Decreased severity of disease during the first global omicron variant covid-19 outbreak in a large hospital in tshwane, south africa.
Decreased severity of disease during the first global omicron variant covid-19 outbreak in a large hospital in tshwane, south africa.
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DOI：
10.1016/j.ijid.2021.12.357
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发表时间：
2022-03
期刊：
影响因子：
--
通讯作者：
Jassat W
中科院分区：
文献类型：
--
作者：
Abdullah F;Myers J;Basu D;Tintinger G;Ueckermann V;Mathebula M;Ramlall R;Spoor S;de Villiers T;Van der Walt Z;Cloete J;Soma-Pillay P;Rheeder P;Paruk F;Engelbrecht A;Lalloo V;Myburg M;Kistan J;van Hougenhouck-Tulleken W;Boswell MT;Gray G;Welch R;Blumberg L;Jassat W
2019年12月在中国武汉首次报告的2019年冠状病毒病（COVID-19）是一种全球大流行病，正在威胁着全世界人民的健康和福祉。迄今为止，已报告的病例超过2.74亿例，死亡530万例。2021年11月9日在南非豪登省茨瓦内市首次记录到的Omicron变异病毒导致病例呈指数级增长，入院人数急剧上升。Tshwane一家大型医院收治的患者的临床资料与以前的波进行了比较。自2021年11月14日起，466名新冠肺炎患者入院，而自2020年5月4日（奥密克隆爆发前）起，则有3，962名患者入院。对疫情期间床位占用高峰期的98例患者记录进行了审查，以确定入院的主要适应症、临床严重程度、供氧水平、疫苗接种和既往COVID-19感染。全省和全市范围的每日病例和报告死亡、住院和超额死亡数据来自国家传染病研究所、国家卫生部和南非医学研究理事会。对于Omicron和之前的波，死亡和ICU入院率分别为4.5% vs 21.3%（p<0.00001）和1% vs 4.3%（p<0.00001）;住院时间为4.0天vs 8.8天;平均年龄为39岁vs 49.8岁。Omicron波的入院人数达到峰值，并迅速下降，峰值床位占用率为Delta波期间最高峰的51%。COVID-19病房的62名（63%）患者在SARS-CoV-2 PCR检测阳性后偶然发生COVID-19。只有三分之一（36人）患有COVID-19肺炎，其中72%患有轻度至中度疾病。其余28%需要高度护理或ICU入院。在COVID-19病房中，只有不到一半（45%）的患者需要补充氧气，而第一波患者的比例为99.5%。在Omicron浪潮期间，城市和省一级的病例呈指数增长，死亡率显示，与前几波相比，病例和死亡脱钩，证实了史蒂夫·比科学术医院收治的患者病情严重程度下降的临床结果。在其第一个全球震中茨瓦内市，Omicron驱动的第四波COVID-19疾病的严重程度有所下降。
The coronavirus disease 2019 (COVID-19) first reported in Wuhan, China in December 2019 is a global pandemic that is threatening the health and wellbeing of people worldwide. To date there have been more than 274 million reported cases and 5.3 million deaths. The Omicron variant first documented in the City of Tshwane, Gauteng Province, South Africa on 9 November 2021 led to exponential increases in cases and a sharp rise in hospital admissions. The clinical profile of patients admitted at a large hospital in Tshwane is compared with previous waves. 466 hospital COVID-19 admissions since 14 November 2021 were compared to 3962 admissions since 4 May 2020, prior to the Omicron outbreak. Ninety-eight patient records at peak bed occupancy during the outbreak were reviewed for primary indication for admission, clinical severity, oxygen supplementation level, vaccination and prior COVID-19 infection. Provincial and city-wide daily cases and reported deaths, hospital admissions and excess deaths data were sourced from the National Institute for Communicable Diseases, the National Department of Health and the South African Medical Research Council. For the Omicron and previous waves, deaths and ICU admissions were 4.5% vs 21.3% (p<0.00001), and 1% vs 4.3% (p<0.00001) respectively; length of stay was 4.0 days vs 8.8 days; and mean age was 39 years vs 49,8 years. Admissions in the Omicron wave peaked and declined rapidly with peak bed occupancy at 51% of the highest previous peak during the Delta wave. Sixty two (63%) patients in COVID-19 wards had incidental COVID-19 following a positive SARS-CoV-2 PCR test . Only one third (36) had COVID-19 pneumonia, of which 72% had mild to moderate disease. The remaining 28% required high care or ICU admission. Fewer than half (45%) of patients in COVID-19 wards required oxygen supplementation compared to 99.5% in the first wave. The death rate in the face of an exponential increase in cases during the Omicron wave at the city and provincial levels shows a decoupling of cases and deaths compared to previous waves, corroborating the clinical findings of decreased severity of disease seen in patients admitted to the Steve Biko Academic Hospital. There was decreased severity of COVID-19 disease in the Omicron-driven fourth wave in the City of Tshwane, its first global epicentre.
影响因子：
64.8
作者：
Viana R;Moyo S;Amoako DG;Tegally H;Scheepers C;Althaus CL;Anyaneji UJ;Bester PA;Boni MF;Chand M;Choga WT;Colquhoun R;Davids M;Deforche K;Doolabh D;du Plessis L;Engelbrecht S;Everatt J;Giandhari J;Giovanetti M;Hardie D;Hill V;Hsiao NY;Iranzadeh A;Ismail A;Joseph C;Joseph R;Koopile L;Kosakovsky Pond SL;Kraemer MUG;Kuate-Lere L;Laguda-Akingba O;Lesetedi-Mafoko O;Lessells RJ;Lockman S;Lucaci AG;Maharaj A;Mahlangu B;Maponga T;Mahlakwane K;Makatini Z;Marais G;Maruapula D;Masupu K;Matshaba M;Mayaphi S;Mbhele N;Mbulawa MB;Mendes A;Mlisana K;Mnguni A;Mohale T;Moir M;Moruisi K;Mosepele M;Motsatsi G;Motswaledi MS;Mphoyakgosi T;Msomi N;Mwangi PN;Naidoo Y;Ntuli N;Nyaga M;Olubayo L;Pillay S;Radibe B;Ramphal Y;Ramphal U;San JE;Scott L;Shapiro R;Singh L;Smith-Lawrence P;Stevens W;Strydom A;Subramoney K;Tebeila N;Tshiabuila D;Tsui J;van Wyk S;Weaver S;Wibmer CK;Wilkinson E;Wolter N;Zarebski AE;Zuze B;Goedhals D;Preiser W;Treurnicht F;Venter M;Williamson C;Pybus OG;Bhiman J;Glass A;Martin DP;Rambaut A;Gaseitsiwe S;von Gottberg A;de Oliveira T
通讯作者：
de Oliveira T