Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Sep 15;7(5):411-429.
doi: 10.1016/j.mayocpiqo.2023.07.004. eCollection 2023 Oct.

Impact of Age and Variant Time Period on Clinical Presentation and Outcomes of Hospitalized Coronavirus Disease 2019 Patients

Pratyaksh K Srivastava  1 , Alexandra M Klomhaus  2 , David M Tehrani  3 , Gregg C Fonarow  4 , Boback Ziaeian  5 , Pooja S Desai  1 , Asim Rafique  6 , James de Lemos  7 , Rushi V Parikh  3 , Eric H Yang  3
Affiliations

Impact of Age and Variant Time Period on Clinical Presentation and Outcomes of Hospitalized Coronavirus Disease 2019 Patients

Pratyaksh K Srivastava et al. Mayo Clin Proc Innov Qual Outcomes. .

Abstract

Objective: To evaluate the impact of age and COVID-19 variant time period on morbidity and mortality among those hospitalized with COVID-19.

Patients and methods: Patients from the American Heart Association's Get With The Guidelines COVID-19 cardiovascular disease registry (January 20, 2020-February 14, 2022) were divided into groups based on whether they presented during periods of wild type/alpha, delta, or omicron predominance. They were further subdivided by age (young: 18-40 years; older: more than 40 years), and characteristics and outcomes were compared.

Results: The cohort consisted of 45,421 hospitalized COVID-19 patients (wild type/alpha period: 41,426, delta period: 3349, and omicron period: 646). Among young patients (18-40 years), presentation during delta was associated with increased odds of severe COVID-19 (OR, 1.6; 95% CI, 1.3-2.1), major adverse cardiovascular events (MACE) (OR, 1.8; 95% CI, 1.3-2.5), and in-hospital mortality (OR, 2.2; 95% CI, 1.5-3.3) when compared with presentation during wild type/alpha. Among older patients (more than 40 years), presentation during delta was associated with increased odds of severe COVID-19 (OR, 1.2; 95% CI, 1.1-1.3), MACE (OR, 1.5; 95% CI, 1.4-1.7), and in-hospital mortality (OR, 1.4; 95% CI, 1.3-1.6) when compared with wild type/alpha. Among older patients (more than 40 years), presentation during omicron associated with decreased odds of severe COVID-19 (OR, 0.7; 95% CI, 0.5-0.9) and in-hospital mortality (OR, 0.6; 95% CI, 0.5-0.9) when compared with wild type/alpha.

Conclusion: Among hospitalized adults with COVID-19, presentation during a time of delta predominance was associated with increased odds of severe COVID-19, MACE, and in-hospital mortality compared with presentation during wild type/alpha. Among older patients (aged more than 40 years), presentation during omicron was associated with decreased odds of severe COVID-19 and in-hospital mortality compared with wild type/alpha.

PubMed Disclaimer

Conflict of interest statement

Dr Fonarow reports consulting for Abbott, Amgen, AstraZeneca, Bayer, Cytokinetics, Edwards, Eli Lilly, Janssen, Medtronic, Merck, and Novartis. Dr Parikh receives research support from the American Heart Association, Janssen, Infraredx, Abbott Vascular, and Bayer, and consulting fees from Abbott Vascular. Dr de Lemos reports consulting income from Eli Lilly, Novo Nordisc, and Astra Zeneca. Dr Yang reports research grants/funding from CSL Behring, Boehringer Ingelheim, Eli Lilly, and Bristol Meyers Squibb, and consulting fees from Pfizer.

Figures

Figure 1
Figure 1
Splines reporting association of continuous age with predicted probability of severe coronavirus disease 2019 (COVID-19).
Figure 2
Figure 2
Splines reporting association of continuous age with predicted probability of major adverse cardiovascular events (MACE).
Figure 3
Figure 3
Splines reporting association of continuous age with predicted probability of death.
See this image and copyright information in PMC

References

    1. Li Q., Guan X., Wu P., et al. Early transmission dynamics in Wuhan, China, of novel coronavirus-infected pneumonia. N Engl J Med. 2020;382(13):1199–1207. - PMC - PubMed
    1. Cascella M., Rajnik M., Aleem A., Dulebohn S.C., Di Napoli R. StatPearls. StatPearlsPublishing; 2022. Features, evaluation, and treatment of coronavirus (COVID-19) - PubMed
    1. COVID data tracker Centers for Disease Control and Prevention. https://covid.cdc.gov/covid-data-tracker/#datatracker-home
    1. Nyberg T., Ferguson N.M., Nash S.G., et al. Comparative analysis of the risks of hospitalisation and death associated with SARS-CoV-2 omicron (B.1.1.529) and delta (B.1.617.2) variants in England: a cohort study. Lancet. 2022;399(10332):1303–1312. - PMC - PubMed
    1. Menni C., Valdes A.M., Polidori L., et al. Symptom prevalence, duration, and risk of hospital admission in individuals infected with SARS-CoV-2 during periods of omicron and delta variant dominance: a prospective observational study from the ZOE COVID Study. Lancet. 2022;399(10335):1618–1624. - PMC - PubMed