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Severity of Severe Acute Respiratory System Coronavirus 2 (SARS-CoV-2) Alpha Variant (B.1.1.7) in England.
Grint, Daniel J; Wing, Kevin; Houlihan, Catherine; Gibbs, Hamish P; Evans, Stephen J W; Williamson, Elizabeth; McDonald, Helen I; Bhaskaran, Krishnan; Evans, David; Walker, Alex J; Hickman, George; Nightingale, Emily; Schultze, Anna; Rentsch, Christopher T; Bates, Chris; Cockburn, Jonathan; Curtis, Helen J; Morton, Caroline E; Bacon, Sebastian; Davy, Simon; Wong, Angel Y S; Mehrkar, Amir; Tomlinson, Laurie; Douglas, Ian J; Mathur, Rohini; MacKenna, Brian; Ingelsby, Peter; Croker, Richard; Parry, John; Hester, Frank; Harper, Sam; DeVito, Nicholas J; Hulme, Will; Tazare, John; Smeeth, Liam; Goldacre, Ben; Eggo, Rosalind M.
  • Grint DJ; Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom.
  • Wing K; Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom.
  • Houlihan C; Division of Infection and Immunity, University College London, London, United Kingdom.
  • Gibbs HP; Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom.
  • Evans SJW; Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom.
  • Williamson E; Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom.
  • McDonald HI; Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom.
  • Bhaskaran K; Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom.
  • Evans D; The DataLab, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom.
  • Walker AJ; The DataLab, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom.
  • Hickman G; The DataLab, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom.
  • Nightingale E; Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, United Kingdom.
  • Schultze A; Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom.
  • Rentsch CT; Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom.
  • Bates C; TPP, Horsforth, Leeds, United Kingdom.
  • Cockburn J; TPP, Horsforth, Leeds, United Kingdom.
  • Curtis HJ; The DataLab, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom.
  • Morton CE; The DataLab, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom.
  • Bacon S; The DataLab, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom.
  • Davy S; The DataLab, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom.
  • Wong AYS; Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom.
  • Mehrkar A; The DataLab, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom.
  • Tomlinson L; Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom.
  • Douglas IJ; Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom.
  • Mathur R; Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom.
  • MacKenna B; The DataLab, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom.
  • Ingelsby P; The DataLab, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom.
  • Croker R; The DataLab, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom.
  • Parry J; TPP, Horsforth, Leeds, United Kingdom.
  • Hester F; TPP, Horsforth, Leeds, United Kingdom.
  • Harper S; TPP, Horsforth, Leeds, United Kingdom.
  • DeVito NJ; The DataLab, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom.
  • Hulme W; The DataLab, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom.
  • Tazare J; Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom.
  • Smeeth L; Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom.
  • Goldacre B; The DataLab, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom.
  • Eggo RM; Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom.
Clin Infect Dis ; 75(1): e1120-e1127, 2022 Aug 24.
Article in English | MEDLINE | ID: covidwho-1706197
ABSTRACT

BACKGROUND:

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) alpha variant (B.1.1.7) is associated with higher transmissibility than wild-type virus, becoming the dominant variant in England by January 2021. We aimed to describe the severity of the alpha variant in terms of the pathway of disease from testing positive to hospital admission and death.

METHODS:

With the approval of NHS England, we linked individual-level data from primary care with SARS-CoV-2 community testing, hospital admission, and Office for National Statistics all-cause death data. We used testing data with S-gene target failure as a proxy for distinguishing alpha and wild-type cases, and stratified Cox proportional hazards regression to compare the relative severity of alpha cases with wild-type diagnosed from 16 November 2020 to 11 January 2021.

RESULTS:

Using data from 185 234 people who tested positive for SARS-CoV-2 in the community (alpha = 93 153; wild-type = 92 081), in fully adjusted analysis accounting for individual-level demographics and comorbidities as well as regional variation in infection incidence, we found alpha associated with 73% higher hazards of all-cause death (adjusted hazard ratio [aHR] 1.73; 95% confidence interval [CI] 1.41-2.13; P < .0001) and 62% higher hazards of hospital admission (1.62; 1.48-1.78; P < .0001) compared with wild-type virus. Among patients already admitted to the intensive care unit, the association between alpha and increased all-cause mortality was smaller and the CI included the null (aHR 1.20; 95% CI .74-1.95; P = .45).

CONCLUSIONS:

The SARS-CoV-2 alpha variant is associated with an increased risk of both hospitalization and mortality than wild-type virus.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: SARS-CoV-2 / COVID-19 Type of study: Observational study / Prognostic study Topics: Variants Limits: Humans Language: English Journal: Clin Infect Dis Journal subject: Communicable Diseases Year: 2022 Document Type: Article Affiliation country: Cid

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Full text: Available Collection: International databases Database: MEDLINE Main subject: SARS-CoV-2 / COVID-19 Type of study: Observational study / Prognostic study Topics: Variants Limits: Humans Language: English Journal: Clin Infect Dis Journal subject: Communicable Diseases Year: 2022 Document Type: Article Affiliation country: Cid