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Inflammatory Biomarkers Differ among Hospitalized Veterans Infected with Alpha, Delta, and Omicron SARS-CoV-2 Variants

Author

Listed:
  • Catherine Park

    (VA’s Health Services Research and Development Service (HSR&D), Center for Innovations in Quality, Effectiveness, and Safety, Michael E. DeBakey VA Medical Center, Houston, TX 77030, USA
    Big Data Scientist Training Enhancement Program, VA Office of Research and Development, Washington, DC 20420, USA
    VA Quality Scholars Coordinating Center, IQuESt, Michael E. DeBakey VA Medical Center, Houston, TX 77030, USA)

  • Shahriar Tavakoli-Tabasi

    (Department of Medicine, Baylor College of Medicine, Houston, TX 77030, USA)

  • Amir Sharafkhaneh

    (VA’s Health Services Research and Development Service (HSR&D), Center for Innovations in Quality, Effectiveness, and Safety, Michael E. DeBakey VA Medical Center, Houston, TX 77030, USA
    Department of Medicine, Baylor College of Medicine, Houston, TX 77030, USA)

  • Benjamin J. Seligman

    (David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA 90024, USA)

  • Bret Hicken

    (VHA Office of Rural Health, Veterans Rural Health Resource Center, Salt Lake City, UT 84148, USA
    George E. Wahlen Department of Veterans Affairs Medical Center, Salt Lake City, UT 84148, USA)

  • Christopher I. Amos

    (Department of Medicine, Baylor College of Medicine, Houston, TX 77030, USA)

  • Andrew Chou

    (VA’s Health Services Research and Development Service (HSR&D), Center for Innovations in Quality, Effectiveness, and Safety, Michael E. DeBakey VA Medical Center, Houston, TX 77030, USA
    Section of Infectious Diseases, Department of Medicine, Baylor College of Medicine, Houston, TX 77030, USA)

  • Javad Razjouyan

    (VA’s Health Services Research and Development Service (HSR&D), Center for Innovations in Quality, Effectiveness, and Safety, Michael E. DeBakey VA Medical Center, Houston, TX 77030, USA
    Big Data Scientist Training Enhancement Program, VA Office of Research and Development, Washington, DC 20420, USA
    VA Quality Scholars Coordinating Center, IQuESt, Michael E. DeBakey VA Medical Center, Houston, TX 77030, USA
    Department of Medicine, Baylor College of Medicine, Houston, TX 77030, USA)

Abstract

Mortality due to COVID-19 has been correlated with laboratory markers of inflammation, such as C-reactive protein (CRP). The lower mortality during Omicron variant infections could be explained by variant-specific immune responses or host factors, such as vaccination status. We hypothesized that infections due to Omicron variant cause less inflammation compared to Alpha and Delta, correlating with lower mortality. This was a retrospective cohort study of veterans hospitalized for COVID-19 at the Veterans Health Administration. We compared inflammatory markers among patients hospitalized during Omicron infection with those of Alpha and Delta. We reported the adjusted odds ratio (aOR) of the first laboratory results during hospitalization and in-hospital mortality, stratified by vaccination status. Of 2,075,564 Veterans tested for COVID-19, 29,075 Veterans met the criteria: Alpha (45.1%), Delta (23.9%), Omicron (31.0%). Odds of abnormal CRP in Delta (aOR = 1.85, 95% CI:1.64–2.09) and Alpha (aOR = 1.94, 95% CI:1.75–2.15) were significantly higher compared to Omicron. The same trend was observed for Ferritin, Alanine aminotransferase, Aspartate aminotransferase, Lactate dehydrogenase, and Albumin. The mortality in Delta (aOR = 1.92, 95% CI:1.73–2.12) and Alpha (aOR = 1.68, 95% CI:1.47–1.91) were higher than Omicron. The results remained significant after stratifying the outcomes based on vaccination status. Veterans infected with Omicron showed milder inflammatory responses and lower mortality than other variants.

Suggested Citation

  • Catherine Park & Shahriar Tavakoli-Tabasi & Amir Sharafkhaneh & Benjamin J. Seligman & Bret Hicken & Christopher I. Amos & Andrew Chou & Javad Razjouyan, 2023. "Inflammatory Biomarkers Differ among Hospitalized Veterans Infected with Alpha, Delta, and Omicron SARS-CoV-2 Variants," IJERPH, MDPI, vol. 20(4), pages 1-11, February.
    • Handle: RePEc:gam:jijerp:v:20:y:2023:i:4:p:2987-:d:1061980
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    References listed on IDEAS

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    1. Kenrie P. Y. Hui & John C. W. Ho & Man-chun Cheung & Ka-chun Ng & Rachel H. H. Ching & Ka-ling Lai & Tonia Tong Kam & Haogao Gu & Ko-Yung Sit & Michael K. Y. Hsin & Timmy W. K. Au & Leo L. M. Poon & M, 2022. "SARS-CoV-2 Omicron variant replication in human bronchus and lung ex vivo," Nature, Nature, vol. 603(7902), pages 715-720, March.
    2. Heidi Ledford, 2021. "How severe are Omicron infections?," Nature, Nature, vol. 600(7890), pages 577-578, December.
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