{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,1]],"date-time":"2026-02-01T00:15:57Z","timestamp":1769904957723,"version":"3.49.0"},"reference-count":47,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2025,10,21]],"date-time":"2025-10-21T00:00:00Z","timestamp":1761004800000},"content-version":"vor","delay-in-days":20,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,10,1]],"date-time":"2025-10-01T00:00:00Z","timestamp":1759276800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Medical Virology"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    COVID\u201019 has posed a significant global health challenge. SARS\u2010CoV\u20102 has accumulated several mutations and adapted to humans, with its clinical manifestations evolving from severe bilateral interstitial pneumonia with respiratory failure to predominantly milder forms of disease. Effective antiviral treatments have been developed but remain underutilized, even in high\u2010risk individuals. We conducted a retrospective study on patients hospitalized for COVID\u201019 in our hospital's Infectious Disease\/COVID\u201019 wards. Written informed consent was obtained from all participants. Demographic, clinical, and therapeutic data were collected. Due to limited viral sequencing, time periods were categorized based on the dominant epidemiological variants: Wild\u2010Type\/Alpha (February 2020 to June 2021), Delta (July to December 2021), and Omicron (January 2022 to January 2024). We included 606 patients, of whom 381 (62.9%) were male, with a mean age of 65.5 years (\u00b117.0) and a mean BMI of 26.4\u2009kg\/m\u00b2 (\u00b15.7). The most common comorbidities were arterial hypertension (43.8%), cardiovascular diseases (25.2%) and diabetes (21%). A total of 380 (62.7%)of patients were infected with the Wild\u2010Type variant, 49 (8.1%) with Wild\u2010Type\/Alpha, 17 (2.8%)with Alpha, 20 (3.3%)with Alpha\/Delta,45 (7.4%)with Delta, 4 (0.7%)with Delta\/Omicron, and 91 (15%) with Omicron. The clinical presentation evolved significantly: we observed a decline in the prevalence of fever (78% in Wild\u2010Type vs. 57% in Omicron), myalgia (19% vs. 4%), diarrhoea (15% vs. 3%), rhinorrhoea (9% vs. 1%), and ageusia, which disappeared entirely in Omicron cases. In contrast, neurological symptoms became more frequent, increasing from 13% in Wild\u2010Type to 27% in Omicron infections, with delirium being the most common manifestation (59% of neurological cases). In\u2010hospital mortality was significantly lower with Omicron variants (5.5%) as compared to the older ones (Delta 15.9%, WT\/alpha 13.2%,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.001). Out of 256 participants with risk factors for severe disease, 116 (45.3%) could have potentially been treated with anti\u2010SARS\u2010CoV\u20102 drugs for early treatment: only two patients (1.7%) were treated with such drugs in out\u2010of\u2010hospital settings. These results underscore the importance of targeted vaccination campaigns, enhanced access to early antiviral therapies, and further research to understand evolving clinical patterns and optimize therapeutic strategies.\n                  <\/jats:p>","DOI":"10.1002\/jmv.70652","type":"journal-article","created":{"date-parts":[[2025,10,21]],"date-time":"2025-10-21T08:25:41Z","timestamp":1761035141000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The Clinical Presentations of Patients With COVID\u201019 in the Omicron Era: Missed Opportunities in the Antiviral Treatment of SARS\u2010CoV\u20102 Infections"],"prefix":"10.1002","volume":"97","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-6955-6619","authenticated-orcid":false,"given":"G.","family":"Bartolucci","sequence":"first","affiliation":[{"name":"Department of Medical Sciences University of Turin Turin Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"E.","family":"Garro","sequence":"additional","affiliation":[{"name":"Department of Medical Sciences University of Turin Turin Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M.","family":"Mussa","sequence":"additional","affiliation":[{"name":"Local Health Authority (ASL) Citt\u00e0 di Torino Turin Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A.","family":"Pepe","sequence":"additional","affiliation":[{"name":"Department of Medical Sciences University of Turin Turin Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R.","family":"Angilletta","sequence":"additional","affiliation":[{"name":"Local Health Authority (ASL) Citt\u00e0 di Torino Turin Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"B.","family":"Rizzello","sequence":"additional","affiliation":[{"name":"Department of Medical Sciences University of Turin Turin Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"F. A.","family":"Ranzani","sequence":"additional","affiliation":[{"name":"Department of Medical Sciences University of Turin Turin Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S.","family":"Bonora","sequence":"additional","affiliation":[{"name":"Department of Medical Sciences University of Turin Turin Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"G.","family":"Di Perri","sequence":"additional","affiliation":[{"name":"Department of Medical Sciences University of Turin Turin Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A.","family":"Calcagno","sequence":"additional","affiliation":[{"name":"Department of Medical Sciences University of Turin Turin Italy"},{"name":"Unit of Infectious Diseases, Department of Translational Medicine University of EASTERN piedmont Novara Italy"},{"name":"Unit of Infectious Diseases Ospedale Maggiore della Carit\u00e0 Novara Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,10,21]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/jmv.29012"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12967-023-04095-6"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1140\/epjp\/s13360-023-03719-6"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2022.28008"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2468-2667(23)00079-8"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(22)00327-0"},{"key":"e_1_2_8_8_1","unstructured":"CDC.People with Certain Medical Conditions and COVID\u201019 Risk Factors. 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ISS accessed May 13 2024 https:\/\/www.iss.it\/-\/comunicato-stampa-n%C2%B004\/2022-covid19-flash-survey-iss-il-10-gennaio-la-variante-omicron-al-100\u2010."},{"key":"e_1_2_8_21_1","unstructured":"Comunicato Stampa N\u00b008\/2022 \u2010 Covid\u201019 flash survey Iss: il 17 gennaio il 95 8% dei campioni positivi a Omicron. ISS accessed May 13 2024 https:\/\/www.iss.it\/cov19-cosa-fa-iss-varianti\/-\/asset_publisher\/yJS4xO2fauqM\/content\/comunicato%C2%A0stampa-n%C2%B008-2022-covid-19-flash-survey-iss-il-17-gennaio-il-95-8-dei-campioni-positivi-a-omicron."},{"key":"e_1_2_8_22_1","unstructured":"Comunicato Stampa N\u00b011\/2023 Covid19: flash survey Iss il 7 febbraio variante Omicron al 99 9% BA.5 in calo. ISS accessed May 13 2024 https:\/\/www.iss.it\/-\/comunicato-stampa-n%C2%B012\/2023-covid19-flash-survey-iss-il-7-febbraio-variante-omicron-al-99-9-ba.5-in-calo."},{"key":"e_1_2_8_23_1","unstructured":"COMUNICATO STAMPA N\u00b012\/2022 \u2010 Covid\u201019 flash survey Iss: il 31 gennaio il 99 1% dei campioni positivi a Omicron. ISS accessed May 13 2024 https:\/\/www.iss.it\/cov19-cosa-fa-iss-varianti\/-\/asset_publisher\/yJS4xO2fauqM\/content\/comunicato-stampa-n%C2%B012-2022-%C2%A0covid-19-flash-survey-iss-il-31-gennaio-il-99-1-dei-campioni-positivi-a-omicron."},{"key":"e_1_2_8_24_1","unstructured":"Comunicato Stampa N\u00b020\/2023 Covid19: flash survey varianti Iss il 7 marzo XBB.1.5 al 38 4%. ISS accessed May 13 2024 https:\/\/www.iss.it\/-\/comunicato-stampa-n%C2%B020\/2023-covid19-flash-survey-varianti-iss-il-7-marzo-xbb.1.5-al-38-4\u2010."},{"key":"e_1_2_8_25_1","unstructured":"Comunicato Stampa N\u00b029\/2023 Covid19: flash survey varianti Iss il 4 aprile XBB.1.5 al 45 3%. ISS accessed May 13 2024 https:\/\/www.iss.it\/-\/comunicato-stampa-n%C2%B028\/2023-covid19-flash-survey-varianti-iss-il-4-aprile-xbb.1.5-al-45-3\u2010."},{"key":"e_1_2_8_26_1","unstructured":"Comunicato Stampa N\u00b030\/2022 \u2010 Covid19: flash survey Iss il 4 aprile Omicron al 100% sottovariante BA.2 predominante. ISS accessed May 13 2024 https:\/\/www.iss.it\/cov19-cosa-fa-iss-varianti\/-\/asset_publisher\/yJS4xO2fauqM\/content\/comunicato-stampa-n%C2%B030-2022-%C2%A0covid19-flash-survey-iss-il-4-aprile-omicron-al-100-sottovariante-ba.2-predominante."},{"key":"e_1_2_8_27_1","unstructured":"Comunicato Stampa N\u00b036\/2022 \u2010 Covid19: flash survey Iss il 3 maggio Omicron al 100% sottovariante BA.2 predominante presenti anche BA.4 e BA.5. ISS accessed May 13 2024 https:\/\/www.iss.it\/cov19-cosa-fa-iss-varianti\/-\/asset_publisher\/yJS4xO2fauqM\/content\/comunicato-stampa-n%C2%B036-2022-covid19-flash-survey-iss-il-3-maggio-omicron-al-100-sottovariante-ba.2-predominante-presenti-anche-ba.4-e-ba.5."},{"key":"e_1_2_8_28_1","unstructured":"Comunicato Stampa N\u00b044\/2022 \u2010 Covid19: flash survey Iss il 7 giugno Omicron al 100% sottovariante BA.2 predominante ma in aumento BA.5 al 23 15%. ISS accessed May 13 2024 https:\/\/www.iss.it\/cov19-cosa-fa-iss-varianti\/-\/asset_publisher\/yJS4xO2fauqM\/content\/comunicato-stampa-n%C2%B044-2022-%C2%A0covid19-flash-survey-iss-il-7-giugno-omicron-al-100-sottovariante-ba.2-predominante-ma-in-aumento-ba.5-al-23-15\u2010."},{"key":"e_1_2_8_29_1","unstructured":"Comunicato Stampa N\u00b052\/2022 \u2010 Covid19: flash survey Iss il 5 luglio Omicron al 100% sottovariante BA.5 predominante al 75 5%. ISS accessed May 13 2024 https:\/\/www.iss.it\/cov19-cosa-fa-iss-varianti\/-\/asset_publisher\/yJS4xO2fauqM\/content\/comunicato-stampa-n%C2%B051-2022-%C2%A0covid19-flash-survey-iss-il-5-luglio-omicron-al-100-sottovariante-ba.5-predominante-al-75-5\u2010."},{"key":"e_1_2_8_30_1","unstructured":"Comunicato Stampa N\u00b057\/2022 \u2010 Covid19: flash survey Iss il 2 agosto Omicron al 100% sottovariante BA.5 predominante al 90 8%. ISS accessed May 13 2024 https:\/\/www.iss.it\/-\/comunicato-stampa-n%C2%B057\/2022-covid19-flash-survey-iss-il-2-agosto-omicron-al-100-sottovariante-ba.5-predominante-al-90-8\u2010."},{"key":"e_1_2_8_31_1","unstructured":"Comunicato Stampa N\u00b078\/2022 Covid19: flash survey Iss l'8 novembre la variante Omicron al 99 8%. ISS accessed May 13 2024 https:\/\/www.iss.it\/-\/comunicato-stampa-n%C2%B078\/2022-covid19-flash-survey-iss-l-8-novembre-la-variante-omicron-al-99-8\u2010."},{"key":"e_1_2_8_32_1","unstructured":"Comunicato Stampa N\u00b085\/2022 \u2010 Covid19: flash survey Iss il 13 dicembre la variante Omicron al 100%. ISS accessed May 13 2024 https:\/\/www.iss.it\/-\/covid19-flash-survey-iss-il-13-dicembre-la-variante-omicron-al-100\u2010."},{"key":"e_1_2_8_33_1","unstructured":"Covid\u201019: analisi acque reflue conferma forte incremento Omicron tra il 5 e il 25 dicembre. ISS accessed May 13 2024 https:\/\/www.iss.it\/cov19-acque-reflue\/-\/asset_publisher\/dJSrLJgOqlTV\/content\/covid-19-analisi-acque-reflue-conferma-forte-incremento-omicron-tra-il-5-e-il-25-dicembre."},{"key":"e_1_2_8_34_1","unstructured":"Covid\u201019: Flash survey su acque reflue nel periodo 30 novembre \u2013 3 dicembre conferma la prevalenza della variante Delta; non rilevata la variante Omicron. 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