Risk of intensive care unit admission and mortality in patients hospitalized due to influenza A or B and SARS‑CoV‑2 variants Omicron or Delta

Omid Rezahosseini, Casper Roed, Adin Sejdic, Mads Frederik Eiberg, Lene Nielsen, Jonas Boel, Caroline Klint Johannesen, Maarten van Wijhe, Kristina Træholt Franck, Sisse Rye Ostrowski, Birgitte Lindegaard, Thea K. Fischer, Troels Bygum Knudsen, Jon Gitz Holler*, Zitta Barrella Harboe*, Betina Lindgaard-Jensen (Member of study group), Christian Søborg (Member of study group), Thyge Lynghøj Nielsen (Member of study group), Peter Haahr Bernhard (Member of study group), Emilie Marie Juelstorp Pedersen (Member of study group)Gertrud Baunbæk Egelund (Member of study group), Inger Hee Mabuza Mathiesen (Member of study group), Naja Zenius Jespersen (Member of study group), Pelle Trier Petersen (Member of study group), Hans Eric Sebastian Seitz-Rasmussen (Member of study group), Barbara Bonnesen Bertelsen (Member of study group), Morten Bestle (Member of study group), Henrik Andersen (Member of study group), Thomas Ulrik Skram (Member of study group), Sarah Altaraihi (Member of study group), Pradeesh Sivapalan (Member of study group), Jens Ulrik Stæhr Jensen (Member of study group), Kristian Bagge, Kristina Melbardis Jørgensen, Magnus Glindvad Ahlström (Member of study group), Sofie Rytter (Member of study group), Nina le Dous (Member of study group), Pernille Ravn (Member of study group), Nanna Reiter (Member of study group), Daria Podlekareva (Member of study group), Jesper Andreas Knudsen (Member of study group), Lars Erik Kristensen (Member of study group), Cæcilie Leding (Member of study group), Thomas Benfield (Member of study group), Ole Kirk (Member of study group), Sigurdur Thor Sigurdsson (Member of study group), Martin Schou Pedersen (Member of study group), the COVID-19 Omicron Delta study group collaborators

*Corresponding author for this work

Abstract

Background: Respiratory viral infections have significant global health impacts. We compared 30-day intensive care unit (ICU) admission and all-cause mortality risks in patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Delta and Omicron variants versus influenza A and B (A/B). Methods: Data from two retrospective inpatient cohorts in Copenhagen were analyzed. Cohorts included hospitalized influenza A/B patients (2017–2018) and SARS-CoV-2 Delta/Omicron patients (2021–2022), aged ≥18 years, admitted within 14 days of a positive real-time polymerase chain reaction test result. Cumulative ICU admission and mortality rates were estimated using the Aalen–Johansen estimator. Cox regression models calculated hazard ratios (HRs) for ICU admission and mortality. Results: The study encompassed 1459 inpatients (Delta: 49%; Omicron: 26%; influenza A: 6.4%; and influenza B: 18%). Cumulative incidence of ICU admission was 11%, 4.0%, 7.5%, and 4.1%, for Delta, Omicron, influenza A, and B, respectively. For ICU admission, adjusted HRs (aHRs) were 3.1 (p <.001) and 1.5 (p =.34) for Delta and Omicron versus influenza B, and 1.5 (p =.36) and 0.71 (p =.48) versus influenza A. For mortality, aHRs were 3.8 (p <.001) and 3.4 (p <.001) for Delta and Omicron versus influenza B, and 2.1 (p =.04) and 1.9 (p =.11) versus influenza A. Conclusion: Delta but not Omicron inpatients had an increased risk for ICU admission compared to influenza B; however, both variants were associated with higher risks of mortality than influenza B. Only Delta inpatients had a higher risk of mortality than influenza A inpatients.

Original languageEnglish
Article numbere1269
JournalImmunity, Inflammation and Disease
Volume12
Issue number7
ISSN2050-4527
DOIs
Publication statusPublished - Jul 2024

Keywords

  • influenza A
  • influenza B
  • intensive care units
  • mortality
  • SARS-CoV-2 Delta variants
  • SARS-CoV-2 Omicron variant

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