Clinical Impact of Covid-19 Omicron Variant on Patients in Home Health Care

Abstract

Coronavirus disease 2019 (COVID-19) risk factors for hospitalization and mortality have been reported to be older age, comorbidities, and vaccination status. However, its clinical course and the risk of hospitalization and mortality in patients who received home health care for their predisposing status and diseases remain unclear. This study aimed to determine the characteristics and outcomes of these patients after being infected with the Omicron variant of COVID-19. This retrospective study included 33 patients diagnosed with COVID-19 after we initiated home health care. We classified the patients into 2 groups, that is, hospitalization (n = 7) and non-hospitalization (n = 26), and non-survival (n = 6) and survival (n = 27) and compared their backgrounds. COVID-19 severity was an affecting factor in hospitalization and survival. The nursing care environments and low daily life activities also affected hospitalization but not survival. The proportion of patients with terminal malignancies (50.0% vs 3.7%, p = .017) and the Charlson Comorbidity Index (5.0 vs 2.0, p = .096) were higher in the non-survival than in the survival group. Some patients had urinary tract infections and persistent weight and appetite loss (post COVID-19 syndrome), regardless of this improvement. Serum IL-6 levels were higher in patients with post COVID-19 syndrome than those without symptoms. Optimizing the nursing care environment is essential to continue home health care and lower the hospitalization rate even with SARS-CoV-2 infection. Post COVID-19 syndrome, such as appetite and weight loss, are associated with IL-6-induced inflammation.