VA's Health Services Research and Development Service (HSR&D), Center for Innovations in Quality, Effectiveness, and Safety, Michael E. DeBakey VA Medical Center, Houston, TX 77030, USA.
Big Data Scientist Training Enhancement Program, VA Office of Research and Development, Washington, DC 20420, USA.
Int J Environ Res Public Health. 2023 Feb 8;20(4):2987. doi: 10.3390/ijerph20042987.
Mortality due to COVID-19 has been correlated with laboratory markers of inflammation, such as C-reactive protein (CRP). The lower mortality during Omicron variant infections could be explained by variant-specific immune responses or host factors, such as vaccination status. We hypothesized that infections due to Omicron variant cause less inflammation compared to Alpha and Delta, correlating with lower mortality. This was a retrospective cohort study of veterans hospitalized for COVID-19 at the Veterans Health Administration. We compared inflammatory markers among patients hospitalized during Omicron infection with those of Alpha and Delta. We reported the adjusted odds ratio (aOR) of the first laboratory results during hospitalization and in-hospital mortality, stratified by vaccination status. Of 2,075,564 Veterans tested for COVID-19, 29,075 Veterans met the criteria: Alpha (45.1%), Delta (23.9%), Omicron (31.0%). Odds of abnormal CRP in Delta (aOR = 1.85, 95% CI:1.64-2.09) and Alpha (aOR = 1.94, 95% CI:1.75-2.15) were significantly higher compared to Omicron. The same trend was observed for Ferritin, Alanine aminotransferase, Aspartate aminotransferase, Lactate dehydrogenase, and Albumin. The mortality in Delta (aOR = 1.92, 95% CI:1.73-2.12) and Alpha (aOR = 1.68, 95% CI:1.47-1.91) were higher than Omicron. The results remained significant after stratifying the outcomes based on vaccination status. Veterans infected with Omicron showed milder inflammatory responses and lower mortality than other variants.
COVID-19 导致的死亡率与炎症的实验室标志物有关，如 C 反应蛋白 (CRP)。Omicron 变体感染期间较低的死亡率可以用变体特异性免疫反应或宿主因素来解释，例如疫苗接种状态。我们假设与 Alpha 和 Delta 相比，Omicron 变体感染引起的炎症反应较轻，这与较低的死亡率有关。这是退伍军人事务部 (VA) 因 COVID-19 住院的退伍军人的回顾性队列研究。我们比较了在 Omicron 感染期间住院患者与 Alpha 和 Delta 患者的炎症标志物。我们报告了在住院期间和住院期间死亡率的第一份实验室结果的调整比值比 (aOR)，并按疫苗接种状态进行分层。在接受 COVID-19 检测的 2075564 名退伍军人中，有 29075 名退伍军人符合标准：Alpha (45.1%)、Delta (23.9%)、Omicron (31.0%)。Delta (aOR = 1.85, 95%CI:1.64-2.09) 和 Alpha (aOR = 1.94, 95%CI:1.75-2.15) 的异常 CRP 几率明显高于 Omicron。Ferritin、丙氨酸氨基转移酶、天冬氨酸氨基转移酶、乳酸脱氢酶和白蛋白也出现了同样的趋势。Delta (aOR = 1.92, 95%CI:1.73-2.12) 和 Alpha (aOR = 1.68, 95%CI:1.47-1.91) 的死亡率均高于 Omicron。根据疫苗接种状态对结果进行分层后，结果仍然显著。感染 Omicron 的退伍军人的炎症反应较轻，死亡率低于其他变体。
