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Reduction in Chest CT Severity and Improved Hospital Outcomes in SARS-CoV-2 Omicron Compared with Delta Variant Infection

BACKGROUND: The SARS-Cov-2 Omicron variant demonstrates rapid spread but reduced disease severity. Studies evaluating lung imaging findings of Omicron infection versus non-Omicron infection remain lacking. PURPOSE: To compare the Omicron variant with the SARS-CoV-2 Delta variant according to their c...

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Autores principales: Tsakok, Maria T., Watson, Robert A., Saujani, Shyamal J., Kong, Mark, Xie, Cheng, Peschl, Heiko, Wing, Louise, MacLeod, Fiona K., Shine, Brian, Talbot, Nicholas P., Benamore, Rachel E., Eyre, David W., Gleeson, Fergus
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Radiological Society of North America 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9272784/
https://www.ncbi.nlm.nih.gov/pubmed/35727150
http://dx.doi.org/10.1148/radiol.220533
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author Tsakok, Maria T.
Watson, Robert A.
Saujani, Shyamal J.
Kong, Mark
Xie, Cheng
Peschl, Heiko
Wing, Louise
MacLeod, Fiona K.
Shine, Brian
Talbot, Nicholas P.
Benamore, Rachel E.
Eyre, David W.
Gleeson, Fergus
author_facet Tsakok, Maria T.
Watson, Robert A.
Saujani, Shyamal J.
Kong, Mark
Xie, Cheng
Peschl, Heiko
Wing, Louise
MacLeod, Fiona K.
Shine, Brian
Talbot, Nicholas P.
Benamore, Rachel E.
Eyre, David W.
Gleeson, Fergus
author_sort Tsakok, Maria T.
collection PubMed
description BACKGROUND: The SARS-Cov-2 Omicron variant demonstrates rapid spread but reduced disease severity. Studies evaluating lung imaging findings of Omicron infection versus non-Omicron infection remain lacking. PURPOSE: To compare the Omicron variant with the SARS-CoV-2 Delta variant according to their chest CT radiologic pattern, biochemical parameters, clinical severity, and hospital outcomes after adjusting for vaccination status. MATERIALS AND METHODS: This retrospective study included hospitalized adult patients with reverse transcriptase–polymerase chain reaction test results positive for SARS-CoV-2, with CT pulmonary angiography performed within 7 days of admission between December 1, 2021, and January 14, 2022. Multiple readers performed blinded radiologic analyses that included RSNA CT classification, chest CT severity score (CTSS) (range, 0 [least severe] to 25 [most severe]), and CT imaging features, including bronchial wall thickening. RESULTS: A total of 106 patients (Delta group, n = 66; Omicron group, n = 40) were evaluated (overall mean age, 58 years ± 18 [SD]; 58 men). In the Omicron group, 37% of CT pulmonary angiograms (15 of 40 patients) were categorized as normal compared with 15% (10 of 66 patients) of angiograms in the Delta group (P = .016). A generalized linear model was used to control for confounding variables, including vaccination status, and Omicron infection was associated with a CTSS that was 7.2 points lower than that associated with Delta infection (β = −7.2; 95% CI: −9.9, −4.5; P < .001). Bronchial wall thickening was more common with Omicron infection than with Delta infection (odds ratio [OR], 2.4; 95% CI: 1.01, 5.92; P = .04). A booster shot was associated with a protective effect for chest infection (median CTSS, 5; IQR, 0–11) when compared with unvaccinated individuals (median CTSS, 11; IQR, 7.5–14.0) (P = .03). The Delta variant was associated with a higher OR of severe disease (OR, 4.6; 95% CI: 1.2, 26; P = .01) and admission to a critical care unit (OR, 7.0; 95% CI: 1.5, 66; P = .004) when compared with the Omicron variant. CONCLUSION: The SARS-CoV-2 Omicron variant was associated with fewer and less severe changes on chest CT images compared with the Delta variant. Patients with Omicron infection had greater frequency of bronchial wall thickening but less severe disease and improved hospital outcomes when compared with patients with Delta infection. © RSNA, 2022 Online supplemental material is available for this article.
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spelling pubmed-92727842022-07-11 Reduction in Chest CT Severity and Improved Hospital Outcomes in SARS-CoV-2 Omicron Compared with Delta Variant Infection Tsakok, Maria T. Watson, Robert A. Saujani, Shyamal J. Kong, Mark Xie, Cheng Peschl, Heiko Wing, Louise MacLeod, Fiona K. Shine, Brian Talbot, Nicholas P. Benamore, Rachel E. Eyre, David W. Gleeson, Fergus Radiology Original Research BACKGROUND: The SARS-Cov-2 Omicron variant demonstrates rapid spread but reduced disease severity. Studies evaluating lung imaging findings of Omicron infection versus non-Omicron infection remain lacking. PURPOSE: To compare the Omicron variant with the SARS-CoV-2 Delta variant according to their chest CT radiologic pattern, biochemical parameters, clinical severity, and hospital outcomes after adjusting for vaccination status. MATERIALS AND METHODS: This retrospective study included hospitalized adult patients with reverse transcriptase–polymerase chain reaction test results positive for SARS-CoV-2, with CT pulmonary angiography performed within 7 days of admission between December 1, 2021, and January 14, 2022. Multiple readers performed blinded radiologic analyses that included RSNA CT classification, chest CT severity score (CTSS) (range, 0 [least severe] to 25 [most severe]), and CT imaging features, including bronchial wall thickening. RESULTS: A total of 106 patients (Delta group, n = 66; Omicron group, n = 40) were evaluated (overall mean age, 58 years ± 18 [SD]; 58 men). In the Omicron group, 37% of CT pulmonary angiograms (15 of 40 patients) were categorized as normal compared with 15% (10 of 66 patients) of angiograms in the Delta group (P = .016). A generalized linear model was used to control for confounding variables, including vaccination status, and Omicron infection was associated with a CTSS that was 7.2 points lower than that associated with Delta infection (β = −7.2; 95% CI: −9.9, −4.5; P < .001). Bronchial wall thickening was more common with Omicron infection than with Delta infection (odds ratio [OR], 2.4; 95% CI: 1.01, 5.92; P = .04). A booster shot was associated with a protective effect for chest infection (median CTSS, 5; IQR, 0–11) when compared with unvaccinated individuals (median CTSS, 11; IQR, 7.5–14.0) (P = .03). The Delta variant was associated with a higher OR of severe disease (OR, 4.6; 95% CI: 1.2, 26; P = .01) and admission to a critical care unit (OR, 7.0; 95% CI: 1.5, 66; P = .004) when compared with the Omicron variant. CONCLUSION: The SARS-CoV-2 Omicron variant was associated with fewer and less severe changes on chest CT images compared with the Delta variant. Patients with Omicron infection had greater frequency of bronchial wall thickening but less severe disease and improved hospital outcomes when compared with patients with Delta infection. © RSNA, 2022 Online supplemental material is available for this article. Radiological Society of North America 2022-06-21 /pmc/articles/PMC9272784/ /pubmed/35727150 http://dx.doi.org/10.1148/radiol.220533 Text en © 2022 by the Radiological Society of North America, Inc. This article is made available via the PMC Open Access Subset for unrestricted re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the COVID-19 pandemic or until permissions are revoked in writing. Upon expiration of these permissions, PMC is granted a perpetual license to make this article available via PMC and Europe PMC, consistent with existing copyright protections.
spellingShingle Original Research
Tsakok, Maria T.
Watson, Robert A.
Saujani, Shyamal J.
Kong, Mark
Xie, Cheng
Peschl, Heiko
Wing, Louise
MacLeod, Fiona K.
Shine, Brian
Talbot, Nicholas P.
Benamore, Rachel E.
Eyre, David W.
Gleeson, Fergus
Reduction in Chest CT Severity and Improved Hospital Outcomes in SARS-CoV-2 Omicron Compared with Delta Variant Infection
title Reduction in Chest CT Severity and Improved Hospital Outcomes in SARS-CoV-2 Omicron Compared with Delta Variant Infection
title_full Reduction in Chest CT Severity and Improved Hospital Outcomes in SARS-CoV-2 Omicron Compared with Delta Variant Infection
title_fullStr Reduction in Chest CT Severity and Improved Hospital Outcomes in SARS-CoV-2 Omicron Compared with Delta Variant Infection
title_full_unstemmed Reduction in Chest CT Severity and Improved Hospital Outcomes in SARS-CoV-2 Omicron Compared with Delta Variant Infection
title_short Reduction in Chest CT Severity and Improved Hospital Outcomes in SARS-CoV-2 Omicron Compared with Delta Variant Infection
title_sort reduction in chest ct severity and improved hospital outcomes in sars-cov-2 omicron compared with delta variant infection
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9272784/
https://www.ncbi.nlm.nih.gov/pubmed/35727150
http://dx.doi.org/10.1148/radiol.220533
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