COVID-19 Variants of Concern: An Analysis of Critical Care Admission in Hospitalized Patients in a Canadian Health Region

PURPOSE: To examine outcomes in COVID-19 positive acute care patients and the differential impact of the presence of COVID-19 Variants of Concern (VOCs). METHODS & MATERIALS: This study was a cross-sectional analysis using patient data from the patient's electronic medical records. Inclusion criteria were COVID-19-positive patients hospitalized within acute care sites in Fraser Health (British Columbia) between January 1 and April 30, 2021. Data analysis was conducted using SAS Studio 3.8 and STATA 17.0. RESULTS: Of the patients included in the study, 934 (33%) were classified as having a VOC. The proportion of VOC-related COVID-19 cases steadily increased from 0.6% of all COVID-19 admissions in January 2021 to 67.2% in April 2021. Males were more likely to have VOCs than females (36% vs. 30%). The age groups with the highest proportion of VOCs were 40-49 (51%), 50-59 (44%), and 60-69 (40%). After controlling for sex and age, it was shown that patients with VOCs were more than twice as likely to require critical care admission than those without VOCs (OR=2.04, 95%CI:1.67, 2.48; p<0.001). There was no statistically significant difference in overall length of stay (p=0.502) or length of stay in critical care (p=0.237) for those with VOCs after controlling for age and sex. While patients with VOCs were more than twice as likely to require critical care, there was no difference in mortality (OR=1.03, 95%CI:0.75,1.41), p=0.877). CONCLUSION: VOCs were more likely to be present in middle-aged hospitalized patients than in older patients, and were more prevalent in males. Patients with VOCs were more likely to require critical care; however, there was no difference in length of stay in critical care, or in overall mortality. This is important to understand, as VOCs make up a larger proportion of COVID-19 cases, and will likely place significant burden on critical care resources. Limitations of this study are that other factors such as co-morbidities and socioeconomic status have not been controlled for, and the findings may not be generalizable to other health regions with different populations and health care systems. This study provides groundwork for future research on this evolving topic.