Patients infected with the Omicron variant of COVID-19 who had comorbid cardiovascular or kidney disease had an increased incidence of pneumonia, according to a study in BMJ Open Respiratory Research.
Researchers assessed patients with Omicron-associated COVID-19 to determine factors related to the highest proportion of cases and to assess these factors’ prognostic value. Toward that end, the researchers analyzed data from 714 outpatients and inpatients, aged 15 to 97 years, who were infected with the Omicron variant in Chongqing, China, from December 20, 2022, to January 20, 2023. All patients had a positive nucleic acid or antigen test result and were included in 3 components of the study.
The first study component evaluated the incidence proportions of Omicron-associated pneumonia.All 714 patients infected with the Omicron variant were included and were stratified into 2 groups, either the pneumonia or the nonpneumonia group. The second study component assessed the prognosis of 186 hospitalized patients with pneumonia, and the third component analyzed laboratory indices in the 186 inpatients.
Of the 714 patients infected with the Omicron variant, 313 presented with pneumonia (43.8%). Among those with pneumonia, 84 patients were older than 80 years of age, and 180 were male. In the 401 patients without pneumonia, 117 were aged 30 to 39 years, and 240 were female.
This study helps us to identify the incidence proportions for pneumonia to protect the susceptible population and helps us to optimize treatment programs to improve the prognosis of patients.
The incidence proportions of pneumonia were greatest in patients who had cardiovascular disease (82.4% of the basic diseases of the cardiovascular system [BDCS] subset) or kidney disease (92.3% of the kidney disease subset). Patients with lung cancer (35.7% of the lung cancer subset) had a lower incidence proportion.
Older patients, men (vs women: odds ratio [OR], 1.66; 95% CI, 1.14-2.41), patients in the BDCS subset (vs healthy patients: OR, 2.01; 95% CI, 1.04-3.87), and patients with kidney disease (vs healthy patients: OR, 10.95; 95% CI, 1.19-101.14) were associated with significantly increased odds of pneumonia, according to binary logistic regression. Lung cancer was associated with marginally lower odds for pneumonia (vs healthy patients: OR, 0.38; 95% CI, 0.16-0.89).
Participants who had thrombosis frequently had a hospital stay greater than 14 days (hazard ratio [HR], 159.83; 95% CI, 6.86-3722.23), and those with a pleural effusion often remained more than 7 days (HR, 50.87; 95% CI, 3.87-668.06). Participants with basic diseases of the respiratory system had an increased mortality risk vs those without (HR, 5.88; 95% CI, 1.09-31.83).
Use of Paxlovid (HR, 0.32; 95% CI, 0.13-0.80) and immunoglobulins (HR, 0.24; 95% CI, 0.09-0.66) was associated with a significantly decreased mortality risk.
Participants with noninvasive ventilation and mechanical ventilation had an increased number of neutrophils (OR, 1.22; 95% CI, 1.12-1.34) and myoglobin (OR, 1.00; 95% CI,1.00-1.01) vs those with routine oxygen inhalation, but a lower number of lymphocytes (OR, 0.43; 95% CI, 0.22-0.87) and partial pressure of oxygen (OR, 0.98; 95% CI, 0.97-0.99).
The researchers noted that they were unable to classify the basic diseases more accurately owing to the limited number of participants.
“This study helps us to identify the incidence proportions for pneumonia to protect the susceptible population and helps us to optimize treatment programs to improve the prognosis of patients,” concluded the investigators.