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Laboratory markers of severity across three COVID-19 outbreaks in Australia: has Omicron and vaccinations changed disease presentation?
Wang, Julie; Choy, Kay Weng; Lim, Hui Yin; Ho, Prahlad.
  • Wang J; Northern Health, Northern Hospital, 185 Cooper St Epping, Melbourne, VIC, 3076, Australia. Julie.wang@nh.org.au.
  • Choy KW; Northern Pathology Victoria, Epping, VIC, Australia. Julie.wang@nh.org.au.
  • Lim HY; University of Melbourne, Parkville, VIC, Australia. Julie.wang@nh.org.au.
  • Ho P; Northern Health, Northern Hospital, 185 Cooper St Epping, Melbourne, VIC, 3076, Australia.
Intern Emerg Med ; 2022 Sep 14.
Article in English | MEDLINE | ID: covidwho-2236798
ABSTRACT
COVID-19 has rapidly evolved since it was first discovered in December 2019. We aimed to retrospectively review our experience with COVID-19 infection across 2020-2022, focusing on differences in laboratory markers at presentation. Consecutive adult patients admitted to hospital with confirmed COVID-19 infection were retrospectively reviewed across three periods (29/3/2020-29/9/2020, 16/8/2021-13/10/2021 and 1/1/2022-31/1/2022), correlating with the lineages B.1.338, Delta (B.1.617.2) and Omicron (B.1.1.159), respectively. Laboratory findings of the first requested blood test within 24 h of presentation were recorded and correlated with patient outcome. The primary outcome was requirement for oxygen therapy at any point. Inflammatory markers, namely serum ferritin, lactate dehydrogenase (LDH), C-reactive protein (CRP) were significantly lower on presentation during 2022 compared to 2021, corresponding to a milder disease course. More than 80% of 2022 patients had received 2 or more vaccine doses and fully vaccinated patients displayed significantly lower inflammatory markers at presentation. Using 2022 data, a multivariate prediction model was constructed to predict for oxygen requirement, with c-statistic 0.86. Patients in 2022, corresponding with the Omicron variant, displayed a milder disease course, even in hospitalised patients, with the majority not requiring oxygen and lower inflammatory markers. We constructed a simple-to-use risk prediction model with c-statistic 0.86 which may identify individuals who can be safely managed as outpatients in the era of highly transmissible variants.
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Full text: Available Collection: International databases Database: MEDLINE Type of study: Prognostic study Topics: Vaccines / Variants Language: English Journal subject: Emergency Medicine / Internal Medicine Year: 2022 Document Type: Article Affiliation country: S11739-022-03081-y

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Full text: Available Collection: International databases Database: MEDLINE Type of study: Prognostic study Topics: Vaccines / Variants Language: English Journal subject: Emergency Medicine / Internal Medicine Year: 2022 Document Type: Article Affiliation country: S11739-022-03081-y