Retrospective Study
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Infect Dis. Nov 22, 2023; 13(4): 37-48
Published online Nov 22, 2023. doi: 10.5495/wjcid.v13.i4.37
Analysis of clinical characteristics and risk factors between elderly patients with severe and nonsevere Omicron variant infection
Xiao-Qin Liu, Guan-Zhu Lu, Dong-Lin Yin, Yao-Yue Kang, Yuan-Yuan Zhou, Yu-Huan Wang, Jie Xu
Xiao-Qin Liu, Guan-Zhu Lu, Dong-Lin Yin, Yao-Yue Kang, Yuan-Yuan Zhou, Yu-Huan Wang, Jie Xu, Department of Infectious Disease, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China
Author contributions: Liu XQ designed the research study, analysed the data, and wrote the manuscript; Lu GZ, Yin DL, Kang YY, Zhou YY, and Wang YH collected and analysed the data; Xu J designed the research study and reviewed and revised the paper.
Institutional review board statement: This study was reviewed and approved by the Ethics Committee of the Ninth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine (Ethics Approval No.: SH9H-2022-T139-1).
Informed consent statement: As the study used anonymous and pre-existing data, the requirement for the informed consent from patients was waived.
Conflict-of-interest statement: We have no financial relationships to disclose.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jie Xu, MD, Chief Physician, Department of Infectious Disease, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, No. 639 Manufacturing Bureau Road, Huangpu District, Shanghai 200011, China. xujie@shsmu.edu.cn
Received: October 3, 2023
Peer-review started: October 3, 2023
First decision: October 24, 2023
Revised: November 2, 2023
Accepted: November 13, 2023
Article in press: November 13, 2023
Published online: November 22, 2023
ARTICLE HIGHLIGHTS
Research background

Elderly patients are at higher risk of contracting and dying from coronavirus disease 2019 (COVID-19) due to advanced age, decreased immune function, intense inflammatory response, and comorbidities. Omicron, a new variant of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has a high transmission rate and significant antibody avoidance, posing a great threat to the prevention and control of COVID-19.

Research motivation

Previous studies have evaluated risk factors for severity or death among elderly people with COVID-19, though analyses of Omicron infection risk and protective factors among elderly people are relatively few.

Research objectives

To identify clinical features and risk factors for disease progression among elderly patients with Omicron infection to provide solid evidence for clinical policy-makers, public health officials, researchers, and the general public.

Research methods

A chi-square test, t test, Mann-Whitney U test, hierarchical log-rank test, univariate and multivariate logistic regression analyses, and hierarchical analyses were used to determine significant differences between elderly patients with severe and nonsevere Omicron SARS-CoV-2 variant infection.

Research results

The clinical course of severe disease patients is more complex, as both the need for symptomatic treatment and the risk of death are higher than those of nonsevere disease patients. Oxygen saturation, cerebral infarction, and D-dimer are risk factors for developing severe COVID-19. D-dimer also showed a suitable role in identifying severe infection.

Research conclusions

Elderly people are vulnerable to severe illness and death due to their age and comorbidities, especially elderly patients with preexisting cerebral infarction. D-dimer is a risk factor for severe COVID-19 in elderly patients and has a good recognition function for severe disease.

Research perspectives

A comprehensive assessment of the comorbidities of older patients with COVID-19 may help to establish risk stratification for admission of COVID-19 patients, and dynamic monitoring of D-dimer levels can provide valuable information for planning appropriate interventions at the health assistance level.