奥密克戎和德尔塔变异株导致的严重急性呼吸综合征冠状病毒 2 的临床结局：33 项研究的系统评价和荟萃分析，涵盖 6037144 例新型冠状病毒疾病 2019 阳性患者。
Clinical outcomes of the severe acute respiratory syndrome coronavirus 2 Omicron and Delta variant: systematic review and meta-analysis of 33 studies covering 6 037 144 coronavirus disease 2019-positive patients.
机构信息
Medical School of Nantong University, Nantong, China.
Department of Hepatobiliary Surgery, The Second Affiliated Hospital of Nantong University, China; Nantong First People's Hospital, Nantong, China.
出版信息
Clin Microbiol Infect. 2023 Jul;29(7):835-844. doi: 10.1016/j.cmi.2023.03.017. Epub 2023 Mar 18.
BACKGROUND
Although the SARS-CoV-2 Omicron variant is considered to induce less severe disease, there have been no consistent results on the extent of the decrease in severity.
OBJECTIVES
To compare the clinical outcomes of COVID-19-positive patients with Omicron and Delta variant infection.
DATA SOURCES
Searches were implemented up to 8 November 2022 in PubMed, Web of Science, BioRvix, and MedRvix.
STUDY ELIGIBILITY CRITERIA
Eligible studies were cohort studies reporting the clinical outcomes of COVID-19-positive patients with Omicron and Delta variant infection, including hospitalization, intensive care unit (ICU) admission, receiving invasive mechanical ventilation (IMV), and death.
PARTICIPANTS
COVID-19-positive patients with Omicron and Delta variant infection.
ASSESSMENT OF RISK OF BIAS
Risk of bias was assessed employing the Newcastle-Ottawa Scale.
METHODS OF DATA SYNTHESIS
Random-effect models were employed to pool the ORs and 95% CIs to compare the risk of clinical outcome. I was employed to evaluate the heterogeneity between studies.
RESULTS
A total of 33 studies with 6 037 144 COVID-19-positive patients were included in this meta-analysis. In the general population of COVID-19-positive patients, compared with Delta, Omicron variant infection resulted in a decreased risk of hospitalization (10.24% vs. 4.14%, OR = 2.91, 95% CI = 2.35-3.60), ICU admission (3.67% vs. 0.48%, OR = 3.64, 95% CI = 2.63-5.04), receiving IMV (3.93% vs. 0.34%, OR = 3.11, 95% CI = 1.76-5.50), and death (2.40% vs. 0.46%, OR = 2.97, 95% CI = 2.17-4.08). In the hospitalized patients with COVID-19, compared with Delta, Omicron variant infection resulted in a decreased risk of ICU admission (20.70% vs. 12.90%, OR = 1.63, 95% CI = 1.32-2.02), receiving IMV (10.90% vs. 5.80%, OR = 1.65, 95% CI = 1.28-2.14), and death (10.72% vs. 7.10%, OR = 1.44, 95% CI = 1.22-1.71).
CONCLUSIONS
Compared with Delta, the severity of Omicron variant infection decreased.
背景
尽管 SARS-CoV-2 的奥密克戎变异株被认为导致的疾病较轻，但关于严重程度降低的程度尚无一致结果。
目的
比较 COVID-19 阳性患者感染奥密克戎和德尔塔变异株的临床结局。
数据来源
截至 2022 年 11 月 8 日，在 PubMed、Web of Science、BioRvix 和 MedRvix 中进行了检索。
研究入选标准
合格的研究为报告 COVID-19 阳性患者感染奥密克戎和德尔塔变异株的临床结局的队列研究，包括住院、入住重症监护病房（ICU）、接受有创机械通气（IMV）和死亡。
参与者
COVID-19 阳性患者感染奥密克戎和德尔塔变异株。
偏倚风险评估
使用纽卡斯尔-渥太华量表评估偏倚风险。
数据综合方法
采用随机效应模型汇总 OR 和 95%CI，以比较临床结局的风险。采用 I² 评估研究之间的异质性。
结果
共有 33 项研究纳入了 6037144 例 COVID-19 阳性患者，进行了荟萃分析。在 COVID-19 阳性患者的普通人群中，与德尔塔相比，奥密克戎变异株感染的住院风险降低（10.24% vs. 4.14%，OR=2.91，95%CI=2.35-3.60）、ICU 入住风险降低（3.67% vs. 0.48%，OR=3.64，95%CI=2.63-5.04）、接受 IMV 的风险降低（3.93% vs. 0.34%，OR=3.11，95%CI=1.76-5.50）和死亡风险降低（2.40% vs. 0.46%，OR=2.97，95%CI=2.17-4.08）。在住院 COVID-19 患者中，与德尔塔相比，奥密克戎变异株感染的 ICU 入住风险降低（20.70% vs. 12.90%，OR=1.63，95%CI=1.32-2.02）、接受 IMV 的风险降低（10.90% vs. 5.80%，OR=1.65，95%CI=1.28-2.14）和死亡风险降低（10.72% vs. 7.10%，OR=1.44，95%CI=1.22-1.71）。
结论
与德尔塔相比，奥密克戎变异株感染的严重程度降低。
Zotero 插件