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Symptom prevalence, duration, and risk of hospital admission in individuals infected with SARS-CoV-2 during periods of omicron and delta variant dominance: a prospective observational study from the ZOE COVID Study.
Menni, Cristina; Valdes, Ana M; Polidori, Lorenzo; Antonelli, Michela; Penamakuri, Satya; Nogal, Ana; Louca, Panayiotis; May, Anna; Figueiredo, Jane C; Hu, Christina; Molteni, Erika; Canas, Liane; Österdahl, Marc F; Modat, Marc; Sudre, Carole H; Fox, Ben; Hammers, Alexander; Wolf, Jonathan; Capdevila, Joan; Chan, Andrew T; David, Sean P; Steves, Claire J; Ourselin, Sebastien; Spector, Tim D.
  • Menni C; Department of Twin Research and Genetic Epidemiology, King's College London, London, UK. Electronic address: cristina.menni@kcl.a.uk.
  • Valdes AM; Nottingham NIHR Biomedical Research Centre at the School of Medicine, University of Nottingham, Nottingham, UK.
  • Polidori L; ZOE, London, UK.
  • Antonelli M; School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK.
  • Penamakuri S; ZOE, London, UK.
  • Nogal A; Department of Twin Research and Genetic Epidemiology, King's College London, London, UK.
  • Louca P; Department of Twin Research and Genetic Epidemiology, King's College London, London, UK.
  • May A; ZOE, London, UK.
  • Figueiredo JC; Department of Medicine, Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles CA, USA.
  • Hu C; ZOE, London, UK.
  • Molteni E; School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK.
  • Canas L; School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK.
  • Österdahl MF; Department of Twin Research and Genetic Epidemiology, King's College London, London, UK; Department of Ageing and Health, Guy's and St Thomas' NHS Foundation Trust, London, UK.
  • Modat M; School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK.
  • Sudre CH; School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK; MRC Unit for Lifelong Health and Ageing, University College London, London, UK; Centre for Medical Image Computing, Department of Computer Science, University College London, London, UK.
  • Fox B; ZOE, London, UK.
  • Hammers A; School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK; King's College London & Guy's and St Thomas' PET Centre, London, UK.
  • Wolf J; ZOE, London, UK.
  • Capdevila J; ZOE, London, UK.
  • Chan AT; Clinical and Translational Epidemiology Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
  • David SP; NorthShore University Health System & University of Chicago Pritzker School of Medicine, Chicago, IL, USA.
  • Steves CJ; Department of Twin Research and Genetic Epidemiology, King's College London, London, UK; Department of Ageing and Health, Guy's and St Thomas' NHS Foundation Trust, London, UK.
  • Ourselin S; School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK.
  • Spector TD; Department of Twin Research and Genetic Epidemiology, King's College London, London, UK. Electronic address: tim.spector@kcl.ac.uk.
Lancet ; 399(10335): 1618-1624, 2022 04 23.
Article in English | MEDLINE | ID: covidwho-1867912
ABSTRACT

BACKGROUND:

The SARS-CoV-2 variant of concern, omicron, appears to be less severe than delta. We aim to quantify the differences in symptom prevalence, risk of hospital admission, and symptom duration among the vaccinated population.

METHODS:

In this prospective longitudinal observational study, we collected data from participants who were self-reporting test results and symptoms in the ZOE COVID app (previously known as the COVID Symptoms Study App). Eligible participants were aged 16-99 years, based in the UK, with a body-mass index between 15 and 55 kg/m2, had received at least two doses of any SARS-CoV-2 vaccine, were symptomatic, and logged a positive symptomatic PCR or lateral flow result for SARS-CoV-2 during the study period. The primary outcome was the likelihood of developing a given symptom (of the 32 monitored in the app) or hospital admission within 7 days before or after the positive test in participants infected during omicron prevalence compared with those infected during delta prevalence.

FINDINGS:

Between June 1, 2021, and Jan 17, 2022, we identified 63 002 participants who tested positive for SARS-CoV-2 and reported symptoms in the ZOE app. These patients were matched 11 for age, sex, and vaccination dose, across two periods (June 1 to Nov 27, 2021, delta prevalent at >70%; n=4990, and Dec 20, 2021, to Jan 17, 2022, omicron prevalent at >70%; n=4990). Loss of smell was less common in participants infected during omicron prevalence than during delta prevalence (16·7% vs 52·7%, odds ratio [OR] 0·17; 95% CI 0·16-0·19, p<0·001). Sore throat was more common during omicron prevalence than during delta prevalence (70·5% vs 60·8%, 1·55; 1·43-1·69, p<0·001). There was a lower rate of hospital admission during omicron prevalence than during delta prevalence (1·9% vs 2·6%, OR 0·75; 95% CI 0·57-0·98, p=0·03).

INTERPRETATION:

The prevalence of symptoms that characterise an omicron infection differs from those of the delta SARS-CoV-2 variant, apparently with less involvement of the lower respiratory tract and reduced probability of hospital admission. Our data indicate a shorter period of illness and potentially of infectiousness which should impact work-health policies and public health advice.

FUNDING:

Wellcome Trust, ZOE, National Institute for Health Research, Chronic Disease Research Foundation, National Institutes of Health, and Medical Research Council.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: SARS-CoV-2 / COVID-19 Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study Topics: Vaccines / Variants Limits: Humans Language: English Journal: Lancet Year: 2022 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: SARS-CoV-2 / COVID-19 Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study Topics: Vaccines / Variants Limits: Humans Language: English Journal: Lancet Year: 2022 Document Type: Article