First Clinical Information on Omicron from South Africa is Encouraging
The South African Medical Research Council (SAMRC) has published the first clinical report on hospitalized patients since the advent of the Omicron variant.
It describes the condition of the infected two weeks after the discovery of the new variant. The data is current as of December 2 and is for medical facilities in the epicenter of the outbreak of Omicron - Tshwane County in Gauteng province. Not all proven COVID cases in these hospitals have been confirmed for Omicron, as appropriate tests are not used everywhere, but it can be reasonably assumed that these are the cases.
The majority of patients in the COVID wards were not oxygen dependent. SARS-CoV-2 was an accidental finding in patients admitted to the hospital for other medical, surgical or obstetric reasons, is one of the main conclusions.
These observations (the full text can be seen HERE) come against the backdrop of two conflicting ones about Omicron - that it is milder than previous versions and that it is much more contagious and is already causing a wave of hospitalizations in South Africa. SAMRC data seem to find a plausible explanation in support of both claims.
The report from early experience with Omicron describes the profile of patients at the Steve Biko / Tshwane District Hospital in Pretoria, in the heart of the Tshwane district. Between November 14 and 29, 166 people with coronavirus were admitted there.
“It is essential to recognize that the patient information presented here represents only the first two weeks of the Omicron wave in Tshwane. The clinical profile of the admitted patients may change significantly in the next two weeks, and until then we will be able to draw conclusions about the severity of the disease with greater accuracy," the authors of the report said.
Out of 42 hospitalized patients on this date (2.12.2021) 29 people (70%) are not dependent on oxygen. These are patients in whom COVID was discovered accidentally after being admitted to hospital for another reason. Thirteen patients were dependent on supplemental oxygen, of whom 9 (21%) were diagnosed with COVID-19 pneumonia based on a combination of symptoms, clinical manifestations, CXR, and inflammatory markers. All have been prescribed steroids as their primary treatment. The other 4 patients are on oxygen for other medical reasons (2 previously on home oxygen, 1 with heart failure and 1 with a confirmed diagnosis of pneumocystis pneumonia), the analysis said.
The authors note that this is a picture that has not been observed in previous waves:
"At the beginning of the three previous waves and in the course of these waves, there were always only a few patients in the room air in the COVID ward, and these patients were usually in the recovery phase and waiting for concomitant disease to resolve before being discharged. The COVID ward was recognizable by the fact that most patients were on some form of oxygen therapy with the continuous sound of high-flow nasal catheters or the beeping alarms of ventilators.
There are only 4 patients under special supervision and one in the intensive care unit. The number of patients on dual oxygen therapy, high-flow nasal oxygen or non-invasive ventilation (NIV) was markedly higher in previous waves. These are unofficial data, but they are confirmed by many doctors who have previously worked in the departments of COVID in the hospital complex.
Of the 38 adults in the COVID wards on 2 December 2021, 6 were vaccinated, 24 were not vaccinated and 8 were of unknown vaccination status. Of the 9 patients with COVID pneumonia, 8 were unvaccinated and 1 was a child. Only one oxygen patient was fully vaccinated, but the cause of the oxygen was chronic obstructive pulmonary disease. "
So far, there is no increase in the proportion of COVID patients who have died in hospital, despite the appearance of the new version. However, it is too early to draw conclusions, as there is usually a longer interval between diagnosis and death, the analysis says.
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