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Real-life studies investigating the impact of these variants on clinical outcomes of severe cases are currently not available. We performed a prospective multicenter observational cohort study. Adult patients with acute respiratory failure admitted between December 7, 2021 and December 15, 2022, in one of the 20 participating intensive care units (17 from the Greater Paris area and 3 from the North of France) were eligible for inclusion if they had SARS-CoV-2 infection confirmed by a positive reverse transcriptase-polymerase chain reaction (RT-PCR). Full-length SARS-CoV-2 genomes from all included patients were sequenced by means of next-generation sequencing. The primary endpoint of the study was day-28 mortality.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>The study included 158 patients infected with three groups of Omicron sublineages, including (i) BA.2 variants and their early sublineages referred as \u201cBA.2\u201d (n\u2009=\u200950), (ii) early BA.4 and BA.5 sublineages (including BA.5.1 and BA.5.2, n\u2009=\u200961) referred as \u201cBA.4\/BA.5\u201d, and (iii) recent emerging BA.5 sublineages (including BQ.1, BQ.1.1, BF.7, BE.1 and CE.1, n\u2009=\u200947) referred as \u201cBQ.1.1\u201d. The clinical phenotype of BQ1.1-infected patients compared to earlier BA.2 and BA.4\/BA.5 sublineages, showed more frequent obesity and less frequent immunosuppression. There was no significant difference between Omicron sublineage groups regarding the severity of the disease at ICU admission, need for organ failure support during ICU stay, nor day 28 mortality (21.7%, n\u2009=\u200910\/47 in BQ.1.1 group vs 26.7%, n\u2009=\u200916\/61 in BA.4\/BA.5 vs 22.0%, n\u2009=\u200911\/50 in BA.2, p\u2009=\u20090.791). No significant relationship was found between any SARS-CoV-2 substitution and\/or deletion on the one hand and survival on the other hand over hospital follow-up.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>Critically-ill patients with Omicron BQ.1.1 infection showed a different clinical phenotype than other patients infected with earlier Omicron sublineage but no day-28 mortality difference.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s40635-023-00536-0","type":"journal-article","created":{"date-parts":[[2023,8,6]],"date-time":"2023-08-06T23:06:53Z","timestamp":1691363213000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Clinical phenotypes and outcomes associated with SARS-CoV-2 Omicron variants BA.2, BA.5 and BQ.1.1 in critically ill patients with COVID-19: a prospective, multicenter cohort 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Informed consent was obtained from all patients or their relatives.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Patients received information during their hospital stay that data abstracted from their medical charts could be used for research purposes.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"S.F. has served as a speaker for GlaxoSmithKline, Cepheid and Astrazeneca. J.-M.P. has served as an advisor or speaker for Abbvie, Arbutus, Assembly Biosciences, Gilead, GSK, and Merck. E.A. has received fees for lectures from Alexion, Sanofi, Gilead and Pfizer. His hospital has received research grant from Pfizer, MSD and Alexion. D.D. served as an advisor for Gilead-Sciences, ViiV Health care, Janssen-Cilag and MSD. F.P. served as an advisor for Gilead; he also received research grant from Alexion. C.-E.L. received lecture fees from MSD, Aerogen, Advanzpharma, and BioM\u00e9rieux, outside the submitted work. Other authors have no conflict of interest to disclose.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"48"}}