Clinical phenotypes and outcomes associated with SARS-CoV-2 variant Omicron in critically ill French patients with COVID-19 - Sorbonne Université Access content directly
Journal Articles Nature Communications Year : 2022

Clinical phenotypes and outcomes associated with SARS-CoV-2 variant Omicron in critically ill French patients with COVID-19

1 CHU Henri Mondor [Créteil]
2 CARMAS - Groupe de recherche clinique CARMAS (Cardiovascular and Respiratory Manifestations of Acute lung injury and Sepsis)
3 UPEC UP12 - Université Paris-Est Créteil Val-de-Marne - Paris 12
4 IMRB - Institut Mondor de Recherche Biomédicale
5 Hôpital Henri Mondor
6 2I - Infection et inflammation
7 Hôpital Raymond Poincaré (Garches) [GHU AP-HP Université Paris-Saclay]
8 Hôpital Ambroise Paré [AP-HP]
9 CESP - Centre de recherche en épidémiologie et santé des populations
10 Hôpital Bicêtre [AP-HP, Le Kremlin-Bicêtre]
11 Hôpital Paul Brousse
12 Département des maladies respiratoires [CHU Cochin]
13 CRSA - Centre de Recherche Saint-Antoine
14 CHU Tenon [AP-HP]
15 iPLESP - Institut Pierre Louis d'Epidémiologie et de Santé Publique
16 CHU Saint-Antoine [AP-HP]
17 CRC (UMR_S_1138 / U1138) - Centre de Recherche des Cordeliers
18 AP-HP - Hopital Saint-Louis [AP-HP]
19 GenCellDis (U944 / UMR7212) - Génomes, biologie cellulaire et thérapeutiques
20 Laboratoire de Virologie [CHU Saint-Louis]
21 HIPI (UMR_S_976 / U976) - Immunologie humaine, physiopathologie & immunothérapie
22 RID-AGE - Facteurs de Risque et Déterminants Moléculaires des Maladies liées au Vieillissement - U 1167
23 CHRU Lille - Centre Hospitalier Régional Universitaire [CHU Lille]
24 Hôpital Roger Salengro [Lille]
25 Service de Virologie [Lille]
26 CHU Pitié-Salpêtrière [AP-HP]
27 ICAN - Unité de Recherche sur les Maladies Cardiovasculaires, du Métabolisme et de la Nutrition = Research Unit on Cardiovascular and Metabolic Diseases
28 INEM - UM 111 (UMR 8253 / U1151) - Institut Necker Enfants-Malades
29 IAME (UMR_S_1137 / U1137) - Infection, Anti-microbiens, Modélisation, Evolution
30 AP-HP - Hôpital Bichat - Claude Bernard [Paris]
31 Hôpital Cochin [AP-HP]
32 Service de Virologie [CHU Cochin]
33 Centre Hospitalier Victor Dupouy
34 CeRéMAIA - Hôpital André Mignot - Centre de Référence des Maladies Auto-Inflammatoires et des Amyloses [CH Versailles]
35 Hôpital Avicenne [AP-HP]
36 DCAC - Défaillance Cardiovasculaire Aiguë et Chronique
37 INI-CRCT - Cardiovascular and Renal Clinical Trialists [Vandoeuvre-les-Nancy]
38 CHRU Nancy - Centre Hospitalier Régional Universitaire de Nancy
39 LCPME - Laboratoire de Chimie Physique et Microbiologie pour les Matériaux et l'Environnement
40 Service de Virologie [CHRU Nancy]
41 NanoRegMed - Nanomédecine Régénérative
42 CRBS - Centre de Recherche en Biomédecine de Strasbourg
43 FMTS - Fédération de Médecine Translationnelle de Strasbourg
44 Service de Médecine Intensive et Réanimation [Strasbourg]
45 IRM - Immuno-Rhumatologie Moléculaire
46 Nouvel Hôpital Civil de Strasbourg
47 Hôpital Saint-Camille [Bry-sur-Marne]
48 CHM - Centre Hospitalier de Melun
49 Service de réanimation medico-chirurgicale [CHU Raymond-Poincaré]
50 Hôpital Henri Mondor
51 U955 Inserm - UPEC - IMRB - VHC/"Viruses-Hepatology-Cancers" [Créteil]
Elie Azoulay

Abstract

Infection with SARS-CoV-2 variant Omicron is considered to be less severe than infection with variant Delta, with rarer occurrence of severe disease requiring intensive care. Little information is available on comorbid factors, clinical conditions and specific viral mutational patterns associated with the severity of variant Omicron infection. In this multicenter prospective cohort study, patients consecutively admitted for severe COVID-19 in 20 intensive care units in France between December 7th 2021 and May 1st 2022 were included. Among 259 patients, we show that the clinical phenotype of patients infected with variant Omicron (n = 148) is different from that in those infected with variant Delta (n = 111). We observe no significant relationship between Delta and Omicron variant lineages/sublineages and 28-day mortality (adjusted odds ratio [95% confidence interval] = 0.68 [0.35-1.32]; p = 0.253). Among Omicroninfected patients, 43.2% are immunocompromised, most of whom have received two doses of vaccine or more (85.9%) but display a poor humoral response to vaccination. The mortality rate of immunocompromised patients infected with variant Omicron is significantly higher than that of nonimmunocompromised patients (46.9% vs 26.2%; p = 0.009). In patients infected with variant Omicron, there is no association between specific sublineages (BA.1/BA.1.1 (n = 109) and BA.2 (n = 21)) or any viral genome polymorphisms/ mutational profile and 28-day mortality.
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hal-03947764 , version 1 (19-01-2023)

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Nicolas de Prost, Etienne Audureau, Nicholas Heming, Elyanne Gault, Tài Pham, et al.. Clinical phenotypes and outcomes associated with SARS-CoV-2 variant Omicron in critically ill French patients with COVID-19. Nature Communications, 2022, 13 (1), pp.6025. ⟨10.1038/s41467-022-33801-z⟩. ⟨hal-03947764⟩

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