Inflammatory Biomarkers Differ among Hospitalized Veterans Infected with Alpha, Delta, and Omicron SARS-CoV-2 Variants

Authors

Catherine Park
Shahriar Tavakoli-Tabasi
Amir Sharafkhaneh
Benjamin J Seligman
Bret Hicken
Christopher I Amos
Andrew Chou
Javad Razjouyan

Publication Date

2-8-2023

Journal

International Journal of Environmental Research and Public Health

DOI

10.3390/ijerph20042987

PMID

36833680

PMCID

PMC9959816

PubMedCentral® Posted Date

2-8-2023

PubMedCentral® Full Text Version

Post-print

Published Open-Access

yes

Keywords

Humans, SARS-CoV-2, Retrospective Studies, Veterans, COVID-19, Biomarkers, C-Reactive Protein, Inflammation, inflammatory markers, SARS-CoV-2 variants, alpha, delta, omicron

Abstract

Mortality due to COVID-19 has been correlated with laboratory markers of inflammation, such as C-reactive protein (CRP). The lower mortality during Omicron variant infections could be explained by variant-specific immune responses or host factors, such as vaccination status. We hypothesized that infections due to Omicron variant cause less inflammation compared to Alpha and Delta, correlating with lower mortality. This was a retrospective cohort study of veterans hospitalized for COVID-19 at the Veterans Health Administration. We compared inflammatory markers among patients hospitalized during Omicron infection with those of Alpha and Delta. We reported the adjusted odds ratio (aOR) of the first laboratory results during hospitalization and in-hospital mortality, stratified by vaccination status. Of 2,075,564 Veterans tested for COVID-19, 29,075 Veterans met the criteria: Alpha (45.1%), Delta (23.9%), Omicron (31.0%). Odds of abnormal CRP in Delta (aOR = 1.85, 95% CI:1.64-2.09) and Alpha (aOR = 1.94, 95% CI:1.75-2.15) were significantly higher compared to Omicron. The same trend was observed for Ferritin, Alanine aminotransferase, Aspartate aminotransferase, Lactate dehydrogenase, and Albumin. The mortality in Delta (aOR = 1.92, 95% CI:1.73-2.12) and Alpha (aOR = 1.68, 95% CI:1.47-1.91) were higher than Omicron. The results remained significant after stratifying the outcomes based on vaccination status. Veterans infected with Omicron showed milder inflammatory responses and lower mortality than other variants.

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