Geriatric risk and protective factors for serious COVID-19 outcomes among older adults in Shanghai Omicron wave
Guanzhu Lu, Yi Zhang, Haocheng Zhang, Jingwen Ai, Liu He, Xiaoling Yuan, Suxia Bao, Xiaohua Chen, Hongyu Wang, Jianpeng Cai, Sen Wang, Wenhong Zhang, Jie Xu
Emerging Microbes & Infections, doi:10.1080/22221751.2022.2109517
Background Omicron variant was featured with high transmissibility and striking antibody evasion.
Shanghai has been experiencing Omicron wave since March 2022. Though several studies have evaluated the risk factors of severe infections, the analyses of BA.2 infection risk and protective factors among geriatric people was much limited.
Methods This multicenter cohort study described clinical characteristics of geriatric Omicron infections (aged more than 60), and assessed risk and protective factors for severe infections.
Results A total of 1377 patients older than 60 were enrolled, with 75.96% had comorbidities. The median viral shedding time and hospitalization time was 9 and 8 days, respectively. Severe/critical were associated with longer virus clearance time (aOR [95%CI]:0.706(0.533-0.935), P=0.015)), while fully vaccinated/booster and paxlovid use shortened viral shedding time (1.
Supplementary materials
References
Ai, Wang, He, Antibody evasion of SARS-CoV-2 Omicron BA, Cell Host Microbe
Cheung, Chan, Jin, Lessons learned from the fifth wave of COVID-19 in Hong Kong in early 2022, Emerg Microbes Infect
Cui, Liu, Wang, Structural and functional characterizations of infectivity and immune evasion of SARS-CoV-2 Omicron, Cell
D'ascanio, Innammorato, Pasquariello, Age is not the only risk factor in COVID-19: the role of comorbidities and of long staying in residential care homes, BMC Geriatr
Damayanthi, Prabani, Weerasekara, Factors Associated for Mortality of Older People With COVID 19: A Systematic Review and Meta-analysis
Gottlieb, Nirula, Chen, Effect of Bamlanivimab as Monotherapy or in Combination With Etesevimab on Viral Load in Patients With Mild to Moderate COVID-19: A Randomized Clinical Trial, JAMA
Guan, Ni, Hu, Clinical Characteristics of Coronavirus Disease 2019 in China, N Engl J Med
Hamming, Timens, Bulthuis, Tissue distribution of ACE2 protein, the functional receptor for SARS coronavirus. A first step in understanding SARS pathogenesis, J Pathol
Hammond, Leister-Tebbe, Gardner, Oral Nirmatrelvir for High-Risk, Nonhospitalized Adults with Covid-19, N Engl J Med
Ho, Peischard, Strutz-Seebohm, Myocardial Damage by SARS-CoV-2: Emerging Mechanisms and Therapies, Viruses
Huang, Wang, Li, Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China, Lancet
Iketani, Liu, Guo, Antibody evasion properties of SARS-CoV-2 Omicron sublineages, Nature
Jara, Undurraga, Zubizarreta, Effectiveness of homologous and heterologous booster doses for an inactivated SARS-CoV-2 vaccine: a large-scale prospective cohort study, Lancet Glob Health
Liu, Chen, Hou, An inter-correlated cytokine network identified at the center of cytokine storm predicted COVID-19 prognosis, Cytokine
Outbreak, None
Peng, Ouyang, Isnard, Sharing CD4+ T Cell Loss: When COVID-19 and HIV Collide on Immune System, Front Immunol
Peters, Raymer, Pal, Association of COVID-19 Vaccination With Risk of COVID-19 Infection, Hospitalization, and Death in Heart Transplant Recipients, JAMA Cardiol
Puhach, Adea, Hulo, Infectious viral load in unvaccinated and vaccinated individuals infected with ancestral, Delta or Omicron SARS-CoV-2, Nat Med
Shi, Qin, Cai, Characteristics and clinical significance of myocardial injury in patients with severe coronavirus disease 2019, Eur Heart J
Shi, Wang, Shao, COVID-19 infection: the perspectives on immune responses, Cell Death Differ
Smith, Hakim, Leung, COVID-19 Mortality and Vaccine Coverage -Hong Kong Special Administrative Region, China, China CDC Wkly
Smith, Hakim, Leung, COVID-19 Mortality and Vaccine Coverage -Hong Kong Special Administrative Region, China, MMWR Morb Mortal Wkly Rep
Tehrani, Killander, Astrand, Risk factors for death in adult COVID-19 patients: Frailty predicts fatal outcome in older patients, Int J Infect Dis
Wolter, Jassat, Walaza, Early assessment of the clinical severity of the SARS-CoV-2 omicron variant in South Africa: a data linkage study, Lancet
Yamasoba, Kimura, Nasser, Virological characteristics of the SARS-CoV-2 Omicron BA.2 spike, Cell
Zhang, Tan, Ling, Viral and host factors related to the clinical outcome of COVID-19, Nature
{ 'indexed': {'date-parts': [[2022, 8, 5]], 'date-time': '2022-08-05T20:13:56Z', 'timestamp': 1659730436223},
'reference-count': 30,
'publisher': 'Informa UK Limited',
'license': [ { 'start': { 'date-parts': [[2022, 8, 4]],
'date-time': '2022-08-04T00:00:00Z',
'timestamp': 1659571200000},
'content-version': 'vor',
'delay-in-days': 0,
'URL': 'http://creativecommons.org/licenses/by/4.0/'}],
'funder': [ { 'DOI': '10.13039/501100001809',
'name': 'National Natural Science Foundation of China',
'doi-asserted-by': 'crossref',
'award': ['82041010; 92169212; 82161138018']},
{ 'name': 'Research on the construction of the work system of the interaction and integration '
'of the Infectious Disease Department and Hospital-Acquired Infection Control '
'Department',
'award': ['SHDC22021207']},
{ 'name': 'Shanghai Municipal Science and Technology Major Project',
'award': ['HS2021SHZX001']}],
'content-domain': {'domain': ['www.tandfonline.com'], 'crossmark-restriction': True},
'DOI': '10.1080/22221751.2022.2109517',
'type': 'journal-article',
'created': {'date-parts': [[2022, 8, 4]], 'date-time': '2022-08-04T07:39:21Z', 'timestamp': 1659598761000},
'page': '1-22',
'update-policy': 'http://dx.doi.org/10.1080/tandf_crossmark_01',
'source': 'Crossref',
'is-referenced-by-count': 0,
'title': 'Geriatric risk and protective factors for serious COVID-19 outcomes among older adults in '
'Shanghai Omicron wave',
'prefix': '10.1080',
'author': [ { 'given': 'Guanzhu',
'family': 'Lu',
'sequence': 'first',
'affiliation': [ { 'name': 'Department of Infectious Disease, Shanghai Ninth People’s '
'Hospital, Shanghai Jiao Tong University School of Medicine, '
'Shanghai, China'}]},
{ 'given': 'Yi',
'family': 'Zhang',
'sequence': 'additional',
'affiliation': [ { 'name': 'Department of Infectious Diseases, National Medical Center for '
'Infectious Diseases, Shanghai Key Laboratory of Infectious '
'Diseases and Biosafety Emergency Response, Huashan Hospital, '
'Fudan University, Shanghai, China'}]},
{ 'given': 'Haocheng',
'family': 'Zhang',
'sequence': 'additional',
'affiliation': [ { 'name': 'Department of Infectious Diseases, National Medical Center for '
'Infectious Diseases, Shanghai Key Laboratory of Infectious '
'Diseases and Biosafety Emergency Response, Huashan Hospital, '
'Fudan University, Shanghai, China'}]},
{ 'given': 'Jingwen',
'family': 'Ai',
'sequence': 'additional',
'affiliation': [ { 'name': 'Department of Infectious Diseases, National Medical Center for '
'Infectious Diseases, Shanghai Key Laboratory of Infectious '
'Diseases and Biosafety Emergency Response, Huashan Hospital, '
'Fudan University, Shanghai, China'},
{'name': 'Huashen Institute of Microbes and Infections, Shanghai, China'}]},
{ 'given': 'Liu',
'family': 'He',
'sequence': 'additional',
'affiliation': [ { 'name': 'Medical section, Shanghai Ninth People’s Hospital, Shanghai Jiao '
'Tong University School of Medicine, Shanghai, China'}]},
{ 'given': 'Xiaoling',
'family': 'Yuan',
'sequence': 'additional',
'affiliation': [ { 'name': 'Department of Infectious Disease, Shanghai Ninth People’s '
'Hospital, Shanghai Jiao Tong University School of Medicine, '
'Shanghai, China'}]},
{ 'given': 'Suxia',
'family': 'Bao',
'sequence': 'additional',
'affiliation': [ { 'name': 'Department of Infectious Disease, Shanghai Ninth People’s '
'Hospital, Shanghai Jiao Tong University School of Medicine, '
'Shanghai, China'}]},
{ 'given': 'Xiaohua',
'family': 'Chen',
'sequence': 'additional',
'affiliation': [ { 'name': 'Department of Infectious Disease, Shanghai Sixth People’s '
'Hospital, Shanghai Jiao Tong University School of Medicine, '
'Shanghai, China'}]},
{ 'given': 'Hongyu',
'family': 'Wang',
'sequence': 'additional',
'affiliation': [ { 'name': 'Department of Infectious Diseases, National Medical Center for '
'Infectious Diseases, Shanghai Key Laboratory of Infectious '
'Diseases and Biosafety Emergency Response, Huashan Hospital, '
'Fudan University, Shanghai, China'}]},
{ 'given': 'Jianpeng',
'family': 'Cai',
'sequence': 'additional',
'affiliation': [ { 'name': 'Department of Infectious Diseases, National Medical Center for '
'Infectious Diseases, Shanghai Key Laboratory of Infectious '
'Diseases and Biosafety Emergency Response, Huashan Hospital, '
'Fudan University, Shanghai, China'}]},
{ 'given': 'Sen',
'family': 'Wang',
'sequence': 'additional',
'affiliation': [ { 'name': 'Department of Infectious Diseases, National Medical Center for '
'Infectious Diseases, Shanghai Key Laboratory of Infectious '
'Diseases and Biosafety Emergency Response, Huashan Hospital, '
'Fudan University, Shanghai, China'},
{'name': 'Huashen Institute of Microbes and Infections, Shanghai, China'}]},
{ 'given': 'Wenhong',
'family': 'Zhang',
'sequence': 'additional',
'affiliation': [ { 'name': 'Department of Infectious Diseases, National Medical Center for '
'Infectious Diseases, Shanghai Key Laboratory of Infectious '
'Diseases and Biosafety Emergency Response, Huashan Hospital, '
'Fudan University, Shanghai, China'},
{'name': 'Huashen Institute of Microbes and Infections, Shanghai, China'}]},
{ 'given': 'Jie',
'family': 'Xu',
'sequence': 'additional',
'affiliation': [ { 'name': 'Department of Infectious Disease, Shanghai Ninth People’s '
'Hospital, Shanghai Jiao Tong University School of Medicine, '
'Shanghai, China'}]}],
'member': '301',
'published-online': {'date-parts': [[2022, 8, 4]]},
'reference': [ { 'key': 'CIT0001',
'unstructured': '1. COVID-19 dashboard by the Center for Systems Science and Engineering '
'(CSSE) at Johns Hopkins University (JHU); [assessed 2022 June 12]. '
'Available from: '
'https://www.arcgis.com/apps/opsdashboard/index.html#bda7594740fd40299423467b48e9ecf6[EB/OL].'},
{ 'key': 'CIT0002',
'unstructured': '2. Outbreak.info; [assessed 2022 May 28]. Available '
'from:https://outbreak.info/situation-reports/omicron'},
{'key': 'CIT0003', 'doi-asserted-by': 'publisher', 'DOI': '10.1016/j.chom.2022.05.001'},
{'key': 'CIT0004', 'doi-asserted-by': 'publisher', 'DOI': '10.1016/j.cell.2022.01.019'},
{'key': 'CIT0005', 'doi-asserted-by': 'publisher', 'DOI': '10.1038/s41586-022-04594-4'},
{ 'key': 'CIT0006',
'unstructured': '6. The government of the Hongkong Special Administrative Region; '
'[assessed 2022 May 28]. Available from: '
'https://www.covidvaccine.gov.hk/pdf/death_analysis.pdf'},
{ 'key': 'CIT0007',
'unstructured': '7. Centers for Disease Control and Prevention. Underlying Medical '
'Conditions Associated with Higher Risk for Severe COVID-19: Information '
'for Healthcare Professionals; [assessed 2022 June 15]. Available '
'from:https://www.cdc.gov/coronavirus/2019-ncov/hcp/clinical-care/underlyingconditions.html'},
{ 'key': 'CIT0008',
'unstructured': '8. Centers for Disease Control and Prevention. People with Certain '
'Medical Conditions; [assessed 2022 May 28]. Available from: '
'https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/people-with-medical-conditions.html'},
{'key': 'CIT0009', 'doi-asserted-by': 'publisher', 'DOI': '10.1016/j.ijid.2020.10.071'},
{'key': 'CIT0010', 'doi-asserted-by': 'publisher', 'DOI': '10.1080/22221751.2022.2060137'},
{'key': 'CIT0011', 'doi-asserted-by': 'publisher', 'DOI': '10.1016/S0140-6736(20)30183-5'},
{'key': 'CIT0012', 'doi-asserted-by': 'publisher', 'DOI': '10.1016/j.cyto.2020.155365'},
{'key': 'CIT0013', 'doi-asserted-by': 'publisher', 'DOI': '10.1016/j.cell.2022.04.035'},
{'key': 'CIT0014', 'doi-asserted-by': 'publisher', 'DOI': '10.1186/s12877-021-02013-3'},
{'key': 'CIT0015', 'doi-asserted-by': 'publisher', 'DOI': '10.1001/jamacardio.2022.0670'},
{'key': 'CIT0016', 'doi-asserted-by': 'publisher', 'DOI': '10.1016/S0140-6736(22)00017-4'},
{'key': 'CIT0017', 'doi-asserted-by': 'publisher', 'DOI': '10.1177/23337214211057392'},
{'key': 'CIT0018', 'doi-asserted-by': 'publisher', 'DOI': '10.15585/mmwr.mm7115e1'},
{'key': 'CIT0019', 'doi-asserted-by': 'publisher', 'DOI': '10.1016/S2214-109X(22)00112-7'},
{'key': 'CIT0020', 'doi-asserted-by': 'publisher', 'DOI': '10.46234/ccdcw2022.071'},
{'key': 'CIT0021', 'doi-asserted-by': 'publisher', 'DOI': '10.1101/2022.01.10.22269010'},
{'key': 'CIT0022', 'doi-asserted-by': 'publisher', 'DOI': '10.1056/NEJMoa2118542'},
{'key': 'CIT0023', 'doi-asserted-by': 'publisher', 'DOI': '10.1001/jama.2021.0202'},
{'key': 'CIT0024', 'doi-asserted-by': 'publisher', 'DOI': '10.1056/NEJMoa2002032'},
{'key': 'CIT0025', 'doi-asserted-by': 'publisher', 'DOI': '10.1038/s41586-020-2355-0'},
{'key': 'CIT0026', 'doi-asserted-by': 'publisher', 'DOI': '10.1038/s41418-020-0530-3'},
{'key': 'CIT0027', 'doi-asserted-by': 'publisher', 'DOI': '10.3389/fimmu.2020.596631'},
{'key': 'CIT0028', 'doi-asserted-by': 'publisher', 'DOI': '10.1002/path.1570'},
{'key': 'CIT0029', 'doi-asserted-by': 'publisher', 'DOI': '10.3390/v13091880'},
{'key': 'CIT0030', 'doi-asserted-by': 'publisher', 'DOI': '10.1093/eurheartj/ehaa408'}],
'container-title': 'Emerging Microbes & Infections',
'original-title': [],
'language': 'en',
'link': [ { 'URL': 'https://www.tandfonline.com/doi/pdf/10.1080/22221751.2022.2109517',
'content-type': 'unspecified',
'content-version': 'vor',
'intended-application': 'similarity-checking'}],
'deposited': { 'date-parts': [[2022, 8, 5]],
'date-time': '2022-08-05T19:59:56Z',
'timestamp': 1659729596000},
'score': 1,
'resource': {'primary': {'URL': 'https://www.tandfonline.com/doi/full/10.1080/22221751.2022.2109517'}},
'subtitle': [],
'short-title': [],
'issued': {'date-parts': [[2022, 8, 4]]},
'references-count': 30,
'alternative-id': ['10.1080/22221751.2022.2109517'],
'URL': 'http://dx.doi.org/10.1080/22221751.2022.2109517',
'relation': {},
'ISSN': ['2222-1751'],
'subject': [ 'Virology', 'Infectious Diseases', 'Drug Discovery', 'General Medicine', 'Immunology',
'Microbiology', 'Parasitology', 'Epidemiology'],
'container-title-short': 'Emerging Microbes & Infections',
'published': {'date-parts': [[2022, 8, 4]]},
'assertion': [ { 'value': 'The publishing and review policy for this title is described in its Aims & '
'Scope.',
'order': 1,
'name': 'peerreview_statement',
'label': 'Peer Review Statement'},
{ 'value': 'http://www.tandfonline.com/action/journalInformation?show=aimsScope&journalCode=temi20',
'URL': 'http://www.tandfonline.com/action/journalInformation?show=aimsScope&journalCode=temi20',
'order': 2,
'name': 'aims_and_scope_url',
'label': 'Aim & Scope'},
{ 'value': '2022-08-04',
'order': 3,
'name': 'published',
'label': 'Published',
'group': {'name': 'publication_history', 'label': 'Publication History'}}]}