Retrospective Observational Study of Complete Blood Count (CBC) Parameters and ICU Mortality of COVID-19 Disease in Delta Variant and Omicron Variant in a Community-Based Hospital in New York City.

BACKGROUND

Severe Acute Respiratory Syndrome-Coronavirus-2 (SARS-CoV-2) is the official name of COVID-19, a respiratory infection that had the first case reported from the Hubei province of China on December 8, 2019. This virus is the main etiological agent behind the most dreaded pandemic of pneumonia that has spread to the entire world in a brief period and continues to pose a threat. The first wave corresponded with the period from February 2020 to June 2020, the Delta variant occurred around the middle of June 2021 and the Omicron wave was reported from December 2021 to February 2022. Objective This study aims to compare the Delta and the Omicron variants of COVID-19 infection in a community-based hospital in New York City considering the comparison of ICU admissions in both variants. We aim to study the comparison of complete blood count (CBC) parameters and inflammatory markers of patients admitted to ICU stratified by two waves of COVID-19 infection. We aim to analyze the association of CBC parameters at admission and the discharge during ICU stay in both variants. We also aim to study the association of CBC parameters at admission and discharge with ICU mortality in both variants.

METHODS

We conducted a retrospective observational study based on data from randomly selected hospitalized patients with COVID-19 in a community-based hospital in New York City during the Delta variant and the Omicron wave. A total of 211 patients COVID-19 positive from June to July 2021 (Delta variant) and 148 patients from December to February 2022 (Omicron wave) were included in the study. A comparison was done between the basic characteristics of patients with and without ICU admissions in both variants of COVID-19. We compared the relationship of different parameters of CBC (hemoglobin (Hgb), white blood count (WBC), lymphocytes, neutrophils, and platelets) on ICU admission and further analyzed any changes associated with ICU mortality. Logistic regression was performed to evaluate the relationship of different presenting CBCs on patients' disposition to ICU.  Result: A total of 211 patients (106 female) in the Delta wave (2021 variant) and 148 patients (80 female) in the Omicron wave (2022 variant) with an average ages of 60.9 ±18.10 (Delta variant) and 63.2 ± 19.10 (Omicron variant) were included in this study. There were 45 patients (21.3%) in the Delta wave and 42 patients (28.4%) in the Omicron wave were admitted to ICU. The average length of hospital stay was seven days in the Delta wave and nine days in the Omicron wave. No significant association was found between presenting cell count and ICU admission (p>0.05). Significant associations were found between different cell counts on admission and discharge and death in Delta waves except Hgb and platelets on admission. However, in the Omicron variant, a significant association was found only between WBC on admission and discharge, and Hgb and neutrophil on discharge with death in the univariate model.

CONCLUSION

Comparative study of different clinical parameters between the Delta and the Omicron variants of COVID-19 with the correlation of ICU stay and mortality can be used as a beneficial modality in assessing the outcome of the disease.