Clinical outcomes of the SARS-cov-2 omicron and delta variant: systematic review and meta-analysis of 33 studies covering 6,037,144 COVID-19 positive patients

Hu, Feihong; Jia, Yijie; Zhao, Danyan; Fu, Xuelei; Zhang, Wanqing; Tang, Wen; Hu, Shiqi; Wu, Hua; Ge, Mengwei; Du, Wei; Shen, Wangqin; Zhu, Bin; Chen, Honglin

doi:10.1016/j.cmi.2023.03.017

ScienceOpen: research and publishing network

For Publishers

For Researchers

Blog
About

Search
Advanced search

views

recommends

Record: found
Abstract: found
Article: not found

Clinical outcomes of the SARS-cov-2 omicron and delta variant: systematic review and meta-analysis of 33 studies covering 6,037,144 COVID-19 positive patients

review-article

Author(s): Feihong Hu ¹ , Yijie Jia ¹ , Danyan Zhao ¹ , Xuelei Fu ¹ , Wanqing Zhang ¹ , Wen Tang ¹ , Shiqi Hu ¹ , Hua Wu ¹ , Mengwei Ge ¹ , Wei Du ¹ , Wangqin Shen ¹ , Bin Zhu ² ^, ^∗∗ , Honglin Chen ³ ^, ^∗

Publication date (Electronic): 18 March 2023

Journal: Clinical Microbiology and Infection

Publisher: European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd.

Keywords: Delta, Hospitalization, Meta-analysis, Omicron, SARS-CoV-2

Read this article at

ScienceOpenPublisher PMC

There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

Abstract

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, 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 (NOS). Methods of data synthesis: Random-effect models were employed to pool the Odds ratios (ORs) and 95% confidence intervals (CIs) to compare the risk of clinical outcome. I ² was employed to evaluate 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, compared to 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 positive, compared to 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).

Discussion

Compared to Delta, the severity of Omicron variant infection decreased.

Related collections

Most cited references 61

Record: found
Abstract: found
Article: found

Characteristics of and Important Lessons From the Coronavirus Disease 2019 (COVID-19) Outbreak in China: Summary of a Report of 72 314 Cases From the Chinese Center for Disease Control and Prevention

Zunyou Wu, Jennifer M. McGoogan (2020)

0 comments Cited 8482 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: found
Article: not found

A Trial of Lopinavir–Ritonavir in Adults Hospitalized with Severe Covid-19

Bin Cao, Yeming Wang, Danning Wen … (2020)

Abstract Background No therapeutics have yet been proven effective for the treatment of severe illness caused by SARS-CoV-2. Methods We conducted a randomized, controlled, open-label trial involving hospitalized adult patients with confirmed SARS-CoV-2 infection, which causes the respiratory illness Covid-19, and an oxygen saturation (Sao 2) of 94% or less while they were breathing ambient air or a ratio of the partial pressure of oxygen (Pao 2) to the fraction of inspired oxygen (Fio 2) of less than 300 mm Hg. Patients were randomly assigned in a 1:1 ratio to receive either lopinavir–ritonavir (400 mg and 100 mg, respectively) twice a day for 14 days, in addition to standard care, or standard care alone. The primary end point was the time to clinical improvement, defined as the time from randomization to either an improvement of two points on a seven-category ordinal scale or discharge from the hospital, whichever came first. Results A total of 199 patients with laboratory-confirmed SARS-CoV-2 infection underwent randomization; 99 were assigned to the lopinavir–ritonavir group, and 100 to the standard-care group. Treatment with lopinavir–ritonavir was not associated with a difference from standard care in the time to clinical improvement (hazard ratio for clinical improvement, 1.24; 95% confidence interval [CI], 0.90 to 1.72). Mortality at 28 days was similar in the lopinavir–ritonavir group and the standard-care group (19.2% vs. 25.0%; difference, −5.8 percentage points; 95% CI, −17.3 to 5.7). The percentages of patients with detectable viral RNA at various time points were similar. In a modified intention-to-treat analysis, lopinavir–ritonavir led to a median time to clinical improvement that was shorter by 1 day than that observed with standard care (hazard ratio, 1.39; 95% CI, 1.00 to 1.91). Gastrointestinal adverse events were more common in the lopinavir–ritonavir group, but serious adverse events were more common in the standard-care group. Lopinavir–ritonavir treatment was stopped early in 13 patients (13.8%) because of adverse events. Conclusions In hospitalized adult patients with severe Covid-19, no benefit was observed with lopinavir–ritonavir treatment beyond standard care. Future trials in patients with severe illness may help to confirm or exclude the possibility of a treatment benefit. (Funded by Major Projects of National Science and Technology on New Drug Creation and Development and others; Chinese Clinical Trial Register number, ChiCTR2000029308.)

0 comments Cited 2629 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: not found
Article: not found

Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement.

David Moher, Alessandro Liberati, Jennifer Tetzlaff … (2010)

0 comments Cited 2047 times – based on 0 reviews      Review now

Bookmark

All references

Author and article information

Journal

Journal ID (nlm-ta): Clin Microbiol Infect

Journal ID (iso-abbrev): Clin Microbiol Infect

Title: Clinical Microbiology and Infection

Publisher: European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd.

ISSN (Print): 1198-743X

ISSN (Electronic): 1469-0691

Publication date PMC-release: 18 March 2023

Publication date (Electronic): 18 March 2023

Affiliations

[1 ]Medical School of Nantong University, Nantong, China

[2 ]Department of Hepatobiliary Surgery, The Second Affiliated Hospital of Nantong University, And Nantong First People's Hospital, Nantong, China

[3 ]School of Public Health, Nantong University, Nantong, China

Author notes

[∗ ]Corresponding Author: Bin Zhu and Honglin Chen, Bin Zhu: Department of Hepatobiliary Surgery, The Second Affiliated Hospital of Nantong University, and Nantong First people's Hospital, Nantong, China.

[∗∗ ]Corresponding Author: Honglin Chen: School of Public Health, Nantong University, Nantong, China.

Article

Publisher Item ID: S1198-743X(23)00133-7

DOI: 10.1016/j.cmi.2023.03.017

PMC ID: 10023211

PubMed ID: 36934872

SO-VID: dc63f02f-ae87-498a-85d6-42695b901dde

License:

Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.

History

Date received : 24 November 2022

Date revision received : 6 March 2023

Date accepted : 11 March 2023

Comments

Comment on this article

scite_

Cited by 13

See all cited by

Most referenced authors 2,786

See all reference authors