Background: Severe Acute Respiratory Syndrome-Coronavirus-2
(SARS-CoV-2) is the official name of COVID-19, a respiratory infection that had
the first case reported from the Hubei province of China on December 8, 2019.
This virus is the main etiological agent behind the most dreaded pandemic of
pneumonia that has spread to the entire world in a brief period and continues
to pose a threat. The first wave corresponded with the period from February
2020 to June 2020, the Delta variant occurred around the middle of June 2021,
and the Omicron wave was reported from December 2021 to February 2022. Studies
have shown the association of COVID-19 infection and severity with several
hematological parameters such as platelets, white blood count (WBC),
lymphocytes, neutrophils (together with neutrophil-lymphocyte and
platelet-lymphocyte ratio), and hemoglobin (Hgb).
Objective: This study aims to compare the Delta and the Omicron
variants of COVID-19 infection in a community-based hospital in New York City
considering the comparison of ICU admissions in both variants. We aim to study
the comparison of complete blood count (CBC) parameters and inflammatory
markers of patients admitted to ICU stratified by two waves of COVID-19
infection. We aim to analyze the association of CBC parameters at admission and
discharge during ICU stay in both variants. We also aim to study the
association of CBC parameters at admission and discharge with ICU mortality in
both variants.
Methods: We conducted a retrospective observational cohort study
based on data from randomly selected hospitalized patients with COVID-19 in a
community-based hospital in New York City during the Delta variant and the
Omicron wave. A total of 211 COVID-19-positive patients from June to July 2021
(Delta variant) and 148 patients from December to February 2022 (Omicron wave)
were included in the study. A comparison was done between the basic
characteristics of patients with and without ICU admissions in both variants of
COVID-19. We compared the relationship of different parameters of CBC
(hemoglobin (Hgb), white blood count (WBC), lymphocytes, neutrophils, and
platelets) on ICU admission and further analyzed any changes associated with
ICU mortality. Logistic regression was performed to evaluate the relationship
of different presenting CBCs on patients’ disposition to ICU.
Results: A total of 211 patients (106 female) in the Delta wave
(2021 variant) and 148 patients (80 female) in the Omicron wave (2022 variant)
with an average age of 60.9 ±18.10 (Delta variant) and 63.2 ± 19.10 (Omicron
variant) were included in this study. In our study in an adjusted regression
model (separate regression analysis for each cell count), a significant
association between odds of death and WBC on admission (OR 1.12, p=0.019), WBC
on discharge (OR 1.36, p<0.001), Hgb on discharge (OR 0.59, p<0.001),
lymphocyte on admission (OR 0.29, p=0.018), lymphocyte on discharge (OR 0.29,
p=0.007), neutrophil on admission (OR 1.18, p=0.003), and neutrophil on
discharge (OR 1.32, p<0.001) were found in the Delta variant. In the
adjusted regression model of the Omicron variant, a significant association
between death and WBC on discharge (OR 1.21, p=0.03), Hgb on discharge (OR
0.55, p<0.001), and neutrophil on discharge (OR 1.24, p=0.002) were found.
There were 45 patients (21.3%) in the Delta wave and 42 patients (28.4%) in the
Omicron wave were admitted to ICU. The average length of hospital stay was
seven days in the Delta wave and nine days in the Omicron wave.
Conclusion: A comparative study of different clinical parameters
between the Delta and the Omicron variants of COVID-19 with the correlation of
ICU stay and mortality can be used as a beneficial modality in assessing the
outcome of the disease. More studies need to be conducted in the future to
emphasize the importance of the clinical parameters in standardizing the
treatment options for COVID-19 variants.
Author
(s) Details
Ruchi
Yadav
Internal Medicine, Brookdale University Hospital Medical Center,
Brooklyn, USA.
Vivek Yadav
Pulmonary and Critical
Care, State University of New York Downstate Health Sciences University, New
York, USA.
Sindhu
Pokhriyal
Internal Medicine, Interfaith Medical Center, Brooklyn, USA.
Umar
Zahid
Internal Medicine, Brookdale University Hospital Medical Center,
Brooklyn, USA.
Anjula
Gandhi
Internal Medicine, Brookdale University Hospital Medical Center,
Brooklyn, USA.
Please see the book here:- https://doi.org/10.9734/bpi/mmrnp/v4/1996
No comments:
Post a Comment