How does a disease with the omicron variant of the coronavirus proceed? Some data suggest that infection is milder. But what exactly is a mild course? And how does this differ from a difficult one?
Omikron is currently worried many, professionals and fellow citizens. The variant of the coronavirus is many times more contagious. But what about the course of the disease? News from Great Britain give cause for slight optimism: Two studies show that corona infections in the Omikron variant lead to hospitalization less often than in the Delta variant. The preliminary study results published on Wednesday thus confirmed earlier findings from South Africa, where the Omikron variant was first registered. Nevertheless, experts warned against excessive optimism.
In a study in Scotland, researchers looked at Covid cases recorded in November and December. They compared infections with the Omikron variant with those of the Delta variant. The study found that Omikron reduced the risk of hospitalization for Covid-19 by two-thirds compared to Delta, and that a booster vaccination offered significant additional protection against symptomatic illnesses. The number of cases in the study was small, however, and no people under the age of 60 were hospitalized. However, the authors stated that they compensated for these limitations using statistical methods.
Drosten on Omicron outbreak: “Doesn’t look like a milder disease to me”
Another study in England found that Omikron’s total hospital stays decreased by 20 to 25 percent compared to Delta. The number of stays in hospital that lasted a night or more fell by as much as 40 to 45 percent. The Scottish study only looked at stays of at least one night, so this could explain part of the difference found.
On Sunday, the virologist Christian Drosten, who is also on the Federal Government’s Expert Council, commented on a corona outbreak at a Christmas party in Norway on Twitter. “Virtually all infected people were double-vaccinated and still symptomatic, half with fever,” he wrote. Nobody was boosted. The oldest infected is 61 years old, the median age is 36 years. After almost two weeks, there were no hospital admissions. “Doesn’t look like a milder disease to me,” Drosten commented on the data. When asked what would make the disease milder, the virologist replied:
On Thursday, Drosten shared two studies on Twitter. During an investigation he spoke of a “groundbreaking study”: “Unvaccinated people have about 24% less risk of Krh intake when infected with Omikron vs. Delta. Omikron is therefore somewhat weakened compared to Delta. Somewhat. Difference in severe courses is still unclear. “
But in the back and forth of studies on the course of the disease and hospitalizations, the question remains: What is a mild course? And how does it differ from severe disease processes?
Several scales and classifications for Covid diseases
Many probably associate a severe Covid course with a stay in hospital and a mild one with symptoms that can be cured at home. By and large, this also coincides with definitions used by health organizations such as the World Health Organization (WHO).
In February 2020, the WHO published an eight-point scale in a paper called:
|
No infection |
No clinical or virological evidence of infection |
0 |
|
Outpatient |
No restriction of daytime activities |
1 |
|
Restriction of daily activities |
2 |
|
|
Hospitalized mild course |
No oxygen in the hospital |
3 |
|
Oxygen through mask or nasal breathing aid |
4 |
|
|
Hospitalized severe course |
Non-invasive ventilation or high-flow oxygen |
5 |
|
Intubation and mechanical ventilation |
6 |
|
|
Ventilation + additional organ support – pressors, RRT, ECMO |
7 |
|
|
Tod |
Tod |
8 |
In another from November of this year, further details on the course of the disease are given. A distinction is made between four categories: mild, moderate, severe and critical. This is how the four levels are distinguished:
Mild illnesses: symptomatic patients with no evidence of viral pneumonia (pneumonia) or hypoxia (lack of oxygen). Symptoms include fever, cough, fatigue, shortness of breath, sore throat, or loss of smell or taste.
Moderate or moderate illnesses: Adolescents or adults with clinical signs of pneumonia (fever, cough, shortness of breath, rapid breathing) but no signs of severe pneumonia when the oxygen saturation is greater than 90 percent. In children: clinical signs of non-severe pneumonia (coughing or difficulty breathing and rapid breathing and / or chest drawing in) and no signs of severe pneumonia.
Serious illness: In adolescents or adults with clinical signs of pneumonia (fever, cough, dyspnea) plus any of the following symptoms: a breathing rate of less than 30 breaths per minute, severe shortness of breath, or oxygen saturation of less than 90 percent. In children, clinical signs of pneumonia (coughing or difficulty breathing, and rapid breathing or drawing in of the chest wall) and at least one of the following symptoms: oxygen saturation of less than 90 percent and / or very difficult drawing in of the chest wall, groans, central cyanosis or the presence of other general signs of danger ( Inability to breastfeed or drink, lethargy or loss of consciousness, or convulsions).
at critical illnesses there are several levels. Critical illness includes, among other things, worsening breathing symptoms, low oxygen saturation or respiratory insufficiency, clouding of the lungs on x-rays or on a CT scan, sepsis, organ failure, weak pulse, cold extremities, low blood pressure, acidosis or thrombosis.
Severe courses with coronavirus: lack of oxygen and breathing problems
The Robert Koch Institute has also made a categorization in a paper entitled:
|
Asymptomatic SARS-CoV-2-Infektion |
Positive SARS-CoV-2 PCR test or positive rapid antigen test in the appropriate clinical and epidemiological context |
No symptoms |
|
Mild / moderate illness |
No criteria for severe or critical Covid-19 |
A variety of symptoms are possible, e. B. respiratory symptoms that have no criteria a severe or critical Covid-19 illness meet cold symptoms, change in taste and / or smell, diarrhea, etc. |
|
Serious illness |
Severe pneumonia |
Defined as: oxygen saturation less than 90-94% in room air, Respiratory rate more than 30 / min, radiological Signs of pneumonia |
|
Critical illness |
ARDS, Sepsis, septic shock +/- Multiorganversagen |
Need for mechanical ventilation or other kind of organ support or Vasopressoren-Gabe |
The US, an agency of the US Department of Health, has also published a definition of the course of the disease. A distinction is made between five categories:
- Asymptomatic or presymptomatic infection: People who test positive for Sars-CoV-2 but have no symptoms
- Mild illnesses: People who have any of the various signs and symptoms of Covid-19 (e.g. fever, cough, sore throat, malaise, headache, muscle pain, nausea, vomiting, diarrhea, loss of taste and smell) but who do not experience shortness of breath or shortness of breath or whose lung x-rays or CT scans do not show any abnormalities
- Moderate illness: People who have a lower respiratory disease and who have an oxygen saturation level of more than 94 percent
- Serious illness: People with an oxygen saturation of less than 94 percent, a breathing rate of less than 30 breaths per minute or lung infiltrates
- Critical illness: People with respiratory failure, septic shock and / or dysfunction of several organs
Virologist Stöhr on Norway: “These are not difficult courses”
The omicron infections from Norway, which Christian Drosten commented in his tweet with “Doesn’t look like a milder disease” seem to have been mild to moderate according to the various definitions. The virologist Klaus Stöhr also said in the broadcaster’s “Wieder was learned” podcast that there were no difficult courses in the example from Norway. “The people have all been treated on an outpatient basis, no one has come to the hospital,” explains the former head of the WHO influenza program. “These are all things that the family doctor can treat. These are not difficult processes. I don’t know where that comes from.”
However, those infected in Oslo were all double vaccinated. So you have basic immunization. The numbers from Norway do not reveal how difficult the course is in unvaccinated people. Cases from Great Britain show that omicron infections are not always mild. As the newspaper reported, at least twelve people in the kingdom died as a result of an Omikron infection, and more than 100 people were hospitalized with Omikron. However, experts assumed that the new variant could result in a ten times higher number of confirmed hospital admissions due to a delay in reports.
There is also a first death from Omikron in Germany. According to it, it is a 60 to 79 year old person. More details are currently not known. According to the daily overview of Omikron cases, there are a total of 48 hospitalizations in Germany with a total of 3198 infections.
Source From: Stern
