Comparing the survival of adult inpatients with COVID-19 during the wild-type, Delta, and Omicron emergence

Abstract

Objective: This study aimed to compare the survival experience of adult inpatients with laboratory-confirmed COVID-19 during the first three waves (wild type, Delta, and Omicron) of the pandemic in Mexico.

Study design: A retrospective and nationwide study was conducted.

Methods: Data from 229,311 participants were analyzed using the Kaplan-Meier method, and estimates per each pandemic wave were obtained. A multivariate Cox proportional hazard regression model was fitted, and hazard ratios (HRs) and 95% confidence intervals (CIs) were computed.

Results: The overall mortality rate was 49.1 per 1000 person-days. Heterogeneous survival rates were observed during the analyzed emergences (log-rank test, P < 0.001), and the lowest survival functions were computed during the Omicron variant dominance. In multiple analyses and after adjusting by host characteristics and COVID-19 vaccination status, cases occurring during the Delta (vs wild type: HR = 1.03, 95% CI 1.01-1.05) and Omicron emergence were at increased risk for a fatal in-hospital outcome (HR = 1.17, 95% CI 1.13-1.22).

Conclusions: Our results suggest variant-related differences in the survival rates of hospitalized patients with laboratory-positive COVID-19. When compared with the wild-type virus, lower rates were observed during the Delta and Omicron emergence.

Keywords: COVID-19; Inpatients; SARS-CoV-2; Survival rate.