The following is a summary of “Evolving landscape of COVID-19: factors associated with in-hospital COVID-19 related mortality during the 2023–2024 phase of JN.1 subvariant dominance,” published in the January 2025 issue of Infectious Disease by Zaçe et al.
Researchers conducted a retrospective study to analyze the characteristics and outcomes of COVID-19-related hospitalizations during JN.1 variant dominance.
They included all adults hospitalized with COVID-19 from 1st November 2023 to 31st August 2024 in a hospital serving a socioeconomically disadvantaged population. The primary outcome, in-hospital mortality, was analyzed in relation to demographic, clinical, and laboratory parameters.
The results showed that among 122 individuals (median age 76 years, 58.2% males, median comorbidity index 5), 93.4% (114/122) had received at least 1 SARS-CoV-2 vaccination, with a median of 23 months since the last dose. Common symptoms included fever (54.9%, 67/122) and dyspnoea (40.2%, 49/122), with 64% (78/122) showing CT evidence of SARS-CoV-2 pneumonia. About 20% (25/122) presented purely neurologically. Treatments included remdesivir (94.3%, 115/122), nirmatrelvir/ritonavir (7.4%, 9/122), sotrovimab (12.3%, 15/122), corticosteroids (50%, 61/122), and oxygen supplementation (62.3%, 76/122), 87.7% (107/122) were discharged after a median of 7 days, while 12.3% (15/122) died after a median of 16 days. Factors associated with mortality included neutrophil-lymphocyte ratio >8, D-dimer ≥1800 ng/mL, procalcitonin ≥1.0 ng/mL, albumin <3.2 g/dL, persistent nasopharyngeal SARS-CoV-2 antigen positivity for >12 days, hospitalization ≥10 days, higher oxygen requirements, corticosteroid use, and healthcare-associated bacteremia.
Investigators concluded that baseline laboratory parameters, persistent SARS-CoV-2 antigen positivity despite antiviral treatment, and a strong emphasis on COVID-19 vaccination, particularly among older adults and vulnerable populations, were crucial for improving outcomes in hospitalized patients with COVID-19.
Source: bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-025-10480-x
