Evidence map›Paper›PMID 37255285›Full record

ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2023

Changing Severity and Epidemiology of Adults Hospitalized With Coronavirus Disease 2019 (COVID-19) in the United States After Introduction of COVID-19 Vaccines, March 2021-August 2022.

Noah Kojima, Katherine Adams, Wesley H Self, Manjusha Gaglani, Tresa McNeal, Shekhar Ghamande, Jay S Steingrub, Nathan I Shapiro, Abhijit Duggal, Laurence W Busse and 36 more

Abstract read
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In one paragraph

Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
23citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

23 citing papers in PubMed, 1 synthesis or guideline pooled it.

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  20. SARS-CoV-2 Case-Definitions Must Include Clinical Criteria: Reply to Kojima et al.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2023
    Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

46 authors.

Noah KojimaInfluenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.ORCID 0000-0002-3667-9719
Katherine AdamsInfluenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Wesley H SelfDepartment of Emergency Medicine and Vanderbilt Institute for Clinical and Translational Research, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Manjusha GaglaniDepartment of Pediatrics, Baylor Scott & White Health and Texas A&M University College of Medicine, Temple and Dallas, Texas, USA.
Tresa McNealDepartment of Medical Education, Baylor Scott & White Health, Texas A&M University College of Medicine, Temple, Texas, USA.
Shekhar GhamandeDepartment of Medical Education, Baylor Scott & White Health, Texas A&M University College of Medicine, Temple, Texas, USA.
Jay S SteingrubDepartment of Medicine, Baystate Medical Center, Springfield, Massachusetts, USA.
Nathan I ShapiroDepartment of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA.
Abhijit DuggalDepartment of Medicine, Cleveland Clinic, Cleveland, Ohio, USA.
Laurence W BusseDepartment of Medicine, Emory University, Atlanta, Georgia, USA.
Matthew E PrekkerDepartment of Emergency Medicine and Medicine, Hennepin County Medical Center, Minneapolis, Minnesota, USA.
Ithan D PeltanDepartment of Medicine, Intermountain Medical Center, Murray, Utah and University of Utah, Salt Lake City, Utah, USA.
Samuel M BrownDepartment of Medicine, Intermountain Medical Center, Murray, Utah and University of Utah, Salt Lake City, Utah, USA.
David N HagerDepartment of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Harith AliDepartment of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Michelle N GongDepartment of Medicine, Montefiore Health System, Albert Einstein College of Medicine, Bronx, New York, USA.
Amira MohamedDepartment of Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York, USA.
Matthew C ExlineDepartment of Medicine, The Ohio State University, Columbus, Ohio, USA.
Akram KhanDepartment of Medicine, Oregon Health and Sciences University, Portland, Oregon, USA.
Jennifer G WilsonDepartment of Emergency Medicine, Stanford University School of Medicine, Stanford, California, USA.
Nida QadirDepartment of Medicine, University of California-Los Angeles, Los Angeles, California, USA.
Steven Y ChangDepartment of Medicine, University of California-Los Angeles, Los Angeles, California, USA.
Adit A GindeDepartment of Emergency Medicine, University of Colorado School of Medicine, Aurora, Colorado, USA.
Cori A WithersDepartment of Emergency Medicine, University of Colorado School of Medicine, Aurora, Colorado, USA.
Nicholas M MohrDepartment of Emergency Medicine, University of Iowa, Iowa City, Iowa, USA.
Christopher MallowDepartment of Medicine, University of Miami, Miami, Florida, USA.
Emily T MartinSchool of Public Health, University of Michigan, Ann Arbor, Michigan, USA.
Adam S LauringDepartment of Internal Medicine, University of Michigan, Ann Arbor, Michigan, USA.
Nicholas J JohnsonDepartment of Emergency Medicine and Division of Pulmonary, Critical Care and Sleep Medicine, University of Washington, Seattle, Washington, USA.
Jonathan D CaseyDepartment of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
William B StubblefieldDepartment of Emergency Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Kevin W GibbsDepartment of Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA.
Jennie H KwonDepartment of Medicine, Washington University, St. Louis, Missouri, USA.
Adrienne BaughmanDepartment of Emergency Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
James D ChappellDepartment of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Kimberly W HartDepartment of Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Ian D JonesDepartment of Emergency Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Jillian P RhoadsVanderbilt Institute for Clinical and Translational Research, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Sydney A SwanDepartment of Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Kelsey N WomackVanderbilt Institute for Clinical and Translational Research, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Yuwei ZhuDepartment of Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Diya SurieCoronavirus and Other Respiratory Viruses Division, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Meredith L McMorrowCoronavirus and Other Respiratory Viruses Division, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Manish M PatelInfluenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Mark W TenfordeInfluenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Investigating Respiratory Viruses in the Acutely Ill (IVY) Network

Funding

Vanderbilt Institute for Clinical and Translational Research (VICTR) -Identifying correlates of functional immunity in SARS-CoV-2 convalescent plasmaUL1TR002243 · NCATS · VANDERBILT UNIVERSITY MEDICAL CENTER · PI Paul A. Harris, Wesley H Self · 2017 to 2026
$130.7M
Memory T follicular helper cell kinetics and localization during recall immune responses to tetanus vaccinationK08AI141761 · NIAID · HENNEPIN HEALTHCARE RESEARCH INSTITUTE · PI FROSCH, ANNE ELIZABETH PARKER · 2019 to 2023
$984k
Bag-Mask Ventilation to PreVent Hypoxemia during Tracheal Intubation in the Emergency Department: A Clinical TrialK23HL153584 · NHLBI · VANDERBILT UNIVERSITY MEDICAL CENTER · PI CASEY, JONATHAN DALE · 2020 to 2024
$900k
Prehospital Activation of ED Teams to Improve Sepsis CareK23GM129661 · NIGMS · IHC HEALTH SERVICES, INC. · PI PELTAN, ITHAN DANIEL · 2019 to 2023
$786k
Intramural CDC HHS CC999999NCATS NIH HHS UL1 TR002243NHLBI NIH HHS K23 HL153584NIAID NIH HHS K08 AI141761NIGMS NIH HHS K23 GM129661
6 · The paper itself

Abstract

introductionUnderstanding the changing epidemiology of adults hospitalized with coronavirus disease 2019 (COVID-19) informs research priorities and public health policies.

methodsAmong adults (≥18 years) hospitalized with laboratory-confirmed, acute COVID-19 between 11 March 2021, and 31 August 2022 at 21 hospitals in 18 states, those hospitalized during the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Omicron-predominant period (BA.1, BA.2, BA.4/BA.5) were compared to those from earlier Alpha- and Delta-predominant periods. Demographic characteristics, biomarkers within 24 hours of admission, and outcomes, including oxygen support and death, were assessed.

resultsAmong 9825 patients, median (interquartile range [IQR]) age was 60 years (47-72), 47% were women, and 21% non-Hispanic Black. From the Alpha-predominant period (Mar-Jul 2021; N = 1312) to the Omicron BA.4/BA.5 sublineage-predominant period (Jun-Aug 2022; N = 1307): the percentage of patients who had ≥4 categories of underlying medical conditions increased from 11% to 21%; those vaccinated with at least a primary COVID-19 vaccine series increased from 7% to 67%; those ≥75 years old increased from 11% to 33%; those who did not receive any supplemental oxygen increased from 18% to 42%. Median (IQR) highest C-reactive protein and D-dimer concentration decreased from 42.0 mg/L (9.9-122.0) to 11.5 mg/L (2.7-42.8) and 3.1 mcg/mL (0.8-640.0) to 1.0 mcg/mL (0.5-2.2), respectively. In-hospital death peaked at 12% in the Delta-predominant period and declined to 4% during the BA.4/BA.5-predominant period.

conclusionsCompared to adults hospitalized during early COVID-19 variant periods, those hospitalized during Omicron-variant COVID-19 were older, had multiple co-morbidities, were more likely to be vaccinated, and less likely to experience severe respiratory disease, systemic inflammation, coagulopathy, and death.

Indexed as

COVID-19COVID-19 VaccinesAdultAgedFemaleHospital MortalityHumansMaleMiddle AgedOxygenSARS-CoV-2United StatesCOVID-19 VaccinesOxygenCOVID-19deathhospitalizationSARS-CoV-2severe disease

Identifiers

PMID37255285
PMCPMC10526883

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.