Evaluation of characteristics and prognosis of COVID-19 patients requiring invasive mechanical ventilation during dominance of nonvariant, alpha, delta, and omicron variants in tertiary hospitals of Japan.

Publication date: Feb 20, 2024

In November 2021, the B. 1.1. 529 (omicron) variant of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was detected in South Africa and subsequently rapidly spread around the world. Despite the reduced severity of the omicron variants, many patients become severely ill after infection and undergo invasive mechanical ventilation, but there are few reports on their background and prognosis throughout all variant periods. This study aimed to evaluate risk factors affecting patients requiring invasive mechanical ventilation with each variant of COVID-19 pandemic in Japan from nonvariants to omicron variants. This retrospective observational study was conducted at the Department of Emergency and Critical Care Medicine, Kansai Medical University Hospital and Kansai Medical University Medical Center, Osaka, Japan, from March 2020 to March 2023. Eligible patients were those who underwent invasive ventilation for COVID-19 pneumonia. We set the primary endpoint as in-hospital mortality. Multivariable logistic regression analysis adjusted for clinically important variables was performed to evaluate the clinical outcomes. We included 377 patients: 118 in the Nonvariant group, 154 in the Alpha group, 42 in the Delta group, and 63 patients in the Omicron group. Mortality rates for each group were 23. 7% for the Nonvariant group, 12. 3% for the Alpha group, 7. 1% for the Delta group, and 30. 5% for the Omicron group. Patient age was significantly associated with increased mortality (adjusted odds ratio [AOR]: 1. 097; 95% confidence interval [CI]: 1. 057-0. 138, P 

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Concepts Keywords
Africa COVID-19
Hospitals Invasive mechanical ventilation
Japan Omicron variant
Pneumonia SARS-CoV-2


Type Source Name
disease MESH COVID-19
disease VO Severe acute respiratory syndrome coronavirus 2
disease MESH infection
disease MESH Emergency
disease MESH pneumonia
disease MESH Infectious Diseases
disease IDO immunodeficiency
disease IDO history
pathway REACTOME Reproduction
disease IDO virulence
disease VO vaccination
disease VO pregnant women
disease MESH cardiopulmonary arrest
disease MESH bacterial pneumonia
disease MESH septic shock
disease VO protocol
drug DRUGBANK Favipiravir
disease VO unvaccinated
drug DRUGBANK Methylprednisolone
disease VO dose
drug DRUGBANK Tocilizumab
drug DRUGBANK Baricitinib
disease IDO blood
disease MESH death
disease VO vaccinated
drug DRUGBANK Methionine
disease MESH collagen disease
disease MESH critically ill
disease MESH coinfection
disease MESH COPD
disease MESH chronic renal failure
disease VO Cpa
disease VO organ
disease VO USA
disease MESH complications
disease MESH bacterial infection
disease MESH abnormalities
disease MESH aspiration pneumonia
disease MESH atelectasis
disease MESH heart failure
disease MESH causes
disease IDO intervention
drug DRUGBANK Meticillin
drug DRUGBANK Tazobactam
drug DRUGBANK Piperacillin
disease VO age
disease MESH Comorbidity
disease MESH Lung cancer
disease MESH sepsis
disease MESH bleeding
disease MESH Immunodeficiency 2
drug DRUGBANK Coenzyme M
disease VO population
disease IDO country
disease VO organization
drug DRUGBANK Dexamethasone
disease VO report
drug DRUGBANK Carboxyamidotriazole
disease MESH syndrome

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