AUTHOR=Roser Lynn P. , Samanapally Harideep , Ali T’shura , Xu Qian , Han Yuchen , Salunkhe Vidyulata , Deepti Fnu , McGuffin Trevor , Huang Emma C. , Furmanek Stephen , Glynn Alex , Ramirez Julio , Jones Christopher M. , Mariyappa Ramesh , Hogue Ryan J. , Williams Alexander M. , Huang Justin J. , Arnold Forest W. , Clifford Sean P. , Pahwa Siddharth , Kong Maiying , Huang Jiapeng TITLE=Different clinical characteristics and outcomes of adult hospitalized SARS-CoV-2 pneumonia patients complicated by cardiovascular events during the first, delta and omicron waves of COVID-19 JOURNAL=Frontiers in Epidemiology VOLUME=4 YEAR=2024 URL=https://www.frontiersin.org/journals/epidemiology/articles/10.3389/fepid.2024.1342917 DOI=10.3389/fepid.2024.1342917 ISSN=2674-1199 ABSTRACT=Background

The effects of SARS-CoV-2 have varied between significant waves of hospitalization.

Research question

Are cardiovascular complications different among the first, delta and omicron waves of hospitalized COVID-19 pneumonia patients?

Study design and methods

This was a multi-centre retrospective study of patients hospitalized with SARS-CoV-2 pneumonia: 632 were hospitalized during the first wave (March–July 2020), 1013 during the delta wave (September 2020–March 2021), and 323 during the omicron wave (January 2022–July 2022). Patients were stratified by wave and occurrence of cardiovascular events.

Results

Among all hospitalized patients with cardiovascular events, patients in the omicron wave were younger (62.4 ± 14 years) than patients in the first wave (67.4 ± 7.8 years) and the delta wave (66.9 ± 12.6 years) and had a higher proportion of non-Hispanic White people than in the first wave (78.6% vs. 61.7%). For COVID-19 patients who suffered from cardiovascular events, the omicron wave patients had significantly higher neutrophil/lymphocyte ratio, white blood cell and platelet counts when compared to the first wave. Omicron wave patients had significantly lower albumin and B-type natriuretic peptide levels (only 5.8% of the first wave and 14.6% of the delta wave) when compared to either the first wave or delta wave patients. In COVID-19 patients who suffered cardiovascular events during hospitalization, mortality rate in the omicron wave (26.8%) was significantly lower than the first wave (48.3%), time to mortality for non-survivors of COVID-19 patients who suffered cardiovascular events was significantly longer in the omicron wave (median 16 days) than in the first wave (median 10 days).

Conclusions

Younger and white patients were affected with cardiovascular complications more often by the omicron variant. Despite higher neutrophil/lymphocyte ratio and WBC counts, the omicron patients with cardiovascular events showed lower heart injuries, lower mortality and longer time to mortality for non-survivors when compared to the first and delta waves.