并症的存在而增加（对于极高风险合并症，40-64岁人群中aHR=4·15，95%置信区间：2·86-6·01），在男性中也增加（40-64岁人群中aHR=2·
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