AUTHOR=Roser Lynn P. , Samanapally Harideep , Ali T’shura , Xu Qian , Han Yuchen , Salunkhe Vidyulata , Deepti Fnu , McGuffin Trevor , Huang Emma C. , Furmanek Stephen , Glynn Alex , Ramirez Julio , Jones Christopher M. , Mariyappa Ramesh , Hogue Ryan J. , Williams Alexander M. , Huang Justin J. , Arnold Forest W. , Clifford Sean P. , Pahwa Siddharth , Kong Maiying , Huang Jiapeng 

TITLE=Different clinical characteristics and outcomes of adult hospitalized SARS-CoV-2 pneumonia patients complicated by cardiovascular events during the first, delta and omicron waves of COVID-19

JOURNAL=Frontiers in Epidemiology

VOLUME=Volume 4 - 2024

YEAR=2024

URL=https://www.frontiersin.org/journals/epidemiology/articles/10.3389/fepid.2024.1342917

DOI=10.3389/fepid.2024.1342917

ISSN=2674-1199

ABSTRACT=Background: The effects of SARS-CoV-2 have varied between significant waves of hospitalization. 
Research Question: Are cardiovascular complications different among the first, delta and omicron waves of hospitalized COVID-19 pneumonia patients? 
Study Design and Methods: This was a multi-centre retrospective study of patients hospitalized with SARS-CoV-2 pneumonia: 632 were hospitalized during the first wave (March–July 2020), 1013 during the delta wave (September 2020–March 2021), and 323 during the omicron wave (January 2022-July 2022). Patients were stratified by wave and occurrence of cardiovascular events. 
Results: Among all hospitalized patients with cardiovascular events, patients in the omicron wave were younger (62.4 ±14 years) than patients in the first wave (67.4 ±7.8 years) and the delta wave (66.9 ±12.6 years) and had a higher proportion of non-Hispanic White people than in the first wave (78.6% vs 61.7%). For COVID-19 patients who suffered from cardiovascular events, the omicron wave patients had significantly higher neutrophil/lymphocyte ratio, white blood cell and platelet counts when compared to the first wave. Omicron wave patients had significantly lower albumin and B-type natriuretic peptide levels (only 5.8% of the first wave and 14.6% of the delta wave) when compared to either the first wave or delta wave patients. In COVID-19 patients who suffered cardiovascular events during hospitalization, mortality rate in the omicron wave (26.8%) was significantly lower than the first wave (48.3%), time to mortality for non-survivors of COVID-19 patients who suffered cardiovascular events was significantly longer in the omicron wave (median 16 days) than in the first wave (median 10 days).
Conclusions: Younger and white patients were affected with cardiovascular complications more often by the omicron variant. Despite higher neutrophil/lymphocyte ratio and WBC counts, the omicron patients with cardiovascular events showed lower heart injuries, lower mortality and longer time to mortality for non-survivors when compared to the first and delta waves.