Clinical phenotypes and outcomes associated with SARS-CoV-2 Omicron variants BA.2, BA.5 and BQ.1.1 in critically ill patients with COVID-19: a prospective, multicenter cohort study

de Prost, Nicolas; Audureau, Etienne; Préau, Sébastien; Favory, Raphaël; Guigon, Aurélie; Bay, Pierre; Heming, Nicholas; Gault, Elyanne; Pham, Tài; Chaghouri, Amal; Voiriot, Guillaume; Morand-Joubert, Laurence; Jochmans, Sébastien; Pitsch, Aurélia; Meireles, Sylvie; Contou, Damien; Henry, Amandine; Joseph, Adrien; Chaix, Marie-Laure; Uhel, Fabrice; Descamps, Diane; Emery, Malo; Garcia-Sanchez, Claudio; Luyt, Charles-Edouard; Marot, Stéphane; Pène, Frédéric; Lhonneur, Anne-Sophie; Gaudry, Stéphane; Brichler, Ségolène; Picard, Lucile; Mekontso Dessap, Armand; Rodriguez, Christophe; Pawlotsky, Jean-Michel; Fourati, Slim

doi:10.1186/s40635-023-00536-0

Intensive Care Medicine Experimental

Table 1 Clinical and biological characteristics of the 158 patients with severe SARS-CoV-2 infection at the time of their intensive care unit admission according to the infecting SARS-CoV-2 “sublineage groups” (BA.2 vs BA.4/BA.5 vs BQ.1.1 group)

From: Clinical phenotypes and outcomes associated with SARS-CoV-2 Omicron variants BA.2, BA.5 and BQ.1.1 in critically ill patients with COVID-19: a prospective, multicenter cohort study

	Data available	All patients	BA.2	BA.4/BA.5	BQ.1.1 group	p-value
	Data available	N = 158	N = 50	N = 61	N = 47	p-value
Demographics and comorbidities
Sex, females	158	50 (31.6)	13 (26.0)	19 (31.1)	18 (38.3)	0.426
Age, years	158	67.4 (± 13.9)	65.1 (± 13.2)	68.3 (± 10.8)	68.7 (± 14.1)	0.364
Diabetes	158	53 (34.4)	19 (38.0)	21 (36.2)	13 (28.3)	0.566
Obesity	158	41 (26.1)	8 (16.3)	15 (24.6)	18 (38.3)	0.047
Chronic heart failure	158	18 (11.7)	2 (4.0)	8 (13.8)	8 (17.4)	0.079
Hypertension	158	94 (61.0)	29 (58.0)	35 (60.3)	30 (65.2)	0.762
Chronic respiratory failure^a	158	37 (24.2)	13 (26.0)	15 (25.9)	9 (20.0)	0.738
Chronic renal failure^b	158	33 (21.4)	12 (24.0)	15 (25.9%)	6 (13.0)	0.247
Cirrhosis	158	3 (1.9)	1 (2.0)	2 (3.4)	0 (0)	0.777
Immunosuppression	158	63 (40.9)	28 (56.0)	23 (39.7)	12 (26.1)	0.012
Immunosuppression
None		91 (59.1)	22 (44.0)	35 (60.3)	34 (73.9)	< 0.0001
Solid organ transplant		20 (13.0)	9 (18.0)	9 (15.5)	2 (4.3)
Onco-hematological malignancies		20 (13.0)	7 (14.0)	7 (12.1)	6 (13.0)
Others^c		23 (14.9)	12 (24.0)	7 (12.1)	4 (8.7)
Number of comorbidities^d	158	2 (1;3)	2 (1;3)	2 (1;3)	2 (1;3)	0.694
Clinical frailty scale	156	3 (3;4)	4 (3;4)	3 (3;4)	3 (3;5)	0.751
SARS-CoV-2 infection and Vaccination
Previous SARS-CoV-2 infection	158	8 (5.2)	3 (6.0)	4 (6.9)	1 (2.2)	0.598
SARS-CoV-2 vaccination	158	116 (75.8)	42 (84.0)	43 (74.1)	31 (68.9)	0.213
Number of doses among vaccinated	111	3 (3;3)	3 (3;3)	3 (3;3)	3 (3;4)	0.452
3rd dose- ICU admission^e, days	15	190 (163;265)	153 (132;181)	231 (200;265)	307 (190;528)	0.013
Last dose—ICU admission^e, days	25	182 (132;254)	153 (101;181)	200 (86;265)	257 (190;508)	0.157
SARS-CoV-2 serology at ICU admission
Unavailable	158	80 (50.6)	18 (31.53%)	41 (67.2)	21 (44.7)	0.008
Negative^f	158	22 (13.9)	8 (38.74%)	8 (13.1)	6 (12.8)
Positive	158	56 (35.4)	24 (29.73%)	12 (19.7)	20 (42.6)
First symptoms—ICU admission, days	158	5 (2;10)	7 (3;13)	4 (2;9)	3 (1;7)	0.013
SARS-CoV-2 RNA detection in nasopharyngeal swabs, Ct	114	20 (16;24)	21 (18;26)	20 (16;23)	19 (15;23)	0.123
Patients severity upon ICU admission and biological features
WHO 10-point scale	157	6 (6;6)	6 (6;6)	6 (5;6)	6 (6;7)	0.598
SAPS II score	153	35 (28;45)	35 (30;43)	37 (30;47)	33 (27;46)	0.460
SOFA score	153	4 (3;7)	5 (3;7)	4 (3;7)	4 (3;7)	0.801
PaO₂/FiO₂ ratio, mmHg	154	150 (98;233)	158 (110;214)	150 (98;257)	140 (97;217)	0.856
ARDS criteria	154	110 (71.4)	37 (75.5)	41 (69.9)	62 (69.6)	0.791
Arterial lactate level, mM	154	1.6 (1.0;2.4)	1.5 (1.0;2.1)	1.5 (1.0;2.4)	1.8 (1.1;3.0)	0381
Blood leukocytes, G/L	156	9.9 (6.4;13.3)	9.8 (5.5;13.3)	8.6 (6.7;13.0)	10.2 (6.3;13.4)	0.187
Blood lymphocytes, G/L	124	0.5 (0.3;0.8)	0.5 (0.2;0.8)	0.4 (0.3;0.7)	0.6 (0.3;1.0)	0.491
Blood platelets, G/L	156	185 (133;262)	165 (111;249)	195 (140;266)	198 (135;278)	0.183
Serum urea level, mM	157	9 (6;15)	10 (6;15)	9 (6;18)	8 (6;13)	0.118
Serum creatinine level, µM	157	101 (71;164)	100 (71;154)	129 (76;222)	92 (69;137)	0.217
Bacterial coinfection	158	35 (22.3)	12 (24.0)	10 (16.7)	13 (27.7)	0.375
Thoracic CT-scan	157	87 (55.4)	30 (60.0)	29 (48.3)	28 (59.6)	0.373
Pulmonary embolism	156	5 (5.7)	1 (3.3)	2 (6.7)	2 (7.4)	0.685
Lung parenchyma involvement, %	55	40 (25;75)	75 (40;75)	35 (25;51)	40 (25;62)	0.063
Oxygen/ventilatory support
Oxygen	158	35 (22.6)	7 (14.0)	16 (27.1)	12 (26.1)	0.584
High flow oxygen	158	62 (40.0)	25 (50.0)	22 (37.3)	15 (32.6)
NIV/C-PAP	158	19 (12.3)	6 (12.0)	7 (11.9)	6 (13.0)
Invasive MV	158	39 (25.2)	12 (24.0)	14 (23.7)	13 (28.3)
ECMO support	158	1 (0.6)	1 (2.0)	0 (0)	0 (0)	0.618
Vasopressor support	158	28 (17.8)	8 (16.0)	10 (16.7)	10 (21.3)	0.780

Results are N(%), means (± standard deviation) or medians (interquartile range). ^arequiring long-term oxygen treatment; ^bdefined as glomerular filtration rate < 60 mL/min/1.73 m^{2 c}includes HIV infection, long-term corticosteroid treatment, and other immunosuppressive treatments; ^dinclude diabetes, obesity, chronic heart, renal and respiratory failure, hypertension, cirrhosis, and immunosuppression; ^etime lag between the last vaccination dose and ICU admission; ^fdefined as < 30 Binding Antibody Units (BAU)/mL; ARDS: acute respiratory distress syndrome; ICU: intensive care unit; Ct: cycle threshold; WHO: World Health Organization; SOFA: Sequential Organ Failure Assessment; SAPS II: Simplified Acute Physiology Score II; NIV: non-invasive ventilation; C-PAP; continuous-positive airway pressure; MV: mechanical ventilation; ECMO: extracorporeal mechanical ventilation; Two-tailed p-values come from unadjusted comparisons using Chi square or Fisher’s exact tests for categorical variables, and t-tests or Mann–Whitney tests for continuous variables, as appropriate. No adjustment for multiple comparisons was performed; Bolded p-values are significant at the p < 0.05 level

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