Risk Factors for Radiological Progression Within Admissive One Week in the Hospitalized COVID-19 Omicron Variant-Infected Patients

Abstract

Purpose

Recently, the SARS-CoV-2 Omicron variant was identified as responsible for a novel wave of COVID-19 worldwide. We perform a retrospective study to identify potential risk factors contributing to radiological progression in the COVID-19 patients due to the Omicron variant infection. These findings would provide guiding information for making clinical decisions that could improve the Omicron infection prognosis and reduce disease-related death.

Methods

This is a retrospective cohort study from a single center in China. According to the radiological change within admissive one week, enrolled cases were divided into two groups: the progressive (1w-PD) and the stable or improved disease (1w-non-PD). Separate analyses were performed on patients stratified into subgroups using the Mann–Whitney U-test, the Fisher exact test, or the Chi-squared test and a multivariable logistic regression analysis.

Results

Both the 1w-non-PD and 1w-PD cohorts displayed comparable asymptomatic infection, have similar underlying disease, impairment in respiratory function, coagulation dysfunction, tissue injury, SARS-CoV-2 viral load, and disease severity. However, the 1w-PD cohort was more inclined to cluster in populations presented with age between 41 and 65, higher CURB-65 scores, undetectable SARS-CoV-2 IgG, and lung affection. Based on the multiple logistic regression analysis, complicated bilateral and ground-glass opacities (GGOs) like pneumonia at admission were independent risk factors to radiological progression within admissive one week.

Conclusion

This study provided preliminary data regarding disease progression in Omicron-infected patients that indicated the development of pneumonia in the context of Omicron infection was worthy of potential risk factors.

Keywords:

• COVID-19
• Omicron
• pneumonia
• radiology
• risk

Abbreviations

ALT, alanine aminotransferase; AUC, area under the curve; BUN, blood urea nitrogen; CI, confidence interval; COVID-19, Coronavirus Disease 2019; Cr, creatinine; CT, computed tomography; Ct value, cycle threshold values; EHRs, electronic health records; GGOs, ground-glass opacities; hsCRP, high-sensitivity C-reactive protein; OR, odds ratio; RT-PCR, reverse transcription polymerase chain reaction; SOFA, sequential organ failure assessment; TBIL, total bilirubin; TnI, troponin I; VOC, variants of concern.

Data Sharing Statement

The datasets used and/or analyzed during the current study are available from the corresponding author upon reasonable request.

Consent for Publication

This study was approved by the Ethics Committee of The Fifth People’s Hospital of Suzhou (2022–009) and was conducted in compliance with ethical, legal, and regulatory norms. The consent was waived by the Ethics Committee of The Fifth People’s Hospital of Suzhou due to the retrospective nature of the review. Privacy of the participants was protected and the data was anonymized or maintained with confidentiality. This study was conducted in accordance with the Declaration of Helsinki.

Acknowledgments

We thank the patients, the nurses, and the clinical staff who are providing care for the patients and staff at the local and state health departments. We thank LetPub (www.letpub.com) for its linguistic assistance during the preparation of this manuscript.

Author Contributions

All authors made a significant contribution to the work reported, whether that is in the conception, study design, execution, acquisition of data, analysis and interpretation, or in all these areas; took part in drafting, revising or critically reviewing the article; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agree to be accountable for all aspects of the work.

Disclosure

The authors report no conflicts of interest in this work.

Additional information

Funding

This work was supported by the Technology Research and Development Funding of Suzhou City SKY2021034 (to CC), the Science and Technology Project of Suzhou City Health Bureau LCZX201918 (to XHS), the Key Project of Health Care Commission of Jiangsu Province ZD2022041 (to XHS) and the Youth Science and Technology Project of Suzhou City KJXW2022049 (to BBG). The funders had no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript.