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Review 3: "Outcomes of SARS-CoV-2 Omicron infection in residents of Long-Term Care"

This preprint examines the mortality and hospitalization rates of the SARS-CoV-2 Omnicronvariant and compares them to the Delta variant. Reviewers found the study reliable but requires additional literary citations.

Published onMar 13, 2022
Review 3: "Outcomes of SARS-CoV-2 Omicron infection in residents of Long-Term Care"
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key-enterThis Pub is a Review of
Outcomes of SARS-CoV-2 Omicron infection in residents of Long-Term Care

AbstractBackgroundRecently there has been a rapid, global increase in SARS-CoV-2 infections associated with the Omicron variant (B.1.1.529). Although severity of Omicron cases may be reduced, the scale of infection suggests hospital admissions and deaths may be substantial. Definitive conclusions about disease severity require evidence from populations with the greatest risk of severe outcomes, such as residents of Long-Term Care Facilities (LTCFs).MethodsWe used a cohort study to compare the risk of hospital admission or death in LTCF residents in England who had tested positive for SARS-CoV-2 in the period shortly before Omicron emerged (Delta dominant) and the Omicron-dominant period, adjusting for age, sex, vaccine type, and booster vaccination. Variants were confirmed by sequencing or spike-gene status in a subset.ResultsRisk of hospital admission was markedly lower in 1241 residents infected in the Omicron-period (4.01% hospitalised, 95% CI: 2.87-5.59) compared to 398 residents infected in the pre-Omicron period (10.8% hospitalised, 95% CI: 8.13-14.29, adjusted Hazard Ratio 0.50, 95% CI: 0.29-0.87, p=0.014); findings were similar in residents with confirmed variant. No residents with previous infection were hospitalised in either period. Mortality was lower in the Omicron versus the pre-Omicron period, (p<0.0001).ConclusionsRisk of severe outcomes in LTCF residents with the SARS-CoV-2 Omicron variant was substantially lower than that seen for previous variants. This suggests the current wave of Omicron infections is unlikely to lead to a major surge in severe disease in LTCF populations with high levels of vaccine coverage and/or natural immunity.Trial Registration NumberISRCTN 14447421

RR:C19 Evidence Scale rating by reviewer:

  • Reliable. The main study claims are generally justified by its methods and data. The results and conclusions are likely to be similar to the hypothetical ideal study. There are some minor caveats or limitations, but they would/do not change the major claims of the study. The study provides sufficient strength of evidence on its own that its main claims should be considered actionable, with some room for future revision.



1. Abstract-:The abstract is well structured and summarizes the overall purpose of the study and the research problem(s) investigated. The basic design of the study, major findings, and trends found as a result of the study are also showcased.

2. Materials and methods: The authors have included a proper survey questionnaire along with the assessment scale to analyze their objectives.

3. Statistics: The involvement of regression methods (logistic and linear models) provides clearance of bias that may have been generated by the different variables. The confounding/impending factors are well neutralized by the statistical methods.

4. Discussion: The discussion requires more additional statements with regards to the existing literature search. I suggest including the following references and citations reflecting the COVID-19 updates to strengthen the
-Origin and transmission (use reference and cite: Umakanthan S, Sahu P, Ranade AV, et al. Origin, transmission, diagnosis and management of coronavirus disease 2019 (COVID-19). Postgrad Med J. 2020;96(1142):753-758. doi:10.1136/postgradmedj-2020-138234)
- To mention in brief about vaccines (use reference and cite: “Francis AI, Ghany S, Gilkes T, et al. Review of COVID-19 vaccine subtypes, efficacy and geographical distributions [published online ahead of print, 2021 Aug 6]. Postgrad Med J. 2021;postgradmedj-2021-140654. doi:10.1136/postgradmedj-2021-140654”)
- For a definition of vaccine resistance and hesitance (use reference and cite: Umakanthan S, Patil S, Subramaniam N, Sharma R. COVID-19 Vaccine Hesitancy and Resistance in India Explored through a Population-Based Longitudinal Survey. Vaccines (Basel). 2021;9(10):1064. Published 2021 Sep 24. doi:10.3390/vaccines9101064)
- Compare the global vaccine status and relate it with the Canadian vaccine status (refer and cite: Umakanthan S, Chauhan A, Gupta MM, Sahu PK, Bukelo MM, Chattu VK. COVID-19 pandemic containment in the Caribbean Region: A review of case-management and public health strategies. AIMS Public Health. 2021;8(4):665-681. Published 2021 Sep 27. doi:10.3934/publichealth.2021053)

5. Conclusion: The authors have shown the importance of variables that can influence the adherence to preventive measures and willingness to vaccinate against COVID-19. The main bulletin messages showcase the summary of the manuscript very well.

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