Ceja-Gálvez Hazael Ramiro, Hernández-Ramírez Cristian Oswaldo, Vega-Magaña Alejandra Natali, Hernández-Bello Jorge, Arellano-Arteaga Kevin Javier, Turrubiates-Hernández Francisco Javier, Padilla-Borquez Diana Lourdes, Muñoz-Valle José Francisco
Institute of Research in Biomedical Sciences, Centro Universitario de Ciencias de la Salud (CUCS), University of Guadalajara, Guadalajara, Jalisco, Mexico.
Department of Internal Medicine, Hospital Civil de Guadalajara Dr. Juan I. Menchaca, Guadalajara, Jalisco, Mexico.
Front Public Health. 2024 Aug 30;12:1425372. doi: 10.3389/fpubh.2024.1425372. eCollection 2024.
COVID-19 is caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a virus notable for its rapid mutation rate, which has led to the emergence of various variants such as Delta and Omicron, each with potentially different levels of transmissibility and virulence. Therefore, this study aims to compare clinical charactheristics and markers associated with the severity of COVID-19 in hospitalized patients from western Mexico who were infected with the Delta and Omicron variants of SARS-CoV-2.
This cross-sectional study involved 66 patients hospitalized for COVID-19, diagnosed by RT-qPCR. SARS-CoV-2 variants were identified through whole genome sequencing using the COVIDseq platform from Illumina. Upon admission, patients underwent a clinical history assessment, blood gas analysis, and blood biometry. Additionally, several tests and markers were measured, including the percentage of neutralizing antibodies, erythrocyte sedimentation rate (ESR), interleukin-6 (IL-6), tumor necrosis factor-alpha (TNFα), D-dimer, lactate dehydrogenase (LDH), C-reactive protein (CRP), and ferritin.
Patients hospitalized with the Omicron were found to be older, compared to those infected with the Delta (64 vs. 54 years, = 0.006). Additionally, a higher proportion of male patients were observed in the Omicron compared to the Delta ( = 0.029). Both Omicron and Delta variants were associated with lymphopenia, although the lymphocyte count was lower in Omicron (0.9 vs. 0.56 10x/L; = 0.007). The COVID-GRAM scale indicated a high risk for severe disease in both groups, but the score was higher in Omicron compared to Delta (157 vs. 128 points; = 0.0004). Patients infected with Omicron exhibited a lower percentage of neutralizing antibodies than those with Delta (35.99 vs. 81%; < 0.05), regardless of their vaccination status. Among the markers assessed, globular ESR was found to be lower in Omicron compared to Delta (30.5 vs. 41.5 mm/h; = 0.001), while ferritin levels were higher in patients infected with the Omicron (1,359 vs. 960.6 μg/L; = 0.007). In patients with severe COVID-19, markers such as lymphopenia, neutralizing antibody levels, ferritin, and COVID-GRAM scores are elevated in the Omicron variant, while only the leukocyte count and ESR for the Delta variant.
新型冠状病毒肺炎（COVID-19）由严重急性呼吸综合征冠状病毒2（SARS-CoV-2）引起，该病毒以其快速的突变率而闻名，这导致了各种变体的出现，如德尔塔和奥密克戎，每种变体的传播性和毒力可能不同。因此，本研究旨在比较墨西哥西部感染SARS-CoV-2德尔塔和奥密克戎变体的住院COVID-19患者的临床特征和与疾病严重程度相关的标志物。
这项横断面研究纳入了66例因COVID-19住院的患者，通过逆转录定量聚合酶链反应（RT-qPCR）确诊。使用Illumina公司的COVIDseq平台通过全基因组测序鉴定SARS-CoV-2变体。入院时，患者接受了临床病史评估、血气分析和血液生物计量。此外，还检测了多项指标，包括中和抗体百分比、红细胞沉降率（ESR）、白细胞介素-6（IL-6）、肿瘤坏死因子-α（TNFα）、D-二聚体、乳酸脱氢酶（LDH）、C反应蛋白（CRP）和铁蛋白。
发现感染奥密克戎的住院患者比感染德尔塔的患者年龄更大（64岁对54岁，P = 0.006）。此外，与德尔塔组相比，奥密克戎组男性患者比例更高（P = 0.029）。奥密克戎和德尔塔变体均与淋巴细胞减少有关，尽管奥密克戎组的淋巴细胞计数更低（0.9对0.56×10⁹/L；P = 0.007）。COVID-GRAM量表显示两组均有重症风险，但奥密克戎组的得分高于德尔塔组（157分对128分；P = 0.0004）。无论疫苗接种状况如何，感染奥密克戎的患者中和抗体百分比均低于感染德尔塔的患者（35.99%对81%；P < 0.05）。在评估的标志物中，发现奥密克戎组的球形ESR低于德尔塔组（30.5对41.5 mm/h；P = 0.001），而感染奥密克戎的患者铁蛋白水平更高（1359对960.6 μg/L；P = 0.007）。在重症COVID-19患者中，奥密克戎变体的淋巴细胞减少、中和抗体水平、铁蛋白和COVID-GRAM评分等标志物升高，而德尔塔变体仅白细胞计数和ESR升高。
