The evolving landscape of COVID-19: factors associated with in-hospital COVID-19 related mortality during the 2023–2024 phase of JN.1 subvariant dominance
Abstract Background COVID-19 remains a complex health challenge. We analysed the characteristics and outcomes of COVID-19-related hospitalisations during JN.1 variant dominance. Methods Conducted in a hospital serving a socioeconomically deprived population, this study included all adults hospitalis...
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2025-01-01
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| Online Access: | https://doi.org/10.1186/s12879-025-10480-x |
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| author | Drieda Zaçe Albiana Çekrezi Christopher Jones Ludovica Ferrari Giuseppe De Simone Elisabetta Teti Vincenzo Malagnino Marco Iannetta Loredana Sarmati Anna Maria Geretti |
| author_facet | Drieda Zaçe Albiana Çekrezi Christopher Jones Ludovica Ferrari Giuseppe De Simone Elisabetta Teti Vincenzo Malagnino Marco Iannetta Loredana Sarmati Anna Maria Geretti |
| author_sort | Drieda Zaçe |
| collection | DOAJ |
| description | Abstract Background COVID-19 remains a complex health challenge. We analysed the characteristics and outcomes of COVID-19-related hospitalisations during JN.1 variant dominance. Methods Conducted in a hospital serving a socioeconomically deprived population, this study included all adults hospitalised with COVID-19 from 1st November 2023 to 31st August 2024. The primary outcome was in-hospital mortality, analysed in relation to demographic, clinical, and laboratory parameters. Results Among 122 individuals (median age 76 years, 58.2% males, median comorbidity index 5), 114/122 (93.4%) had received ≥ 1 SARS-CoV-2 vaccination, with a median of 23 months elapsed since the last dose. Fever (67/122, 54.9%) and dyspnoea (49/122, 40.2%) were common presenting symptoms, with 78/122 (64%) showing CT evidence of SARS-CoV-2 pneumonia; 25/122 (20%) had purely neurological presentations. Treatment included remdesivir (115/122, 94.3%) and/or nirmatrelvir/ritonavir (9/122, 7.4%), sotrovimab (15/122, 12.3%), corticosteroids (61/122, 50.0%), and oxygen supplementation (76/122, 62.3%). Whereas 107/122 (87.7%) were discharged after a median of seven days, in-hospital mortality was 15/122 (12.3%) after a median of 16 days. Baseline factors associated with mortality were neutrophil-lymphocyte ratio > 8, D-dimer ≥ 1800 ng/mL, procalcitonin ≥ 1.0 ng/mL, and albumin < 3.2 g/dL; during admission, nasopharyngeal SARS-CoV-2 antigen positivity persisting for > 12 days, hospitalisation for ≥ 10 days, higher oxygen requirements with the resulting corticosteroid use, and healthcare-associated bacteraemia were associated with increased odds of mortality. Conclusions Baseline laboratory parameters and persistent SARS-CoV-2 antigen positivity despite antiviral therapy offer readily available prognostic insights for patients hospitalised with COVID-19. It is imperative to advocate for up-to-date COVID-19 vaccination among older people and other vulnerable groups. |
| format | Article |
| id | doaj-art-a29a2e800ff74092ac68c6d1f45712f9 |
| institution | Kabale University |
| issn | 1471-2334 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Infectious Diseases |
| spelling | doaj-art-a29a2e800ff74092ac68c6d1f45712f92025-02-02T12:10:42ZengBMCBMC Infectious Diseases1471-23342025-01-0125111110.1186/s12879-025-10480-xThe evolving landscape of COVID-19: factors associated with in-hospital COVID-19 related mortality during the 2023–2024 phase of JN.1 subvariant dominanceDrieda Zaçe0Albiana Çekrezi1Christopher Jones2Ludovica Ferrari3Giuseppe De Simone4Elisabetta Teti5Vincenzo Malagnino6Marco Iannetta7Loredana Sarmati8Anna Maria Geretti9Department of Systems Medicine, University of Rome Tor VergataDepartment of Systems Medicine, University of Rome Tor VergataDepartment of Primary Care and Public Health, Brighton and Sussex Medical SchoolInfectious Diseases Unit, University Hospital Tor VergataInfectious Diseases Unit, University Hospital Tor VergataInfectious Diseases Unit, University Hospital Tor VergataDepartment of Systems Medicine, University of Rome Tor VergataDepartment of Systems Medicine, University of Rome Tor VergataDepartment of Systems Medicine, University of Rome Tor VergataDepartment of Systems Medicine, University of Rome Tor VergataAbstract Background COVID-19 remains a complex health challenge. We analysed the characteristics and outcomes of COVID-19-related hospitalisations during JN.1 variant dominance. Methods Conducted in a hospital serving a socioeconomically deprived population, this study included all adults hospitalised with COVID-19 from 1st November 2023 to 31st August 2024. The primary outcome was in-hospital mortality, analysed in relation to demographic, clinical, and laboratory parameters. Results Among 122 individuals (median age 76 years, 58.2% males, median comorbidity index 5), 114/122 (93.4%) had received ≥ 1 SARS-CoV-2 vaccination, with a median of 23 months elapsed since the last dose. Fever (67/122, 54.9%) and dyspnoea (49/122, 40.2%) were common presenting symptoms, with 78/122 (64%) showing CT evidence of SARS-CoV-2 pneumonia; 25/122 (20%) had purely neurological presentations. Treatment included remdesivir (115/122, 94.3%) and/or nirmatrelvir/ritonavir (9/122, 7.4%), sotrovimab (15/122, 12.3%), corticosteroids (61/122, 50.0%), and oxygen supplementation (76/122, 62.3%). Whereas 107/122 (87.7%) were discharged after a median of seven days, in-hospital mortality was 15/122 (12.3%) after a median of 16 days. Baseline factors associated with mortality were neutrophil-lymphocyte ratio > 8, D-dimer ≥ 1800 ng/mL, procalcitonin ≥ 1.0 ng/mL, and albumin < 3.2 g/dL; during admission, nasopharyngeal SARS-CoV-2 antigen positivity persisting for > 12 days, hospitalisation for ≥ 10 days, higher oxygen requirements with the resulting corticosteroid use, and healthcare-associated bacteraemia were associated with increased odds of mortality. Conclusions Baseline laboratory parameters and persistent SARS-CoV-2 antigen positivity despite antiviral therapy offer readily available prognostic insights for patients hospitalised with COVID-19. It is imperative to advocate for up-to-date COVID-19 vaccination among older people and other vulnerable groups.https://doi.org/10.1186/s12879-025-10480-xCOVID-19SARS-CoV-2HospitalisationMortalityRemdesivir |
| spellingShingle | Drieda Zaçe Albiana Çekrezi Christopher Jones Ludovica Ferrari Giuseppe De Simone Elisabetta Teti Vincenzo Malagnino Marco Iannetta Loredana Sarmati Anna Maria Geretti The evolving landscape of COVID-19: factors associated with in-hospital COVID-19 related mortality during the 2023–2024 phase of JN.1 subvariant dominance BMC Infectious Diseases COVID-19 SARS-CoV-2 Hospitalisation Mortality Remdesivir |
| title | The evolving landscape of COVID-19: factors associated with in-hospital COVID-19 related mortality during the 2023–2024 phase of JN.1 subvariant dominance |
| title_full | The evolving landscape of COVID-19: factors associated with in-hospital COVID-19 related mortality during the 2023–2024 phase of JN.1 subvariant dominance |
| title_fullStr | The evolving landscape of COVID-19: factors associated with in-hospital COVID-19 related mortality during the 2023–2024 phase of JN.1 subvariant dominance |
| title_full_unstemmed | The evolving landscape of COVID-19: factors associated with in-hospital COVID-19 related mortality during the 2023–2024 phase of JN.1 subvariant dominance |
| title_short | The evolving landscape of COVID-19: factors associated with in-hospital COVID-19 related mortality during the 2023–2024 phase of JN.1 subvariant dominance |
| title_sort | evolving landscape of covid 19 factors associated with in hospital covid 19 related mortality during the 2023 2024 phase of jn 1 subvariant dominance |
| topic | COVID-19 SARS-CoV-2 Hospitalisation Mortality Remdesivir |
| url | https://doi.org/10.1186/s12879-025-10480-x |
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