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COVID-19 Across Pandemic Variant Periods: The Severe Acute Respiratory Infection-Preparedness (SARI-PREP) Study
Vikramjit Mukherjee1, Radu Postelnicu1, Chelsie Parker2
1Division of Pulmonary, Critical Care, and Sleep Medicine, NYU Grossman School of Medicine, NYU Langone Health, New York, NY.
Critical Care Explorations
|July 18, 2024
Summary
Hospitalized patients with severe acute respiratory infection (SARI) showed increasing comorbidities but improved outcomes throughout the COVID-19 pandemic. This highlights the need for ongoing clinical networks to track viral diseases.
Area of Science:
- Infectious Diseases
- Critical Care Medicine
- Epidemiology
Background:
- The COVID-19 pandemic presented evolving challenges in patient care and outcomes.
- Understanding the progression of severe acute respiratory infection (SARI) is crucial for adapting medical strategies.
- Differences in patient characteristics and care evolved across distinct pandemic phases.
Purpose of the Study:
- To analyze changes in patient demographics and clinical care for hospitalized SARI patients during the COVID-19 pandemic.
- To compare outcomes across different SARS-CoV-2 variant periods.
- To identify factors influencing SARI patient trajectories over time.
Main Methods:
- A longitudinal multicenter cohort study (SARI-PREP) involving adult patients with laboratory-confirmed viral respiratory infections.
- Data collected on patient demographics, comorbidities, physiological measures, treatments, and outcomes.
- Analysis of outcomes stratified by four pandemic variant periods: pre-Delta, Delta, Omicron BA.1, and post-BA.1.
Main Results:
- 874 adult SARI patients were enrolled; 89% had SARS-CoV-2 infection.
- Median age was 60 years, 66% were male; 49% from underserved communities.
- Hospital mortality decreased from 32% to 12%, ICU utilization from 94% to 58%, and LOS from 26 to 8.5 days, despite increasing comorbidities.
Conclusions:
- Patient outcomes for SARI improved across pandemic variant periods, despite rising comorbidity rates.
- Evolving care delivery, medical countermeasures, and viral variants contributed to observed outcome improvements.
- Understanding patient-level factors is essential for managing future variants and novel respiratory pathogens.
