Description of Hospitalizations due to the Severe Acute Respiratory Syndrome Coronavirus 2 Omicron Variant Based on Vaccination Status

Matthew A Moffa; Nathan R Shively; Dustin R Carr; Derek N Bremmer; Carley Buchanan; Tamara L Trienski; Max W Jacobs; Vikram Saini; Thomas L Walsh

doi:10.1093/ofid/ofac438

Description of Hospitalizations due to the Severe Acute Respiratory Syndrome Coronavirus 2 Omicron Variant Based on Vaccination Status

Open Forum Infect Dis. 2022 Aug 25;9(9):ofac438. doi: 10.1093/ofid/ofac438. eCollection 2022 Sep.

Authors

Matthew A Moffa¹, Nathan R Shively¹, Dustin R Carr², Derek N Bremmer², Carley Buchanan², Tamara L Trienski², Max W Jacobs³, Vikram Saini¹, Thomas L Walsh¹

Affiliations

¹ Medicine Institute and Division of Infectious Diseases, Allegheny Health Network, Pittsburgh, Pennsylvania, USA.
² Department of Pharmacy, Allegheny Health Network, Pittsburgh, Pennsylvania, USA.
³ Medicine Institute, Allegheny Health Network, Pittsburgh, Pennsylvania, USA.

Abstract

Background: Limited descriptive data exist regarding the clinical characteristics of hospitalizations due to the severe acute respiratory syndrome coronavirus 2 Omicron variant based on vaccination status.

Methods: This was a retrospective cohort study of all patients hospitalized with a diagnosis of coronavirus disease 2019 (COVID-19) between 15 January 2022 and 15 February 2022 across 9 hospitals in a large health network. Data were extracted by manual records review.

Results: A total of 351 of 452 (77.7%) unvaccinated, 209 of 331 (63.1%) fully vaccinated, and 107 of 163 (65.6%) boosted patients hospitalized with a COVID-19 diagnosis were determined to be admitted specifically due to COVID-19 (P < .001). Most (85%) boosted patients admitted due to COVID-19 were at least 65 years old and/or had severe immunosuppression, compared to 72.2% of fully vaccinated and 60.7% of unvaccinated patients (P < .001). Significantly more unvaccinated patients (34.2%) required >6 L/minute of supplemental oxygen compared to fully vaccinated (24.4%) and boosted (25.2%) patients (P = .027). The age-adjusted vaccine effectiveness (VE) against hospitalization due to COVID-19 was estimated to be 81.1% and 94.1% for full vaccination and boosted status, respectively, whereas VE against mortality related to COVID-19 was estimated to be 84.7% and 94.8%, respectively.

Conclusions: During the Omicron BA.1 sublineage wave, unvaccinated patients hospitalized with a COVID-19 diagnosis were more likely than vaccinated patients to be admitted specifically due to COVID-19. Despite being younger with fewer comorbidities, unvaccinated patients required higher levels of care. Vaccination with a booster provides the greatest protection against hospitalization and death from COVID-19.

Keywords: COVID-19; Omicron; SARS-CoV-2; hospitalization; vaccination.