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Clinical outcomes of COVID-19 caused by the Alpha variant compared with one by wild type in Kobe, Japan. A multi-center nested case-control study.
Doi, Asako; Iwata, Kentaro; Nakamura, Tadahiro; Oh, Koji; Isome, Kenichi; Hasegawa, Kohei; Kuroda, Hirokazu; Hasuike, Toshikazu; Seo, Ryutaro; Kosai, Hisato; Nakanishi, Noriko; Nomoto, Ryohei; Fujiyama, Riyo; Kusunoki, Nobuya; Iwamoto, Tomotada; Nishioka, Hiroaki; Tomii, Keisuke; Kihara, Yasuki.
  • Doi A; Department of Infectious Diseases, Kobe City Medical Center General Hospital, 2-1-1, Minamimachi, Minatojima, Chuoku, Kobe, Hyogo, 650-0047, Japan. Electronic address: asakodoi@gmail.com.
  • Iwata K; Division of Infectious Diseases, Kobe University Hospital, 7-5-2 Kusunokicho, Chuoku, Kobe, Hyogo, 650-0017, Japan.
  • Nakamura T; Department of Infectious Diseases, National Hospital Organization Kobe Medical Center, 3-1-1, Nishi-Ochiai, Sumaku, Kobe, Hyogo, 654-0155, Japan.
  • Oh K; Department of General Internal Medicine, Kobe City Medical Center West Hospital, 2-4 Ichiban-cho, Nagataku, Kobe, Hyogo, 653-0013, Japan.
  • Isome K; Department of Pediatrics, Kobe City Nishi-Kobe Medical Center, 5-7-1, Kojidai, Nishiku, Kobe, Hyogo, 651-2273, Japan.
  • Hasegawa K; Department of Infectious Diseases, Kobe City Medical Center General Hospital, 2-1-1, Minamimachi, Minatojima, Chuoku, Kobe, Hyogo, 650-0047, Japan.
  • Kuroda H; Department of Infectious Diseases, Kobe City Medical Center General Hospital, 2-1-1, Minamimachi, Minatojima, Chuoku, Kobe, Hyogo, 650-0047, Japan.
  • Hasuike T; Department of Infectious Diseases, Kobe City Medical Center General Hospital, 2-1-1, Minamimachi, Minatojima, Chuoku, Kobe, Hyogo, 650-0047, Japan.
  • Seo R; Emergency Department, Kobe City Medical Center General Hospital, 2-1-1, Minamimachi, Minatojima, Chuoku, Kobe, Hyogo, 650-0047, Japan.
  • Kosai H; Kobe City Public Health Management Center, 6-5-1, Kanocho, Chuoku, Kobe, Hyogo, 650-8570, Japan.
  • Nakanishi N; Kobe Institute of Health, 6-5, Nakamachi, Minatojima, Chuoku, Kobe, Hyogo, 650-0046, Japan.
  • Nomoto R; Kobe Institute of Health, 6-5, Nakamachi, Minatojima, Chuoku, Kobe, Hyogo, 650-0046, Japan.
  • Fujiyama R; Kobe City Public Health Management Center, 6-5-1, Kanocho, Chuoku, Kobe, Hyogo, 650-8570, Japan.
  • Kusunoki N; Kobe City Public Health Management Center, 6-5-1, Kanocho, Chuoku, Kobe, Hyogo, 650-8570, Japan.
  • Iwamoto T; Kobe Institute of Health, 6-5, Nakamachi, Minatojima, Chuoku, Kobe, Hyogo, 650-0046, Japan.
  • Nishioka H; Department of Infectious Diseases, Kobe City Medical Center General Hospital, 2-1-1, Minamimachi, Minatojima, Chuoku, Kobe, Hyogo, 650-0047, Japan.
  • Tomii K; Department of Respiratory Medicine, Kobe City Medical Center General Hospital, 2-1-1, Minamimachi, Minatojima, Chuoku, Kobe, Hyogo, 650-0047, Japan.
  • Kihara Y; Kobe City Medical Center General Hospital, 2-1-1, Minamimachi, Minatojima, Chuoku, Kobe, Hyogo, 650-0047, Japan.
J Infect Chemother ; 29(3): 289-293, 2023 Mar.
Article in English | MEDLINE | ID: covidwho-2240326
ABSTRACT

OBJECTIVES:

The emergence of the Alpha variant of novel coronavirus 2019 (SARS-CoV-2) is a concerning issue but their clinical implications have not been investigated fully.

METHODS:

We conducted a nested case-control study to compare severity and mortality caused by the Alpha variant (B.1.1.7) with the one caused by the wild type as a control from December 2020 to March 2021, using whole-genome sequencing. 28-day mortality and other clinically important outcomes were evaluated.

RESULTS:

Infections caused by the Alpha variant were associated with an increase in the use of oxygen (43.4% vs 26.3%. p = 0.017), high flow nasal cannula (21.2% vs 4.0%, p = 0.0007), mechanical ventilation (16.2% vs 6.1%, p = 0.049), ICU care (30.3% vs 14.1%, p = 0.01) and the length of hospital stay (17 vs 10 days, p = 0.031). More patients with the Alpha variant received medications such as dexamethasone. However, the duration of each modality did not differ between the 2 groups. Likewise, there was no difference in 28-day mortality between the 2 groups (12% vs 8%, p = 0.48), even after multiple sensitivity analyses, including propensity score analysis.

CONCLUSION:

The Alpha variant was associated with a severe form of COVID-19, compared with the non-Alpha wild type, but might not be associated with higher mortality.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 Type of study: Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Topics: Variants Limits: Humans Country/Region as subject: Asia Language: English Journal: J Infect Chemother Journal subject: Microbiology / Drug Therapy Year: 2023 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 Type of study: Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Topics: Variants Limits: Humans Country/Region as subject: Asia Language: English Journal: J Infect Chemother Journal subject: Microbiology / Drug Therapy Year: 2023 Document Type: Article