Publication date: Oct 01, 2023

To evaluate the impact of age and COVID-19 variant time period on morbidity and mortality among those hospitalized with COVID-19. Patients from the American Heart Association’s Get With The Guidelines COVID-19 cardiovascular disease registry (January 20, 2020-February 14, 2022) were divided into groups based on whether they presented during periods of wild type/alpha, delta, or omicron predominance. They were further subdivided by age (young: 18-40 years; older: more than 40 years), and characteristics and outcomes were compared. The cohort consisted of 45,421 hospitalized COVID-19 patients (wild type/alpha period: 41,426, delta period: 3349, and omicron period: 646). Among young patients (18-40 years), presentation during delta was associated with increased odds of severe COVID-19 (OR, 1. 6; 95% CI, 1. 3-2. 1), major adverse cardiovascular events (MACE) (OR, 1. 8; 95% CI, 1. 3-2. 5), and in-hospital mortality (OR, 2. 2; 95% CI, 1. 5-3. 3) when compared with presentation during wild type/alpha. Among older patients (more than 40 years), presentation during delta was associated with increased odds of severe COVID-19 (OR, 1. 2; 95% CI, 1. 1-1. 3), MACE (OR, 1. 5; 95% CI, 1. 4-1. 7), and in-hospital mortality (OR, 1. 4; 95% CI, 1. 3-1. 6) when compared with wild type/alpha. Among older patients (more than 40 years), presentation during omicron associated with decreased odds of severe COVID-19 (OR, 0. 7; 95% CI, 0. 5-0. 9) and in-hospital mortality (OR, 0. 6; 95% CI, 0. 5-0. 9) when compared with wild type/alpha. Among hospitalized adults with COVID-19, presentation during a time of delta predominance was associated with increased odds of severe COVID-19, MACE, and in-hospital mortality compared with presentation during wild type/alpha. Among older patients (aged more than 40 years), presentation during omicron was associated with decreased odds of severe COVID-19 and in-hospital mortality compared with wild type/alpha.

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