Mortality risk among patients hospitalized with COVID-19 decreased during omicron
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A study published Thursday showed that the risk of death among hospitalized patients with COVID-19 was substantially lower during the later period of omicron variant predominance compared with earlier omicron and delta predominance.
“Early in the emergence of the omicron variant of SARS-CoV-2, mortality among hospitalized COVID-19 patients was lower than that during previous pandemic peaks, and some health authorities reported that a substantial proportion of COVID-19 hospitalizations were not primarily for COVID-19-related illness, which might account for the lower mortality among hospitalized patients, Stacey Adjei, MPH, researcher in the Division of Bacterial Diseases at the CDC’s National Center for Immunization and Respiratory Diseases, and colleagues wrote.
To assess in-hospital mortality risk overall and by demographic and clinical characteristics during the delta (July-October 2021), early omicron (January-March 2022), and later omicron (April- June 2022) variant periods among patients hospitalized primarily for COVID-19, Adjei and colleagues used a large hospital administrative database to gather data on patients aged 18 years and older.
Overall, the study showed that crude mortality risk, determined as deaths per 100 patients hospitalized primarily for COVID-19, decreased from 15.1% during the delta period to 13.1% during early omicron and 4.9% during the later omicron period, despite high-risk patient groups representing a larger proportion of hospitalizations. Researchers added that during the later omicron period. Most in-hospital deaths occurred among adults aged 65 years and older (81.9%) and people with three or more underlying medical conditions (73.4%).
After assessing for specific patient characteristics, data showed that among patients hospitalized for COVID-19 who then died in-hospital during the delta, early omicron and later omicron periods, 57.8%, 58% and 51.4%, respectively, were male; 63.8%, 66.8% and 69.1% were white; 53.7%, 73.5% and 81.9% were aged 65 years and older; 15.1%, 22.9% and 28.9% had a disability; and 61.7%, 70.8% and 73.4% had three or more underlying medical conditions.
Additionally, the researchers found that a decreasing proportion of patients who died in-hospital had other indicators of disease severity during the delta, early omicron and later omicron periods. According to the study, 76.1%, 64% and 57.2%, respectively, were admitted to an ICU; 93.8%, 86.8% and 76.4% received COVID-19 medications; 61.8%, 51.2% and 35% received noninvasive ventilation; and 71.9%, 57.6% and 43.6% received invasive mechanical ventilation.
“COVID-19related hospitalizations and mortality should continue to be monitored as protective immunity evolves and new SARS-CoV-2 variants arise to inform public health guidance,” the authors wrote. “Vaccination, early treatment, and appropriate nonpharmaceutical interventions remain important public health priorities to prevent severe COVID-19 illness and death, especially among persons most at risk.”
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Adjei S, et al. MMWR Morbid Mortal Wkly Rep. 2022;doi:10.15585/mmwr.mm7137a4_w
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