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Article

Retrospective, Observational Analysis on the Impact of SARS-CoV-2 Variant Omicron in Hospitalized Immunocompromised Patients in a German Hospital Network—The VISAGE Study

by
Irit Nachtigall
1,2,†,
Stefan Kwast
3,*,†,
Sven Hohenstein
3,
Sebastian König
3,4,
Phi Long Dang
5,
Johannes Leiner
3,4,
Nicola Giesen
6,
Benjamin Thomas Schleenvoigt
7,
Marzia Bonsignore
8,
Andreas Bollmann
3,4,
Ralf Kuhlen
9 and
Fungwe Jah
10
1
Department of Infectious Diseases and Infection Prevention, Helios Hospital Emil-von-Behring, 14165 Berlin, Germany
2
Medical School Berlin, Chair of Infectiology and Immunology, 14197 Berlin, Germany
3
Helios Health Institute, Real World Evidence and Health Technology Assessment, 13125 Berlin, Germany
4
Department of Electrophysiology, Heart Center Leipzig, University of Leipzig, 04289 Leipzig, Germany
5
Market Access, AstraZeneca, 22763 Hamburg, Germany
6
Department of Hematology, Oncology and Palliative Care, Robert Bosch Hospital, 70376 Stuttgart, Germany
7
Institute of Infectious Diseases and Infection Control, Jena University Hospital, 07743 Jena, Germany
8
Center for Clinical and Translational Research, Helios Universitätsklinikum Wuppertal, University of Witten/Herdecke, 42283 Wuppertal, Germany
9
Helios Health, 13125 Berlin, Germany
10
Medical Affairs, AstraZeneca, 22763 Hamburg, Germany
*
Author to whom correspondence should be addressed.
†
These authors contributed equally to this work.
Vaccines 2024, 12(6), 634; https://doi.org/10.3390/vaccines12060634
Submission received: 23 April 2024 / Revised: 29 May 2024 / Accepted: 30 May 2024 / Published: 7 June 2024
(This article belongs to the Section COVID-19 Vaccines and Vaccination)
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Abstract

Aims: Endemic SARS-CoV-2 infections still burden the healthcare system and represent a considerable threat to vulnerable patient cohorts, in particular immunocompromised (IC) patients. This study aimed to analyze the in-hospital outcome of IC patients with severe SARS-CoV-2 infection in Germany. Methods: This retrospective, observational study, analyzed administrative data from inpatient cases (n = 146,324) in 84 German Helios hospitals between 1 January 2022 and 31 December 2022 with regard to in-hospital outcome and health care burden in IC patients during the first 12 months of Omicron dominance. As the primary objective, in-hospital outcomes of patients with COVID-19-related severe acute respiratory infection (SARI) were analyzed by comparing patients with (n = 2037) and without IC diagnoses (n = 14,772). Secondary analyses were conducted on IC patients with (n = 2037) and without COVID-19-related SARI (n = 129,515). A severe in-hospital outcome as a composite endpoint was defined per the WHO definition if one of the following criteria were met: intensive care unit (ICU) treatment, mechanical ventilation (MV), or in-hospital death. Results: In total, 12% of COVID-related SARI cases were IC patients, accounting for 15% of ICU admissions, 15% of MV use, and 16% of deaths, resulting in a higher prevalence of severe in-hospital courses in IC patients developing COVID-19-related SARI compared to non-IC patients (Odds Ratio, OR = 1.4, p < 0.001), based on higher in-hospital mortality (OR = 1.4, p < 0.001), increased need for ICU treatment (OR = 1.3, p < 0.001) and mechanical ventilation (OR = 1.2, p < 0.001). Among IC patients, COVID-19-related SARI profoundly increased the risk for severe courses (OR = 4.0, p < 0.001). Conclusions: Our findings highlight the vulnerability of IC patients to severe COVID-19. The persistently high prevalence of severe outcomes in these patients in the Omicron era emphasizes the necessity for continuous in-hospital risk assessment and monitoring of IC patients.
Keywords: Omicron; immunocompromised; SARI; in-hospital mortality; mechanical ventilation; intensive care unit; COVID-19 and SARS-CoV2 Omicron; immunocompromised; SARI; in-hospital mortality; mechanical ventilation; intensive care unit; COVID-19 and SARS-CoV2

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MDPI and ACS Style

Nachtigall, I.; Kwast, S.; Hohenstein, S.; König, S.; Dang, P.L.; Leiner, J.; Giesen, N.; Schleenvoigt, B.T.; Bonsignore, M.; Bollmann, A.; et al. Retrospective, Observational Analysis on the Impact of SARS-CoV-2 Variant Omicron in Hospitalized Immunocompromised Patients in a German Hospital Network—The VISAGE Study. Vaccines 2024, 12, 634. https://doi.org/10.3390/vaccines12060634

AMA Style

Nachtigall I, Kwast S, Hohenstein S, König S, Dang PL, Leiner J, Giesen N, Schleenvoigt BT, Bonsignore M, Bollmann A, et al. Retrospective, Observational Analysis on the Impact of SARS-CoV-2 Variant Omicron in Hospitalized Immunocompromised Patients in a German Hospital Network—The VISAGE Study. Vaccines. 2024; 12(6):634. https://doi.org/10.3390/vaccines12060634

Chicago/Turabian Style

Nachtigall, Irit, Stefan Kwast, Sven Hohenstein, Sebastian König, Phi Long Dang, Johannes Leiner, Nicola Giesen, Benjamin Thomas Schleenvoigt, Marzia Bonsignore, Andreas Bollmann, and et al. 2024. "Retrospective, Observational Analysis on the Impact of SARS-CoV-2 Variant Omicron in Hospitalized Immunocompromised Patients in a German Hospital Network—The VISAGE Study" Vaccines 12, no. 6: 634. https://doi.org/10.3390/vaccines12060634

APA Style

Nachtigall, I., Kwast, S., Hohenstein, S., König, S., Dang, P. L., Leiner, J., Giesen, N., Schleenvoigt, B. T., Bonsignore, M., Bollmann, A., Kuhlen, R., & Jah, F. (2024). Retrospective, Observational Analysis on the Impact of SARS-CoV-2 Variant Omicron in Hospitalized Immunocompromised Patients in a German Hospital Network—The VISAGE Study. Vaccines, 12(6), 634. https://doi.org/10.3390/vaccines12060634

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