{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,6]],"date-time":"2026-04-06T14:02:59Z","timestamp":1775484179519,"version":"3.50.1"},"reference-count":50,"publisher":"MDPI AG","issue":"17","license":[{"start":{"date-parts":[[2023,8,26]],"date-time":"2023-08-26T00:00:00Z","timestamp":1693008000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Polish Association of Epidemiologists and Infectiologists"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>This study aimed to compare the clinical picture of COVID-19 in the initial and later period of Omicron dominance and to identify populations still at risk. A retrospective comparison of the clinical data of 965 patients hospitalized during the early period of Omicron\u2019s dominance (EO, January\u2013June 2022) with 897 patients from a later period (LO, July 2022\u2013April 2023) from the SARSTer database was performed. Patients hospitalized during LO, compared to EO, were older, had a better clinical condition on admission, had a lower need for oxygen and mechanical ventilation, had less frequent lung involvement in imaging, and showed much faster clinical improvement. Moreover, the overall mortality during EO was 14%, higher than that in LO\u20149%. Despite the milder course of the disease, mortality exceeding 15% was similar in both groups among patients with lung involvement. The accumulation of risk factors such as an age of 60+, comorbidities, lung involvement, and oxygen saturation &lt;90% resulted in a constant need for oxygen in 98% of patients, an 8% risk of mechanical ventilation, and a 30% mortality rate in the LO period. Multiple logistic regression revealed lower odds of death during the LO phase. Despite the milder course of infections caused by the currently dominant subvariants, COVID-19 prophylaxis is necessary in people over 60 years of age, especially those with comorbidities, and in the case of pneumonia and respiratory failure.<\/jats:p>","DOI":"10.3390\/jcm12175572","type":"journal-article","created":{"date-parts":[[2023,8,28]],"date-time":"2023-08-28T05:46:47Z","timestamp":1693201607000},"page":"5572","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":27,"title":["Change in the Clinical Picture of Hospitalized Patients with COVID-19 between the Early and Late Period of Dominance of the Omicron SARS-CoV-2 Variant"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3394-1635","authenticated-orcid":false,"given":"Robert","family":"Flisiak","sequence":"first","affiliation":[{"name":"Department of Infectious Diseases and Hepatology, Medical University of Bia\u0142ystok, 15-540 Bia\u0142ystok, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0938-1084","authenticated-orcid":false,"given":"Dorota","family":"Zar\u0119bska-Michaluk","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases and Allergology, Jan Kochanowski University, 25-317 Kielce, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Krystyna","family":"Dobrowolska","sequence":"additional","affiliation":[{"name":"Collegium Medicum, Jan Kochanowski University, 25-317 Kielce, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5318-4945","authenticated-orcid":false,"given":"Marta","family":"Rorat","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases and Hepatology, Wroc\u0142aw Medical University, 51-149 Wroc\u0142aw, Poland"},{"name":"Department of Forensic Medicine, Wroc\u0142aw Medical University, 50-367 Wroc\u0142aw, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Magdalena","family":"Rogalska","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases and Hepatology, Medical University of Bia\u0142ystok, 15-540 Bia\u0142ystok, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-7995-4427","authenticated-orcid":false,"given":"Justyna Anna","family":"Kry\u0144ska","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases and Hepatology, Medical University of Bia\u0142ystok, 15-540 Bia\u0142ystok, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anna","family":"Moniuszko-Malinowska","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases and Neuroinfections, Medical University of Bia\u0142ystok, 15-809 Bia\u0142ystok, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0072-2180","authenticated-orcid":false,"given":"Piotr","family":"Czupryna","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases and Neuroinfections, Medical University of Bia\u0142ystok, 15-809 Bia\u0142ystok, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4651-6443","authenticated-orcid":false,"given":"Dorota","family":"Kozielewicz","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases and Hepatology, Faculty of Medicine, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University, 87-100 Toru\u0144, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jerzy","family":"Jaroszewicz","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases and Hepatology, Medical University of Silesia in Katowice, 41-902 Bytom, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5678-5669","authenticated-orcid":false,"given":"Katarzyna","family":"Sikorska","sequence":"additional","affiliation":[{"name":"Division of Tropical and Parasitic Diseases, Faculty of Health Sciences, Medical University of Gda\u0144sk, 80-210 Gda\u0144sk, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Agnieszka","family":"Bednarska","sequence":"additional","affiliation":[{"name":"Department of Adult\u2019s Infectious Diseases, Medical University of Warsaw, Hospital for Infectious Diseases, 02-091 Warsaw, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7188-4881","authenticated-orcid":false,"given":"Anna","family":"Piekarska","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases and Hepatology, Medical University of \u0141\u00f3d\u017a, 90-419 \u0141\u00f3d\u017a, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4713-0801","authenticated-orcid":false,"given":"Piotr","family":"Rzymski","sequence":"additional","affiliation":[{"name":"Department of Environmental Medicine, Pozna\u0144 University of Medical Sciences, 60-806 Pozna\u0144, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,8,26]]},"reference":[{"key":"ref_1","unstructured":"(2023, June 16). Tracking SARS-CoV-2 Variants. Available online: https:\/\/www.who.int\/activities\/tracking-SARS-CoV-2-variants\/tracking-SARS-CoV-2-variants."},{"key":"ref_2","unstructured":"(2023, June 16). WHO Coronavirus (COVID-19) Dashboard. Available online: https:\/\/covid19.who.int\/."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"2376","DOI":"10.1002\/jmv.27643","article-title":"The Emergence and Epidemic Characteristics of the Highly Mutated SARS-CoV-2 Omicron Variant","volume":"94","author":"Tian","year":"2022","journal-title":"J. Med. Virol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"835","DOI":"10.1016\/j.cmi.2023.03.017","article-title":"Clinical Outcomes of the Severe Acute Respiratory Syndrome Coronavirus 2 Omicron and Delta Variant: Systematic Review and Meta-Analysis of 33 Studies Covering 6 037 144 Coronavirus Disease 2019-Positive Patients","volume":"29","author":"Hu","year":"2023","journal-title":"Clin. Microbiol. Infect."},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Chatterjee, S., Bhattacharya, M., Nag, S., Dhama, K., and Chakraborty, C. (2023). A Detailed Overview of SARS-CoV-2 Omicron: Its Sub-Variants, Mutations and Pathophysiology, Clinical Characteristics, Immunological Landscape, Immune Escape, and Therapies. Viruses, 15.","DOI":"10.3390\/v15010167"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"831","DOI":"10.7326\/M22-0308","article-title":"Comparison of Patients Infected with Delta Versus Omicron COVID-19 Variants Presenting to Paris Emergency Departments: A Retrospective Cohort Study","volume":"175","author":"Bouzid","year":"2022","journal-title":"Ann. Intern. Med."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"e069761","DOI":"10.1136\/bmj-2021-069761","article-title":"Clinical Severity of, and Effectiveness of MRNA Vaccines against, Covid-19 from Omicron, Delta, and Alpha SARS-CoV-2 Variants in the United States: Prospective Observational Study","volume":"376","author":"Lauring","year":"2022","journal-title":"BMJ"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"e239","DOI":"10.1002\/mco2.239","article-title":"The Rapid Rise of SARS-CoV-2 Omicron Subvariants with Immune Evasion Properties: XBB.1.5 and BQ.1.1 Subvariants","volume":"4","author":"Ao","year":"2023","journal-title":"MedComm"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"100556","DOI":"10.1016\/j.lanepe.2022.100556","article-title":"Severity of Omicron (B.1.1.529) and Delta (B.1.617.2) SARS-CoV-2 Infection among Hospitalised Adults: A Prospective Cohort Study in Bristol, United Kingdom","volume":"25","author":"Hyams","year":"2023","journal-title":"Lancet Reg. Health Eur."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"e28138","DOI":"10.1002\/jmv.28138","article-title":"The Outbreak of SARS-CoV-2 Omicron Lineages, Immune Escape, and Vaccine Effectivity","volume":"95","author":"Zhou","year":"2023","journal-title":"J. Med. Virol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1130539","DOI":"10.3389\/fimmu.2023.1130539","article-title":"SARS-CoV-2 Omicron Variants: Burden of Disease, Impact on Vaccine Effectiveness and Need for Variant-Adapted Vaccines","volume":"14","author":"Pather","year":"2023","journal-title":"Front. Immunol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"593","DOI":"10.1038\/s41586-022-04980-y","article-title":"BA.2.12.1, BA.4 and BA.5 Escape Antibodies Elicited by Omicron Infection","volume":"608","author":"Cao","year":"2022","journal-title":"Nature"},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Flisiak, R., Rzymski, P., Zar\u0119bska-Michaluk, D., Ciechanowski, P., Dobrowolska, K., Rogalska, M., Jaroszewicz, J., Szymanek-Pasternak, A., Rorat, M., and Kozielewicz, D. (2023). Variability in the Clinical Course of COVID-19 in a Retrospective Analysis of a Large Real-World Database. Viruses, 15.","DOI":"10.3390\/v15010149"},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Seyler, L., Van Nedervelde, E., De Cock, D., Mann, C., Pien, K., Allard, S.D., and Demuyser, T. (2023). Surfing the Waves: Differences in Hospitalised COVID-19 Patients across 4 Variant Waves in a Belgian University Hospital. Viruses, 15.","DOI":"10.3390\/v15030618"},{"key":"ref_15","unstructured":"(2023, June 07). WHO Statement on the Fifteenth Meeting of the IHR (2005) Emergency Committee on the COVID-19 Pandemic. Available online: https:\/\/www.who.int\/news\/item\/05-05-2023-statement-on-the-fifteenth-meeting-of-the-international-health-regulations-(2005)-emergency-committee-regarding-the-coronavirus-disease-(covid-19)-pandemic."},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Rzymski, P., Pokorska-\u015apiewak, M., Jackowska, T., Kuchar, E., Nitsch-Osuch, A., Paw\u0142owska, M., Babicki, M., Jaroszewicz, J., Szenborn, L., and Wysocki, J. (2023). Key Essentials during the Transition from the Acute Phase of the COVID-19 Pandemic. Preprints, 2023081245.","DOI":"10.20944\/preprints202308.1245.v1"},{"key":"ref_17","first-page":"487","article-title":"Management of SARS-CoV-2 Infection: Recommendations of the Polish Association of Epidemiologists and Infectiologists as of April 26, 2021","volume":"131","author":"Flisiak","year":"2021","journal-title":"Pol. Arch. Intern. Med."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"16230","DOI":"10.20452\/pamw.16230","article-title":"Management of SARS-CoV-2 Infection: Recommendations of the Polish Association of Epidemiologists and Infectiologists as of February 23, 2022","volume":"132","author":"Flisiak","year":"2022","journal-title":"Pol. Arch. Intern. Med."},{"key":"ref_19","unstructured":"(2023, June 25). Genomic Epidemiology of SARS-CoV-2 with Subsampling Focused on Europe Since Pandemic Start. Available online: https:\/\/nextstrain.org\/ncov\/gisaid\/europe\/."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1279","DOI":"10.1007\/s43440-022-00408-6","article-title":"Real-World Experience with Molnupiravir during the Period of SARS-CoV-2 Omicron Variant Dominance","volume":"74","author":"Flisiak","year":"2022","journal-title":"Pharmacol. Rep."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"829","DOI":"10.1016\/j.kint.2020.03.005","article-title":"Kidney Disease Is Associated with In-Hospital Death of Patients with COVID-19","volume":"97","author":"Cheng","year":"2020","journal-title":"Kidney Int."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1186\/s12985-023-02018-x","article-title":"A Comparison of Transmissibility of SARS-CoV-2 Variants of Concern","volume":"20","author":"Manathunga","year":"2023","journal-title":"Virol. J."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1056\/NEJMoa2203965","article-title":"Effects of Previous Infection and Vaccination on Symptomatic Omicron Infections","volume":"387","author":"Altarawneh","year":"2022","journal-title":"N. Engl. J. Med."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"4675","DOI":"10.1038\/s41467-022-32363-4","article-title":"Protection of Omicron Sub-Lineage Infection against Reinfection with Another Omicron Sub-Lineage","volume":"13","author":"Chemaitelly","year":"2022","journal-title":"Nat. Commun."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"217","DOI":"10.15585\/mmwr.mm7106e2","article-title":"Clinical Characteristics and Outcomes Among Adults Hospitalized with Laboratory-Confirmed SARS-CoV-2 Infection During Periods of B.1.617.2 (Delta) and B.1.1.529 (Omicron) Variant Predominance\u2014One Hospital, California, July 15\u2013September 23, 2021, and December 21, 2021\u2013January 27, 2022","volume":"71","author":"Modes","year":"2022","journal-title":"MMWR Morb. Mortal. Wkly. Rep."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"e28831","DOI":"10.1002\/jmv.28831","article-title":"Evolution of SARS-CoV-2 Variants of Concern over a Period of Delta and Omicron Cocirculation, among Patients Hospitalized for COVID-19 in an Italian Reference Hospital: Impact on Clinical Outcomes","volume":"95","author":"Mondi","year":"2023","journal-title":"J. Med. Virol."},{"key":"ref_27","first-page":"e35261","article-title":"Clinical Characteristics and Outcomes of Laboratory-Confirmed SARS-CoV-2 Cases Infected with Omicron Subvariants and the XBB Recombinant Variant","volume":"15","author":"Karyakarte","year":"2023","journal-title":"Cureus"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1933","DOI":"10.1038\/s41591-022-01887-z","article-title":"Clinical Outcomes Associated with SARS-CoV-2 Omicron (B.1.1.529) Variant and BA.1\/BA.1.1 or BA.2 Subvariant Infection in Southern California","volume":"28","author":"Lewnard","year":"2022","journal-title":"Nat. Med."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1029171","DOI":"10.3389\/fpubh.2022.1029171","article-title":"Omicron Subvariant BA.5 Is Highly Contagious but Containable: Successful Experience from Macau","volume":"10","author":"Xu","year":"2022","journal-title":"Front. Public. Health"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1016\/S0140-6736(22)00981-3","article-title":"Clinical Severity of Omicron Lineage BA.2 Infection Compared with BA.1 Infection in South Africa","volume":"400","author":"Wolter","year":"2022","journal-title":"Lancet"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"7896","DOI":"10.1038\/s41598-023-34712-9","article-title":"A Retrospective Analysis of Clinical Features of Patients Hospitalized with SARS-CoV-2 Omicron Variants BA.1 and BA.2","volume":"13","author":"Groza","year":"2023","journal-title":"Sci. Rep."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"e28423","DOI":"10.1002\/jmv.28423","article-title":"Clinical Severity of Omicron Subvariants BA.1, BA.2, and BA.5 in a Population-Based Cohort Study in British Columbia, Canada","volume":"95","author":"Russell","year":"2023","journal-title":"J. Med. Virol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"1276","DOI":"10.1093\/cid\/ciac885","article-title":"Omicron Subvariants: Clinical, Laboratory, and Cell Culture Characterization","volume":"76","author":"Morris","year":"2023","journal-title":"Clin. Infect. Dis."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"135694","DOI":"10.1016\/j.neulet.2021.135694","article-title":"Smell and Taste Disorders in COVID-19: From Pathogenesis to Clinical Features and Outcomes","volume":"748","author":"Mastrangelo","year":"2021","journal-title":"Neurosci. Lett."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"1426","DOI":"10.1016\/j.cmi.2020.05.017","article-title":"Anosmia in COVID-19 Patients","volume":"26","author":"Hornuss","year":"2020","journal-title":"Clin. Microbiol. Infect."},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Nakakubo, S., Kishida, N., Okuda, K., Kamada, K., Iwama, M., Suzuki, M., Yokota, I., Ito, Y.M., Nasuhara, Y., and Boucher, R.C. (2023). Associations of COVID-19 Symptoms with Omicron Subvariants BA.2 and BA.5, Host Status, and Clinical Outcomes: A Registry-Based Observational Study in Sapporo, Japan. medRxiv.","DOI":"10.2139\/ssrn.4342775"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"252","DOI":"10.1148\/radiol.220676","article-title":"Chest CT Findings in Hospitalized Patients with SARS-CoV-2: Delta versus Omicron Variants","volume":"306","author":"Yoon","year":"2023","journal-title":"Radiology"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"261","DOI":"10.1148\/radiol.220533","article-title":"Reduction in Chest CT Severity and Improved Hospital Outcomes in SARS-CoV-2 Omicron Compared with Delta Variant Infection","volume":"306","author":"Tsakok","year":"2023","journal-title":"Radiology"},{"key":"ref_39","doi-asserted-by":"crossref","unstructured":"Duong, B.V., Larpruenrudee, P., Fang, T., Hossain, S.I., Saha, S.C., Gu, Y., and Islam, M.S. (2022). Is the SARS CoV-2 Omicron Variant Deadlier and More Transmissible Than Delta Variant?. Int. J. Environ. Res. Public. Health, 19.","DOI":"10.3390\/ijerph19084586"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"167","DOI":"10.1016\/S1473-3099(22)00595-3","article-title":"Risk of Reinfection, Vaccine Protection, and Severity of Infection with the BA.5 Omicron Subvariant: A Nation-Wide Population-Based Study in Denmark","volume":"23","author":"Hansen","year":"2023","journal-title":"Lancet Infect. Dis."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1016\/j.ijid.2022.11.024","article-title":"Outcomes of Laboratory-Confirmed SARS-CoV-2 Infection during Resurgence Driven by Omicron Lineages BA.4 and BA.5 Compared with Previous Waves in the Western Cape Province, South Africa","volume":"127","author":"Davies","year":"2023","journal-title":"Int. J. Infect. Dis."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"128","DOI":"10.1016\/j.jinf.2023.05.019","article-title":"Directions of Change in Intrinsic Case Severity across Successive SARS-CoV-2 Variant Waves Have Been Inconsistent","volume":"87","author":"Pascall","year":"2023","journal-title":"J. Infect."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"3992","DOI":"10.1016\/j.cell.2022.09.018","article-title":"Virological Characteristics of the SARS-CoV-2 Omicron BA.2 Subvariants, Including BA.4 and BA.5","volume":"185","author":"Kimura","year":"2022","journal-title":"Cell"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"2178241","DOI":"10.1080\/22221751.2023.2178241","article-title":"SARS-CoV-2 Omicron Subvariants Exhibit Distinct Fusogenicity, but Similar Sensitivity, to Pan-CoV Fusion Inhibitors","volume":"12","author":"Xia","year":"2023","journal-title":"Emerg. Microbes Infect."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"e28641","DOI":"10.1002\/jmv.28641","article-title":"SARS-CoV-2 Omicron XBB Subvariants Exhibit Enhanced Fusogenicity and Substantial Immune Evasion in Elderly Population, but High Sensitivity to Pan-Coronavirus Fusion Inhibitors","volume":"95","author":"Xia","year":"2023","journal-title":"J. Med. Virol."},{"key":"ref_46","doi-asserted-by":"crossref","unstructured":"Planas, D., Bruel, T., Staropoli, I., Guivel-Benhassine, F., Porrot, F., Maes, P., Grzelak, L., Prot, M., Mougari, S., and Planchais, C. (2022). Resistance of Omicron Subvariants BA.2.75.2, BA.4.6 and BQ.1.1 to Neutralizing Antibodies. bioRxiv.","DOI":"10.1101\/2022.11.17.516888"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"468","DOI":"10.1056\/NEJMc2207519","article-title":"Efficacy of Antibodies and Antiviral Drugs against Omicron BA.2.12.1, BA.4, and BA.5 Subvariants","volume":"387","author":"Takashita","year":"2022","journal-title":"N. Engl. J. Med."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1056\/NEJMc2214302","article-title":"Efficacy of Antiviral Agents against Omicron Subvariants BQ.1.1 and XBB","volume":"388","author":"Imai","year":"2023","journal-title":"N. Engl. J. Med."},{"key":"ref_49","doi-asserted-by":"crossref","unstructured":"Bergeri, I., Whelan, M.G., Ware, H., Subissi, L., Nardone, A., Lewis, H.C., Li, Z., Ma, X., Valenciano, M., and Cheng, B. (2022). Global SARS-CoV-2 Seroprevalence from January 2020 to April 2022: A Systematic Review and Meta-Analysis of Standardized Population-Based Studies. PLoS Med., 19.","DOI":"10.1371\/journal.pmed.1004107"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"eabn4947","DOI":"10.1126\/science.abn4947","article-title":"Increased Risk of SARS-CoV-2 Reinfection Associated with Emergence of Omicron in South Africa","volume":"376","author":"Pulliam","year":"2022","journal-title":"Science"}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/12\/17\/5572\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T20:39:48Z","timestamp":1760128788000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/12\/17\/5572"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,8,26]]},"references-count":50,"journal-issue":{"issue":"17","published-online":{"date-parts":[[2023,9]]}},"alternative-id":["jcm12175572"],"URL":"https:\/\/doi.org\/10.3390\/jcm12175572","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,8,26]]}}}