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Clinical outcomes associated with SARS-CoV-2 Omicron (B.1.1.529) variant and BA.1/BA.1.1 or BA.2 subvariant infection in southern California
Nature Medicine ( IF 82.9 ) Pub Date : 2022-06-08 , DOI: 10.1038/s41591-022-01887-z
Joseph A Lewnard 1, 2, 3 , Vennis X Hong 4 , Manish M Patel 5 , Rebecca Kahn 5 , Marc Lipsitch 5 , Sara Y Tartof 4, 6
Affiliation  

Epidemiologic surveillance has revealed decoupling of COVID-19 hospitalizations and deaths from case counts following emergence of the Omicron (B.1.1.529) SARS-CoV-2 variant globally. However, assessment of the relative severity of Omicron variant infections presents challenges because of differential acquired immune protection against Omicron and prior variants, and because longer-term changes have occurred in testing and healthcare practices. Here we show that Omicron variant infections were associated with substantially reduced risk of progression to severe clinical outcomes relative to time-matched Delta (B.1.617.2) variant infections within a large, integrated healthcare system in southern California. Adjusted hazard ratios (aHRs) for any hospital admission, symptomatic hospital admission, intensive care unit admission, mechanical ventilation, and death comparing cases with Omicron versus Delta variant infection were 0.59 (95% confidence interval: 0.51-0.69), 0.59 (0.51-0.68), 0.50 (0.29-0.87), 0.36 (0.18-0.72), and 0.21 (0.10-0.44) respectively. This reduced severity could not be explained by differential history of prior infection among cases with Omicron or Delta variant infection, and was starkest among cases not previously vaccinated against COVID-19 (aHR=0.40 [0.33-0.49] for any hospital admission and 0.14 [0.07-0.28] for death). Infections with the Omicron BA.2 subvariant were not associated with differential risk of severe outcomes in comparison to BA.1/BA.1.1 subvariant infections. Lower risk of severe clinical outcomes among cases with Omicron variant infection should inform public health response amid establishment of the Omicron variant as the dominant SARS-CoV-2 lineage globally.



中文翻译:

南加州与 SARS-CoV-2 Omicron (B.1.1.529) 变体和 BA.1/BA.1.1 或 BA.2 亚变体感染相关的临床结果

流行病学监测显示,在全球出现 Omicron (B.1.1.529) SARS-CoV-2 变种后,COVID-19 住院治疗和死亡人数与病例数脱钩。然而,由于针对 Omicron 和先前变体的获得性免疫保护存在差异,并且检测和医疗保健实践中发生了长期变化,因此评估 Omicron 变体感染的相对严重程度提出了挑战。在这里,我们表明,在南加州的大型综合医疗系统中,与时间匹配的 Delta (B.1.617.2) 变异感染相比,Omicron 变异感染与进展为严重临床结果的风险大大降低相关。任何入院、有症状入院、重症监护病房入院、机械通气、与 Delta 变异感染病例相比,Omicron 病例的死亡率和死亡率分别为 0.59(95% 置信区间:0.51-0.69)、0.59(0.51-0.68)、0.50(0.29-0.87)、0.36(0.18-0.72)和 0.21(0.10-0.44) ) 分别。这种严重程度的降低无法用 Omicron 或 Delta 变异感染病例之间既往感染史的差异来解释,并且在之前未接种过 COVID-19 疫苗的病例中最为明显(任何入院的 aHR=0.40 [0.33-0.49],且 0.14 [ 0.07-0.28]死亡)。与 BA.1/BA.1.1 亚变体感染相比,Omicron BA.2 亚变体感染与严重后果的差异风险无关。

更新日期:2022-06-09
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