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Acute and Post-Acute COVID-19 Outcomes Among Immunologically Naïve Adults During Delta Versus Omicron Waves

IMPORTANCE: The U.S. 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 and/or persons with a prior history of infection, comprehensive data describing infections among immu...

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Autores principales: 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
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cold Spring Harbor Laboratory 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9685683/
https://www.ncbi.nlm.nih.gov/pubmed/36425923
http://dx.doi.org/10.1101/2022.11.13.22282222
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author 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
author_facet 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
author_sort Doll, Margaret K.
collection PubMed
description IMPORTANCE: The U.S. 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 and/or persons with a prior history of infection, comprehensive data describing infections among immunologically naïve adults is lacking. OBJECTIVE: To examine COVID-19 acute and post-acute 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. DESIGN: A prospective cohort undergoing high-resolution symptom and virologic monitoring between June 2021 and September 2022 SETTING: Multisite recruitment of community-dwelling adults in 8 U.S. states PARTICIPANTS: Healthy, unvaccinated adults between 30 to 64 years of age 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 PCR testing. EXPOSURE(S): Omicron (BA.1/BA.2 lineages) versus Delta SARS-CoV-2 infection, defined as a positive PCR that occurred during a period when the variant represented ≥50% of circulating SARS-CoV-2 variants in the participant’s geographic region. MAIN OUTCOME(S) AND MEASURE(S): The main outcomes examined were the prevalence and severity of acute (≤28 days post-onset) and post-acute (≥5 weeks post-onset) symptoms. RESULTS: Among 274 immunologically naïve participants, 166 (61%) contracted SARS-CoV-2. Of these, 137 (83%) and 29 (17%) infections occurred during the Omicron- and Delta-predominant periods, respectively. Asymptomatic infections occurred among 6.7% (95% CI: 3.1%, 12.3%) of Omicron cases and 0.0% (95% CI: 0.0%, 11.9%) of Delta cases. Healthcare utilization among Omicron cases was 79% (95% CI: 43%, 92%, P =0.001) lower relative to Delta cases. Relative to Delta, Omicron infections also experienced a 56% (95% CI: 26%, 74%, P =0.004) and 79% (95% CI: 54%, 91%, P <0.001) reduction in the risk and rate of post-acute symptoms, respectively. CONCLUSIONS AND RELEVANCE: These findings suggest that among previously immunologically naïve adults, few Omicron (BA.1/BA.2) and Delta infections are asymptomatic, and relative to Delta, Omicron infections were less likely to seek healthcare and experience post-acute symptoms.
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spelling pubmed-96856832022-11-25 Acute and Post-Acute COVID-19 Outcomes Among Immunologically Naïve Adults During Delta Versus Omicron Waves 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 medRxiv Article IMPORTANCE: The U.S. 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 and/or persons with a prior history of infection, comprehensive data describing infections among immunologically naïve adults is lacking. OBJECTIVE: To examine COVID-19 acute and post-acute 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. DESIGN: A prospective cohort undergoing high-resolution symptom and virologic monitoring between June 2021 and September 2022 SETTING: Multisite recruitment of community-dwelling adults in 8 U.S. states PARTICIPANTS: Healthy, unvaccinated adults between 30 to 64 years of age 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 PCR testing. EXPOSURE(S): Omicron (BA.1/BA.2 lineages) versus Delta SARS-CoV-2 infection, defined as a positive PCR that occurred during a period when the variant represented ≥50% of circulating SARS-CoV-2 variants in the participant’s geographic region. MAIN OUTCOME(S) AND MEASURE(S): The main outcomes examined were the prevalence and severity of acute (≤28 days post-onset) and post-acute (≥5 weeks post-onset) symptoms. RESULTS: Among 274 immunologically naïve participants, 166 (61%) contracted SARS-CoV-2. Of these, 137 (83%) and 29 (17%) infections occurred during the Omicron- and Delta-predominant periods, respectively. Asymptomatic infections occurred among 6.7% (95% CI: 3.1%, 12.3%) of Omicron cases and 0.0% (95% CI: 0.0%, 11.9%) of Delta cases. Healthcare utilization among Omicron cases was 79% (95% CI: 43%, 92%, P =0.001) lower relative to Delta cases. Relative to Delta, Omicron infections also experienced a 56% (95% CI: 26%, 74%, P =0.004) and 79% (95% CI: 54%, 91%, P <0.001) reduction in the risk and rate of post-acute symptoms, respectively. CONCLUSIONS AND RELEVANCE: These findings suggest that among previously immunologically naïve adults, few Omicron (BA.1/BA.2) and Delta infections are asymptomatic, and relative to Delta, Omicron infections were less likely to seek healthcare and experience post-acute symptoms. Cold Spring Harbor Laboratory 2022-11-14 /pmc/articles/PMC9685683/ /pubmed/36425923 http://dx.doi.org/10.1101/2022.11.13.22282222 Text en https://creativecommons.org/licenses/by-nc-nd/4.0/This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (https://creativecommons.org/licenses/by-nc-nd/4.0/) , which allows reusers to copy and distribute the material in any medium or format in unadapted form only, for noncommercial purposes only, and only so long as attribution is given to the creator.
spellingShingle Article
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
Acute and Post-Acute COVID-19 Outcomes Among Immunologically Naïve Adults During Delta Versus Omicron Waves
title Acute and Post-Acute COVID-19 Outcomes Among Immunologically Naïve Adults During Delta Versus Omicron Waves
title_full Acute and Post-Acute COVID-19 Outcomes Among Immunologically Naïve Adults During Delta Versus Omicron Waves
title_fullStr Acute and Post-Acute COVID-19 Outcomes Among Immunologically Naïve Adults During Delta Versus Omicron Waves
title_full_unstemmed Acute and Post-Acute COVID-19 Outcomes Among Immunologically Naïve Adults During Delta Versus Omicron Waves
title_short Acute and Post-Acute COVID-19 Outcomes Among Immunologically Naïve Adults During Delta Versus Omicron Waves
title_sort acute and post-acute covid-19 outcomes among immunologically naïve adults during delta versus omicron waves
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9685683/
https://www.ncbi.nlm.nih.gov/pubmed/36425923
http://dx.doi.org/10.1101/2022.11.13.22282222
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