Identification of CKD, bedridden history and cancer as higher-risk comorbidities and their impact on prognosis of hospitalized Omicron patients: a multi-centre cohort study

ABSTRACT

To further describe the effect of the “fragile population” and their “higher-risk” comorbidities on prognosis among hospitalized Omicron patients, this observational cohort study enrolled hospitalized patients confirmed with SARS-CoV-2 during the 2022 Omicron wave in Shanghai, China. The primary outcome was progression to severe or critical cases. The secondary outcome was viral shedding time from the first positive SARS-CoV-2 detection. A total of 847 participants were enrolled, most of whom featured as advanced age (>70 years old: 30.34%), not fully vaccinated (55.84%), combined with at least 1 comorbidity (65.41%). Multivariate cox regression suggested age >70 years old (aHR[95%CI] 0.78[0.61–0.99]), chronic kidney disease (CKD) stage 4–5 (aHR[95%CI] 0.61[0.46–0.80]), heart conditions (aHR[95%CI] 0.76[0.60–0.97]) would elongate viral shedding time and fully/booster vaccination (aHR[95%CI] 1.4 [1.14–1.72]) would shorten this duration. Multivariate logistic regression suggested CKD stage 4–5 (aHR[95%CI] 3.21[1.45–7.27]), cancer (aHR[95%CI] 9.52[4.19–22.61]), and long-term bedridden status (aHR[95%CI] 4.94[2.36–10.44]) were the “higher” risk factor compared with the elderly, heart conditions, metabolic disorders, isolated hypertension, etc. for severity while female (aHR[95%CI] 0.34[0.16–0.68]) and fully/booster Vaccination (aHR[95%CI] 0.35[0.12–0.87]) could provide protection from illness progression. CKD stage 4–5, cancer and long-term bedridden history were “higher-risk” factors among hospitalized Omicron patients for severity progression while full vaccination could provide protection from illness progression.

KEYWORDS:

• Omicron
• SARS-CoV-2
• COVID-19
• risk factors
• hospialized population

Acknowledgements

We thank all the patients who volunteered for this trial and the study site personnel for their contributions.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Correction Statement

This article has been corrected with minor changes. These changes do not impact the academic content of the article.

Additional information

Funding

This study was funded by a project supported by Three-year Action Plan to Promote Clinical Skills and Clinical Innovation Capabilities in Municipal Hospitals, Shanghai Shenkang Hospital Development Center [No. SHDC2020CR2039B], Shanghai ShenKang Hospital Development Center, Clinical Research Plan of SHDC [No. SHDC2020CR6019], Biomedical Technology Support Special Project of Shanghai 2020 “Science and Technology Innovation Action Plan” [No. 20S31900300], Biomedical Technology Support Special Project of Shanghai 2021 “Science and Technology Innovation Action Plan” [No. 21S31902300], Clinical Research Center (CRC) of Shanghai University of Medicine and Health Sciences [No.20MC2020001], Shanghai Municipal Science and Technology Major Project [HS2021SHZX001], the Shanghai Science and Technology Committee [20dz2260100, 20Z11901100, 20dz2210403], Key Discipline Construction Plan from Shanghai Municipal Health Commission [GWV-10.1-XK01, GWV-3.1, GWV-2], National key R&D Program of China [No. 2021YFC2400805].