Impact of SARS-CoV-2 variants on inpatient clinical outcome

alexandrossfakianakis shared this article with you from Inoreader Impact of SARS-CoV-2 variants on inpatient clinical outcome via Clinical Infectious Diseases Advance Access Abstract Background Prior observation has shown differences in COVID-19 hospitalization risk between SARS-CoV-2 variants, but limited information describes hospitalization outcomes. Methods Inpatients with COVID-19 at five hospitals in the eastern United States were included if they had hypoxia, tachypnea, tachycardia, or fever, and SARS-CoV-2 variant data, determined from whole genome sequencing or local surveillance inference. Analyses were stratified by history of SARS-CoV-2 vaccination or infection. The average effect of SARS-CoV-2 variant on 28-day risk of severe disease, defined by advanced respiratory support needs, or death was evaluated using models weighted on propensity scores derived from baseline clinical features. Results Severe disease or death within 28 days occurred for 977 (29%) of 3,369 unvaccinated patients and 269 (22%) of 1,230 patients with history of vaccination or prior SARS-CoV-2 infection. Among unvac cinated patients, the relative risk of severe disease or death for Delta variant compared to ancestral lineages was 1.30 (95% confidence interval [CI] 1.11-1.49). Compared to Delta, this risk for Omicron patients was 0.72 (95% CI 0.59-0.88) and compared to ancestral lineages was 0.94 (95% CI 0.78-1.1). Among Omicron and Delta infections, patients with history of vaccination or prior SARS-CoV-2 infection had half the risk of severe disease or death (adjusted hazard ratio 0.40, 95% CI 0.30-0.54), but no significant outcome difference by variant. Conclusions Although risk of severe disease or death for unvaccinated inpatients with Omicron was lower than Delta, it was similar to ancestral lineages. Severe outcomes were less common in vaccinated inpatients, with no difference between Delta and Omicron infections. View on Web

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Errors of Interpretation - correcting the record on the comparative efficacy of surgical masks versus respirators

alexandrossfakianakis shared this article with you from Inoreader Errors of Interpretation - correcting the record on the comparative efficacy of surgical masks versus respirators via Clinical Infectious Diseases Advance Access View on Web

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Tuberculosis and the Risk of Ischemic Heart Disease: A Nationwide Cohort Study

alexandrossfakianakis shared this article with you from Inoreader Tuberculosis and the Risk of Ischemic Heart Disease: A Nationwide Cohort Study via Clinical Infectious Diseases Advance Access Abstract Background Little is known about the risk of ischemic heart disease (IHD) in tuberculosis (TB) survivors. Methods We performed a population-based retrospective cohort study using the Korean National Health Insurance Service database. TB survivors (n = 60,602) and their 1:1 age- and sex-matched controls (n = 60,602) were enrolled. Eligible participants were followed up from 1 year after their TB diagnosis to the date of an IHD event, date of deat h, or the end of the study period (December 31, 2018), whichever came first. The risk of IHD was estimated using a Cox proportional hazards regression, and stratified analyses were performed for related factors. Among IHD events, we additionally analyzed for myocardial infarction (MI). Results During a median of 3.9 years of follow-up, 2.7% of TB survivors (1,633/60,602) and 2.0% of the matched controls (1,228/60,602) developed IHD, and 0.6% of TB patients (341/60,602) and 0.4% of the matched controls (223/60,602) developed MI. The overall risk of developing IHD and MI was higher in TB patients (adjusted hazard [aHR] 1.21, 95% CI 1.12–1.32 for IHD and aHR 1.48, 95% CI 1.23–1.78 for MI) than in the matched controls. Stratified analyses showed that TB survivors have an increased risk of IHD and MI regardless of income, place of residence, smoking status, alcohol consumption, physical activity, body mass index, and Charlson comorbidity index. Conclusions TB surviv ors have a higher risk of IHD than matched controls. Strategies are needed to reduce the burden of IHD in TB survivors. View on Web

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