Identification of CKD, bedridden history and cancer as higher-risk comorbidities and their impact on prognosis of hospitalized Omicron patients: a multi-centre cohort study

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Abstract
To further describe the effect of the “fragile population” and their “higher-risk” comorbidities on prognosis among hospitalized Omicron patients, this observational cohort study enrolled hospitalized patients confirmed with SARS-CoV-2 during the 2022 Omicron wave in Shanghai, China. The primary outcome was progression to severe or critical cases. The secondary outcome was viral shedding time from the first positive SARS-CoV-2 detection. A total of 847 participants were enrolled, most of whom featured as advanced age (>70 years old: 30.34%), not fully vaccinated (55.84%), combined with at least 1 comorbidity (65.41%). Multivariate cox regression suggested age >70 years old (aHR[95%CI] 0.78[0.61–0.99]), chronic kidney disease (CKD) stage 4–5 (aHR[95%CI] 0.61[0.46–0.80]), heart conditions (aHR[95%CI] 0.76[0.60–0.97]) would elongate viral shedding time and fully/booster vaccination (aHR[95%CI] 1.4 [1.14–1.72]) would shorten this duration. Multivariate logistic regression suggested CKD stage 4–5 (aHR[95%CI] 3.21[1.45–7.27]), cancer (aHR[95%CI] 9.52[4.19–22.61]), and long-term bedridden status (aHR[95%CI] 4.94[2.36–10.44]) were the “higher” risk factor compared with the elderly, heart conditions, metabolic disorders, isolated hypertension, etc. for severity while female (aHR[95%CI] 0.34[0.16–0.68]) and fully/booster Vaccination (aHR[95%CI] 0.35[0.12–0.87]) could provide protection from illness progression. CKD stage 4–5, cancer and long-term bedridden history were “higher-risk” factors among hospitalized Omicron patients for severity progression while full vaccination could provide protection from illness progression.
Funding Information
  • Three-year Action Plan to Promote Clinical Skills and Clinical Innovation Capabilities in Municipal Hospitals
  • Shanghai Municipal Hospital Development Center (SHDC2020CR2039B)
  • Shanghai Shen Kang Hospital Development Center (SHDC2020CR6019)
  • Biomedical Technology Support Special Project of Shanghai 2020 “Science and Technology Innovation Action Plan” (20S31900300)
  • Biomedical Technology Support Special Project of Shanghai 2021 “Science and Technology Innovation Action Plan” (21S31902300)
  • Clinical Research Center (CRC) of Shanghai University of Medicine and Health Sciences (20MC2020001)
  • Science and Technology Commission of Shanghai Municipality (HS2021SHZX001)
  • Science and Technology Commission of Shanghai Municipality (20dz2260100)
  • Science and Technology Commission of Shanghai Municipality (20Z11901100)
  • Science and Technology Commission of Shanghai Municipality (20dz2210403)
  • Key Discipline Construction Plan from Shanghai Municipal Health Commission (GWV-10.1-XK01)
  • Key Discipline Construction Plan from Shanghai Municipal Health Commission (GWV-3.1)
  • Key Discipline Construction Plan from Shanghai Municipal Health Commission (GWV-2)
  • National Key Research and Development Program of China (2021YFC2400805)

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