ABSTRACT
ObjectiveTo assess whether mortality of patients admitted for covid-19 treatment was different in the second UK epidemic wave of covid-19 compared to the first wave accounting for improvements in the standard of care available and differences in the distribution of risk factors between the two waves. DesignSingle-centre, analytical, dynamic cohort study. Participants2,701 adults ([≥]18 years) with SARS-CoV-2 infection confirmed by polymerase chain reaction (PCR) and/or clinico-radiological diagnosis of covid-19, who required hospital admission to covid-19 specific wards, between January 2020 and March 2021. There were 884 covid-19 admissions during the first wave (before 30 Jun 2020) and 1,817 during the second wave. Outcome measuresin-hospital covid-19 associated mortality, ascertained from clinical records and Medical Certificate Cause of Death. ResultsThe crude mortality rate was 25% lower during the second wave (2.23 and 1.66 deaths per 100 person-days in first and second wave respectively). However, after accounting for age, sex, dexamethasone, oxygen requirements, symptoms at admission and Charlson Comorbidity Index, mortality hazard ratio associated with covid-19 hospital admissions was 1.62 (95% confidence interval 1.26, 2.08) times higher in the second wave compared to the first. ConclusionsAnalysis of covid-19 admissions recorded in St. Georges Hospital, shows a larger second epidemic wave, with a lower crude mortality in hospital admissions. Nevertheless, after accounting for other factors underlying risk of death for covid-19 admissions was higher in the second wave. These findings are temporally and ecologically correlated with an increased circulation of SARS-CoV-2 variant of concern 202012/1 (alpha).
ABSTRACT
We report dynamics of seroconversion to SARS-CoV-2 infections detected by IgG ELISA in 177 individuals diagnosed by RT-PCR. Longitudinal analysis identifies 2-8.5% of individuals who do not seroconvert even weeks after infection. They are younger than seroconverters who have increased co-morbidity and higher inflammatory markers such as C-Reactive Protein. Higher antibody responses are associated with non-white ethnicity. Antibody responses do not decline during follow up almost to 2 months. Serological assays increase understanding of disease severity. Their application in regular surveillance will clarify the duration and protective nature of humoral responses to SARS-CoV-2.
ABSTRACT
Here we describe an open and transparent consortium for the rapid development of COVID-19 rapid diagnostics tests. We report diagnostic accuracy data on the Mologic manufactured IgG COVID-19 ELISA on known positive serum samples and on a panel of known negative respiratory and viral serum samples pre-December 2019. In January, Mologic, embarked on a product development pathway for COVID-19 diagnostics focusing on ELISA and rapid diagnostic tests (RDTs), with anticipated funding from Wellcome Trust and DFID. 834 clinical samples from known COVID-19 patients and hospital negative controls were tested on Mologics IgG ELISA. The reported sensitivity on 270 clinical samples from 124 prospectively enrolled patients was 94% (95% CI: 89.60% - 96.81%) on day 10 or more post laboratory diagnosis, and 96% (95% CI: 84.85% - 99.46%) between 14-21 days post symptom onset. A specificity panel comprising 564 samples collected pre-December 2019 were tested to include most common respiratory pathogens, other types of coronavirus, and flaviviruses. Specificity in this panel was 97% (95% CI: 95.65% - 98.50%). This is the first in a series of Mologic products for COVID-19, which will be deployed for COVID-19 diagnosis, contact tracing and sero-epidemiological studies to estimate disease burden and transmission with a focus on ensuring access, affordability, and availability to low-resource settings.
