Acute and Postacute COVID-19 Outcomes Among Immunologically Naive Adults During Delta vs Omicron Waves

Medientyp: E-Artikel
Titel: Acute and Postacute COVID-19 Outcomes Among Immunologically Naive Adults During Delta vs Omicron Waves
Beteiligte: Doll, Margaret K.; Waghmare, Alpana; Heit, Antje; Levenson Shakoor, Brianna; Kimball, Louise E.; Ozbek, Nina; Blazevic, Rachel L.; Mose, Larry; Boonyaratanakornkit, Jim; Stevens-Ayers, Terry L.; Cornell, Kevin; Sheppard, Benjamin D.; Hampson, Emma; Sharmin, Faria; Goodwin, Benjamin; Dan, Jennifer M.; Archie, Tom; O’Connor, Terry; Heckerman, David; Schmitz, Frank; Boeckh, Michael; Crotty, Shane
Erschienen: American Medical Association (AMA), 2023
Erschienen in: JAMA Network Open
Sprache: Englisch
DOI: 10.1001/jamanetworkopen.2023.1181
ISSN: 2574-3805
Entstehung:
Anmerkungen:
Beschreibung: <jats:sec id="ab-zoi230067-4"><jats:title>Importance</jats:title><jats:p>The US arrival of the Omicron variant led to a rapid increase in SARS-CoV-2 infections. While numerous studies report characteristics of Omicron infections among vaccinated individuals or persons with previous infection, comprehensive data describing infections among adults who are immunologically naive are lacking.</jats:p></jats:sec><jats:sec id="ab-zoi230067-5"><jats:title>Objectives</jats:title><jats:p>To examine COVID-19 acute and postacute clinical outcomes among a well-characterized cohort of unvaccinated and previously uninfected adults who contracted SARS-CoV-2 during the Omicron (BA.1/BA.2) surge, and to compare outcomes with infections that occurred during the Delta wave.</jats:p></jats:sec><jats:sec id="ab-zoi230067-6"><jats:title>Design, Setting, and Participants</jats:title><jats:p>This prospective multisite cohort study included community-dwelling adults undergoing high-resolution symptom and virologic monitoring in 8 US states between June 2021 and September 2022. Unvaccinated adults aged 30 to less than 65 years without an immunological history of SARS-CoV-2 who were at high risk of infection were recruited. Participants were followed for up to 48 weeks, submitting regular COVID-19 symptom surveys and nasal swabs for SARS-CoV-2 polymerase chain reaction (PCR) testing. Data were analyzed from May to October 2022.</jats:p></jats:sec><jats:sec id="ab-zoi230067-7"><jats:title>Exposures</jats:title><jats:p>Omicron (BA.1/BA.2 lineages) vs Delta SARS-CoV-2 infection, defined as a positive PCR test result that occurred during a period when the variant represented at least 50% of circulating SARS-CoV-2 variants in the participant’s geographic region.</jats:p></jats:sec><jats:sec id="ab-zoi230067-8"><jats:title>Main Outcomes and Measure(s)</jats:title><jats:p>The main outcomes examined were the prevalence and severity of acute (≤28 days after onset) and postacute (≥5 weeks after onset) symptoms.</jats:p></jats:sec><jats:sec id="ab-zoi230067-9"><jats:title>Results</jats:title><jats:p>Among 274 participants who were immunologically naive (mean [SD] age, 49 [9.7] years; 186 [68%] female; 19 [7%] Hispanic participants; 242 [88%] White participants), 166 (61%) contracted SARS-CoV-2. Of these, 137 infections (83%) occurred during the Omicron-predominant period and 29 infections (17%) occurred during the Delta-predominant period. Asymptomatic infections occurred among 7% (95% CI, 3%-12%) of Omicron-wave infections and 0% (95% CI, 0%-12%) of Delta-wave infections. Health care use among individuals with Omicron-wave infections was 79% (95% CI, 43%-92%) lower relative to individuals with Delta-wave infections (<jats:italic>P</jats:italic> = .001). Compared with individuals infected during the Delta wave, individuals infected during the Omicron wave also experienced a 56% (95% CI, 26%-74%, <jats:italic>P</jats:italic> = .004) relative reduction in the risk of postacute symptoms and a 79% (95% CI, 54%-91%, <jats:italic>P</jats:italic> &amp;lt; .001) relative reduction in the rate of postacute symptoms.</jats:p></jats:sec><jats:sec id="ab-zoi230067-10"><jats:title>Conclusions and Relevance</jats:title><jats:p>These findings suggest that among adults who were previously immunologically naive, few Omicron-wave (BA.1/BA.2) and Delta-wave infections were asymptomatic. Compared with individuals with Delta-wave infections, individuals with Omicron-wave infections were less likely to seek health care and experience postacute symptoms.</jats:p></jats:sec>
Zugangsstatus: Freier Zugang

Nur in Feld suchen:

Zuletzt gesuchte Begriffe: