Clinical phenotypes and outcomes associated with SARS-CoV-2 Omicron sublineage JN.1 in critically ill COVID-19 patients: a prospective, multicenter cohort study in France, November 2022 to January 2024 - Inserm - Institut national de la santé et de la recherche médicale Access content directly
Journal Articles Annals of Intensive Care Year : 2024

Clinical phenotypes and outcomes associated with SARS-CoV-2 Omicron sublineage JN.1 in critically ill COVID-19 patients: a prospective, multicenter cohort study in France, November 2022 to January 2024

1 Service d'anesthésie-réanimation SAMU94-SMUR94 [Mondor]
2 CARMAS - Groupe de recherche clinique CARMAS (Cardiovascular and Respiratory Manifestations of Acute lung injury and Sepsis)
3 U955 Inserm - UPEC - IMRB - VHC/"Viruses-Hepatology-Cancers" [Créteil]
4 Service de santé publique [Mondor]
5 U955 Inserm - UPEC - IMRB - CEPIA/"Clinical Epidemiology And Ageing : Geriatrics, Primary Care and Public Health" [Créteil]
6 CEPR - Centre d’Etude des Pathologies Respiratoires (CEPR), UMR 1100
7 MAVIVHe - Morphogénèse et antigénicité du VIH, des Virus des Hépatites et Emergents
8 CHRU Tours - Centre Hospitalier Régional Universitaire de Tours
9 RID-AGE - Facteurs de Risque et Déterminants Moléculaires des Maladies liées au Vieillissement - U 1167
10 Service de Virologie [Lille]
11 DMU ESPRIT - Epidémiologie et biostatistique, Santé publique, Pharmacie, Pharmacologie, Recherche, Information médicale, Thérapeutique et Médicaments [Hôpital Louis Mourier AP-HP]
12 INEM - UM 111 (UMR 8253 / U1151) - Institut Necker Enfants-Malades
13 IAME (UMR_S_1137 / U1137) - Infection, Anti-microbiens, Modélisation, Evolution
14 Service des maladies infectieuses et réanimation médicale [Rennes] = Infectious Disease and Intensive Care [Rennes]
15 Laboratoire de Virologie [Rennes] = Virology [Rennes]
16 CHU Rouen
17 DYNAMICURE - Dynamique Microbienne associée aux Infections Urinaires et Respiratoires
18 Centre Hospitalier Le Mans (CH Le Mans)
19 Centre Hospitalier Victor Dupouy
20 CIC1435 - Centre d'Investigation Clinique de Limoges
21 RESINFIT - Anti-infectieux : supports moléculaires des résistances et innovations thérapeutiques
22 CHU Limoges
23 CHU Nice - Centre Hospitalier Universitaire de Nice
24 DMU 4 CORREVE "Maladies du Cœur Et Des Vaisseaux" [Hôpital de Bicêtre AP-HP]
25 CESP - Centre de recherche en épidémiologie et santé des populations
26 Hôpital Paul Brousse
27 CHU Henri Mondor [Créteil]
Fabienne Tamion
  • Function : Author

Abstract

Background A notable increase in severe cases of COVID-19, with significant hospitalizations due to the emergence and spread of JN.1 was observed worldwide in late 2023 and early 2024. However, no clinical data are available regarding critically-ill JN.1 COVID-19 infected patients. Methods The current study is a substudy of the SEVARVIR prospective multicenter observational cohort study. Patients admitted to any of the 40 participating ICUs between November 17, 2022, and January 22, 2024, were eligible for inclusion in the SEVARVIR cohort study (NCT05162508) if they met the following inclusion criteria: age ≥ 18 years, SARS-CoV-2 infection confirmed by a positive reverse transcriptase-polymerase chain reaction (RT-PCR) in nasopharyngeal swab samples, ICU admission for acute respiratory failure. The primary clinical endpoint of the study was day-28 mortality. Evaluation of the association between day-28 mortality and sublineage group was conducted by performing an exploratory multivariable logistic regression model, after systematically adjusting for predefined prognostic factors previously shown to be important confounders (i.e. obesity, immunosuppression, age and SOFA score) computing odds ratios (OR) along with their corresponding 95% confidence intervals (95% CI). Results During the study period (November 2022–January 2024) 56 JN.1- and 126 XBB-infected patients were prospectively enrolled in 40 French intensive care units. JN.1-infected patients were more likely to be obese (35.7% vs 20.8%; p = 0.033) and less frequently immunosuppressed than others (20.4% vs 41.4%; p = 0.010). JN.1-infected patients required invasive mechanical ventilation support in 29.1%, 87.5% of them received dexamethasone, 14.5% tocilizumab and none received monoclonal antibodies. Only one JN-1 infected patient (1.8%) required extracorporeal membrane oxygenation support during ICU stay (vs 0/126 in the XBB group; p = 0.30). Day-28 mortality of JN.1-infected patients was 14.6%, not significantly different from that of XBB-infected patients (22.0%; p = 0.28). In univariable logistic regression analysis and in multivariable analysis adjusting for confounders defined a priori, we found no statistically significant association between JN.1 infection and day-28 mortality (adjusted OR 1.06 95% CI (0.17;1.42); p = 0.19). There was no significant between group difference regarding duration of stay in the ICU (6.0 [3.5;11.0] vs 7.0 [4.0;14.0] days; p = 0.21). Conclusions Critically-ill patients with Omicron JN.1 infection showed a different clinical phenotype than patients infected with the earlier XBB sublineage, including more frequent obesity and less immunosuppression. Compared with XBB, JN.1 infection was not associated with higher day-28 mortality.
Fichier principal
Vignette du fichier
s13613-024-01319-w.pdf (923.51 Ko) Télécharger le fichier
Origin Publication funded by an institution
Licence

Dates and versions

inserm-04635770 , version 1 (04-07-2024)

Licence

Identifiers

Cite

Nicolas de Prost, Etienne Audureau, Antoine Guillon, Lynda Handala, Sébastien Préau, et al.. Clinical phenotypes and outcomes associated with SARS-CoV-2 Omicron sublineage JN.1 in critically ill COVID-19 patients: a prospective, multicenter cohort study in France, November 2022 to January 2024. Annals of Intensive Care, 2024, 14 (1), pp.101. ⟨10.1186/s13613-024-01319-w⟩. ⟨inserm-04635770⟩
0 View
0 Download

Altmetric

Share

Gmail Mastodon Facebook X LinkedIn More