Comparison of the Prognosis and Mortality of Sars-Cov-2 Variants in Critically İll Patients

Sinem Bayrakci *

Department of Intensive Care, Ersin Arslan Training and Research Hospital, Turkey.

*Author to whom correspondence should be addressed.


Abstract

Backround: Since the beginning of the pandemic,the globally circulation of SARS-CoV-2 has caused the virus to constantly mutate,resulting in the emergence of new variants.Some of these variants have been designated as variants of concern(VOC),defined by the WHO as variants associated with increased infectivity,increased disease severity,or change in clinical disease presentation.

Aim and Objective: We aimed  to evaluate and compare the prognosis and mortality of the critically ill patients infected with SARS-CoV-2 and SARS-CoV-2 variants.

Materials and Methods: A total of 335 critically ill patient who were positive for SARS-CoV-2 by polymerase chain reaction enrolled in the study.

Results: Hypertension was significantly higher in the patients in delta group(p=0,02).The presence of comorbidity was statistically significantly associated with mortality in all groups(p <0,05). Unvaccinated patients were significantly higher in all groups and being unvaccinated was associated with mortality in all groups(p <0,05).Mortality was statistically significantly associated with all groups(p=0,01).The delta variant poses a higher risk of mortality compared to other variants(p=0,0001).

Conclusion: The study indicates that severe disease requiring intensive care admission were common in the elderly.Hypertension was higher in the patients in delta group and the presence of comorbidity was associated with mortality in all variant types of COVID-19.Severe disease requiring intensive care admission was more common in the unvaccinated population, regardless of variant type, and being unvaccinated was associated with mortality.All variant types were associated with mortality, but the mortality risk was higher in patients infected with delta variant compared to other variants.

Keywords: COVID-19, variants of concern, mortality, prognosis, unvaccinated


How to Cite

Bayrakci , S. (2023). Comparison of the Prognosis and Mortality of Sars-Cov-2 Variants in Critically İll Patients. Asian Journal of Research in Infectious Diseases, 14(3), 26–33. https://doi.org/10.9734/ajrid/2023/v14i3295

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References

Cucinotta D, Vanelli M. WHO Declares COVID-19 a Pandemic. Acta Biomed. 2020 Mar 19;91(1):157-160. DOI: 10.23750/abm.v91i1.9397 PMID: 32191675; PMCID: PMC7569573.

WHO. Tracking SARS-CoV-2 variants; May 31, 2021. Available:https://www.who.int/en/activities/tracking-SARS-CoV-2-variants/ (Accessed June 6, 2021)

Wise J. Covid-19: New coronavirus variant is identified in UK. BMJ. 2020 Dec 16;371:m4857.

DOI: 10.1136/bmj.m4857 PMID: 33328153.

Davies NG, Abbott S, Barnard RC, Jarvis CI, Kucharski AJ, Munday JD, et al. CMMID COVID-19 Working Group; COVID-19 Genomics UK (COG-UK) Consortium, Diaz-Ordaz K, Keogh R, Eggo RM, Funk S, Jit M, Atkins KE, Edmunds WJ. Estimated transmissibility and impact of SARS-CoV-2 lineage B.1.1.7 in England. Science. 2021 Apr 9;372(6538): eabg3055. DOI: 10.1126/science.abg3055 Epub 2021 Mar 3. PMID: 33658326; PMCID: PMC8128288.

World Health Organization (WHO). Tracking SARS-CoV-2 Variants. Available:https://www.who.int/en/activities/ tracking-SARS-CoV-2-variants/ (Accessed on 26 October 2021).

European Centre for Disease Prevention and Control. Threat Assessment Brief: Emergence of SARS-CoV-2 B.1.617 Variants in India and Situation in the EU/EEA. Available:https://www.ecdc.europa.eu/en/publications-data/threatE-assessmentemergence-sars-cov-2-b1617-variants (Accessed on 26 October 2021)

Luo CH, Morris CP, Sachithanandham J, Amadi A, Gaston DC, Li M, et al. Infection with the SARS-CoV-2 Delta Variant is Associated with Higher Recovery of Infectious Virus Compared to the Alpha Variant in both Unvaccinated and Vaccinated Individuals. Clin Infect Dis. 2021 Dec 18:ciab986. DOI: 10.1093/cid/ciab986

Epub ahead of print. PMID: 34922338.

Sheikh A, McMenamin J, Taylor B, Robertson C; Public Health Scotland and the EAVE II Collaborators. SARS-CoV-2 Delta VOC in Scotland: Demographics, risk of hospital admission, and vaccine effectiveness. Lancet. 2021 Jun 26; 397(10293):2461-2462. DOI: 10.1016/S0140-6736(21)01358-1 Epub 2021 Jun 14. PMID: 34139198; PMCID: PMC8201647.

Fisman DN, Tuite AR. Progressive increase in virulence of novel SARS-CoV-2 variants in Ontario, Canada. medRxiv [Preprint]; 2021. DOI: 10.1101/2021.07.05.21260050

Ong SW, Chiew CJ, Ang LW, Mak TM, Cui L, Toh MP, et al. . Clinical and virological features of SARS-CoV-2 variants of concern: A retrospective cohort study comparing B.1.1.7 (Alpha), B.1.315 (Beta), and B.1.617.2 (Delta). SSRN J; 2021. DOI: 10.2139/ssrn.3861566 [Epub ahead of print].

Fisman DN, Tuite AR. Evaluation of the relative virulence of novel SARS-CoV-2 variants: A retrospective cohort study in Ontario, Canada. CMAJ. 2021 Oct 25; 193(42):E1619-E1625. DOI: 10.1503/cmaj.211248

Epub 2021 Oct 4. PMID: 34610919; PMCID: PMC8562985.

Challen R, Brooks-Pollock E, Read JM, Dyson L, Tsaneva-Atanasova K, Danon L. Risk of mortality in patients infected with SARS-CoV-2 variant of concern 202012/1: Matched cohort study. BMJ. 2021 Mar 9;372:n579. DOI: 10.1136/bmj.n579 PMID: 33687922; PMCID: PMC7941603.

Paredes MI, Lunn SM, Famulare M, Frisbie LA, Painter I, Burstein R, et al. Associations between SARS-CoV-2 variants and risk of COVID-19 hospitalization among confirmed cases in Washington State: A retrospective cohort study. medRxiv [Preprint]. 2021 Oct 27:2021.09.29.21264272. DOI: 10.1101/2021.09.29.21264272 PMID: 34729567; PMCID: PMC8562551.

Ryu BH, Hong SI, Lim SJ, Cho Y, Hwang C, Kang H, et al. Clinical Features of Adult COVID-19 Patients without Risk Factors before and after the Nationwide SARS-CoV-2 B.1.617.2 (Delta)-variant Outbreak in Korea: Experience from Gyeongsangnam-do. J Korean Med Sci. 2021 Dec 20;36(49):e341. DOI: 10.3346/jkms.2021.36.e341 PMID: 34931500; PMCID: PMC8688347.

Peckham H, de Gruijter NM, Raine C, Radziszewska A, Ciurtin C, Wedderburn LR, et al. Male sex identified by global COVID-19 meta-analysis as a risk factor for death and ITU admission. Nat Commun. 2020 Dec 9;11(1):6317. DOI: 10.1038/s41467-020-19741-6 PMID: 33298944; PMCID: PMC7726563.

Venkatraja B, Srilakshminarayana G, Krishna Kumar B. The Dominance of Severe Acute Respiratory Syndrome Coronavirus 2 B.1.617 and Its Sublineages and Associations with Mortality during the COVID-19 Pandemic in India between 2020 and 2021. Am J Trop Med Hyg. 2021 Nov 17;106(1):142-149. DOI: 10.4269/ajtmh.21-0812 PMID: 34788739; PMCID: PMC8733510.

Osibogun A, Balogun M, Abayomi A, Idris J, Kuyinu Y, Odukoya O,et al. Outcomes of COVID-19 patients with comorbidities in southwest Nigeria. PLoS One. 2021 Mar 15;16(3):e0248281. DOI: 10.1371/journal.pone.0248281 PMID: 33720975; PMCID: PMC7959379.

Ng WH, Tipih T, Makoah NA, Vermeulen JG, Goedhals D, Sempa JB, et al. Comorbidities in SARS-CoV-2 Patients: A Systematic Review and Meta-Analysis. mBio. 2021 Feb 9;12(1):e03647-20. DOI: 10.1128/mBio.03647-20 PMID: 33563817; PMCID: PMC7885108.

Gunadi, Hakim MS, Wibawa H, Marcellus, Setiawaty V, Slamet, et al. Is the Infection of the SARS-CoV-2 Delta Variant Associated With the Outcomes of COVID-19 Patients? Front Med (Lausanne). 2021 Dec 9;8:780611. DOI: 10.3389/fmed.2021.780611 PMID: 34957154; PMCID: PMC8695874.

Abu-Raddad LJ, Chemaitelly H, Butt AA; National Study Group for COVID-19 Vaccination. Effectiveness of the BNT162b2 Covid-19 Vaccine against the B.1.1.7 and B.1.351 Variants. N Engl J Med. 2021 Jul 8;385(2):187-189. DOI: 10.1056/NEJMc2104974 Epub 2021 May 5. PMID: 33951357; PMCID: PMC8117967.

Shinde V, Bhikha S, Hoosain Z, Archary M, Bhorat Q, Fairlie L, et al.; 2019nCoV-501 Study Group. Efficacy of NVX-CoV2373 Covid-19 Vaccine against the B.1.351 Variant. N Engl J Med. 2021 May 20;384(20):1899-1909. DOI: 10.1056/NEJMoa2103055 Epub 2021 May 5. PMID: 33951374; PMCID: PMC8091623.

Lopez Bernal J, Andrews N, Gower C, Robertson C, Stowe J, Tessier E, et al. Effectiveness of the Pfizer-BioNTech and Oxford-AstraZeneca vaccines on covid-19 related symptoms, hospital admissions, and mortality in older adults in England: test negative case-control study. BMJ. 2021 May 13;373:n1088. DOI: 10.1136/bmj.n1088 PMID: 33985964; PMCID: PMC8116636.

Chia PY, Ong SWX, Chiew CJ, Ang LW, Chavatte JM, Mak TM, et al. Virological and serological kinetics of SARS-CoV-2 Delta variant vaccine breakthrough infections: A multicentre cohort study. Clin Microbiol Infect. 2021 Nov 23:S1198-743X(21)00638-8. DOI: 10.1016/j.cmi.2021.11.010 Epub ahead of print. PMID: 34826623; PMCID: PMC8608661.

Bayrakci Onur, Onay Mehmet, Altay Çetin Murat, Bayrakci Sinem, Binboğa Ali Burak. CT Score and Prognosis of Vaccinated and Unvaccinated Patients in COVID 19 Pneumonia. AJMAH 2021;19(12):124-130.

Yang X, Yu Y, Xu J, Shu H, Xia J, Liu H,et al. Clinical course and outcomes of critically ill patients with SARS-CoV-2 pneumonia in Wuhan, China: A single-centered, retrospective, observational study. Lancet Respir Med. 2020 May;8(5): 475-481. DOI: 10.1016/S2213-2600(20)30079-5.

Epub 2020 Feb 24. Erratum in: Lancet Respir Med. 2020 Apr;8(4):e26. PMID: 32105632; PMCID: PMC7102538.

Marini JJ, Gattinoni L. Management of COVID-19 Respiratory Distress. JAMA. 2020 Jun 9;323(22):2329-2330. DOI: 10.1001/jama.2020.6825 PMID: 32329799.

Arnal JM, Chatburn R. Paying attention to patient self-inflicted lung injury. Minerva Anestesiol. 2019 Sep;85(9):940-942. DOI: 10.23736/S0375-9393.19.13778-9 Epub 2019 May 3. PMID: 31064175.

Gupta S, Coca SG, Chan L, Melamed ML, Brenner SK, Hayek SS, et al. STOP-COVID Investigators. AKI Treated with Renal Replacement Therapy in Critically Ill Patients with COVID-19. J Am Soc Nephrol. 2021 Jan;32(1):161-176. DOI: 10.1681/ASN.2020060897. Epub 2020 Oct 16. PMID: 33067383; PMCID: PMC7894677.

Patone M, Thomas K, Hatch R, Tan PS, Coupland C, Liao W,et al. Mortality and critical care unit admission associated with the SARS-CoV-2 lineage B.1.1.7 in England: an observational cohort study. Lancet Infect Dis. 2021 Nov;21(11):1518-1528. DOI: 10.1016/S1473-3099(21)00318-2. Epub 2021 Jun 23. PMID: 34171232; PMCID: PMC8219489.

Challen R, Brooks-Pollock E, Read JM, Dyson L, Tsaneva-Atanasova K, Danon L. Risk of mortality in patients infected with SARS-CoV-2 variant of concern 202012/1: matched cohort study. BMJ. 2021 Mar 9;372:n579. DOI: 10.1136/bmj.n579 PMID: 33687922; PMCID: PMC7941603.