1887
  1. Home
  2. Eurosurveillance
  3. Volume 27, Issue 20, 19/May/2022
  4. Article
Research Open Access
Like 0
Download

Abstract

Background

The emergence of the SARS-CoV-2 Alpha variant in England coincided with a rapid increase in the number of PCR-confirmed COVID-19 cases in areas where the variant was concentrated.

Aim

Our aim was to assess whether infection with Alpha was associated with more severe clinical outcomes than the wild type.

Methods

Laboratory-confirmed infections with genomically sequenced SARS-CoV-2 Alpha and wild type between October and December 2020 were linked to routine healthcare and surveillance datasets. We conducted two statistical analyses to compare the risk of hospital admission and death within 28 days of testing between Alpha and wild-type infections: a matched cohort study and an adjusted Cox proportional hazards model. We assessed differences in disease severity by comparing hospital admission and mortality, including length of hospitalisation and time to death.

Results

Of 63,609 COVID-19 cases sequenced in England between October and December 2020, 6,038 had the Alpha variant. In the matched cohort analysis, we matched 2,821 cases with Alpha to 2,821 to cases with wild type. In the time-to-event analysis, we observed a 34% increased risk in hospitalisation associated with Alpha compared with wild type, but no significant difference in the risk of mortality.

Conclusion

We found evidence of increased risk of hospitalisation after adjusting for key confounders, suggesting increased infection severity associated with the Alpha variant. Rapid assessments of the relative morbidity in terms of clinical outcomes and mortality associated with emerging SARS-CoV-2 variants compared with dominant variants are required to assess overall impact of SARS-CoV-2 mutations.

© Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.
Loading

Article metrics loading...

/content/10.2807/1560-7917.ES.2022.27.20.2100377
2022-05-19
2024-12-03
http://instance.metastore.ingenta.com/content/10.2807/1560-7917.ES.2022.27.20.2100377
Loading
Loading full text...

Full text loading...

/deliver/fulltext/eurosurveillance/27/20/eurosurv-27-20-5.html?itemId=/content/10.2807/1560-7917.ES.2022.27.20.2100377&mimeType=html&fmt=ahah

References

  1. Investigation of novel SARS-COV-2 variant 202012/01: technical briefing 1. London: Public Health England; 2020. Available from: https://www.gov.uk/government/publications/investigation-of-novel-sars-cov-2-variant-variant-of-concern-20201201
  2. World Health Organization (WHO). WHO announces simple, easy-to-say labels for SARS-CoV-2 variants of interest and concern. Geneva: WHO; 2021. Available from: https://www.who.int/news/item/31-05-2021-who-announces-simple-easy-to-say-labels-for-sars-cov-2-variants-of-interest-and-concern
  3. Rambaut A, Loman N, Pybus O, Barclay W, Barrett J, Carabelli A, et al. Preliminary genomic characterisation of an emergent SARS-CoV-2 lineage in the UK defined by a novel set of spike mutations. 2020. Available from: https://virological.org/t/preliminary-genomic-characterisation-of-an-emergent-sars-cov-2-lineage-in-the-uk-defined-by-a-novel-set-of-spike-mutations/563
  4. Public Health England (PHE). Investigation of novel SARS-CoV-2 variant 202012/01: technical briefing 2. London: PHE; 2020. Available from: https://www.gov.uk/government/publications/investigation-of-novel-sars-cov-2-variant-variant-of-concern-20201201
  5. Volz E, Mishra S, Chand M, Barrett JC, Johnson R, Geidelberg L, et al. Assessing transmissibility of SARS-CoV-2 lineage B.1.1.7 in England. Nature. 2021;593(7858):266-9.  https://doi.org/10.1038/s41586-021-03470-x  PMID: 33767447 
  6. Connor TR, Loman NJ, Thompson S, Smith A, Southgate J, Poplawski R, et al. CLIMB (the Cloud Infrastructure for Microbial Bioinformatics): an online resource for the medical microbiology community. Microb Genom. 2016;2(9):e000086.  https://doi.org/10.1099/mgen.0.000086  PMID: 28785418 
  7. NHS Digital. Secondary Uses Service (SUS). Leeds: NHS Digital. [Accessed: 21 Mar 2021]. Available from: https://digital.nhs.uk/services/secondary-uses-service-sus
  8. Public Health England (PHE). UKHSA data series on deaths in people with COVID-19: technical summary. London: PHE; 2020. Available from: https://www.gov.uk/government/publications/phe-data-series-on-deaths-in-people-with-covid-19-technical-summary
  9. Office for national statistics (ONS). Ethnic group, national identity and religion. Newport: ONS. [Accessed: 19 Mar 2021]. Available from: https://www.ons.gov.uk/methodology/classificationsandstandards/measuringequality/ethnicgroupnationalidentityandreligion
  10. World Health Organization. COVID-19 weekly epidemiological update. Geneva: WHO; 2021. Available from: https://www.who.int/docs/default-source/coronaviruse/situation-reports/20210209_weekly_epi_update_26.pdf
  11. Public Health Ontario. COVID-19 B.1.1.7 (501Y.V1) variant of concern – what we know so far. Toronto: Public Health Ontario; 2021. Available from: https://www.publichealthontario.ca/-/media/Documents/nCoV/COVID-WWKSF/2020/12/what-we-know-uk-variant.pdf?sc_lang=en
  12. New and Emerging Respiratory Virus Threats Advisory Group (NERVTAG). NERVTAG paper on COVID-19 variant of concern B.1.1.7. London: NERVTAG; 2021. Available from: https://www.gov.uk/government/publications/nervtag-paper-on-covid-19-variant-of-concern-b117
  13. Public Health England. Investigation of novel SARS-CoV-2 variant 202012/01: technical briefing 5. London: PHE; 2021 . Available from: https://www.gov.uk/government/publications/investigation-of-novel-sars-cov-2-variant-variant-of-concern-20201201
  14. Davies NG, Jarvis CI, Edmunds WJ, Jewell NP, Diaz-Ordaz K, Keogh RH, et al. Increased mortality in community-tested cases of SARS-CoV-2 lineage B.1.1.7. Nature. 2021;593(7858):270-4.  https://doi.org/10.1038/s41586-021-03426-1  PMID: 33723411 
  15. Challen R, Brooks-Pollock E, Read JM, Dyson L, Tsaneva-Atanasova K, Danon L. Risk of mortality in patients infected with SARS-CoV-2 variant of concern 202012/1: matched cohort study. BMJ. 2021;372(579):n579.  https://doi.org/10.1136/bmj.n579  PMID: 33687922 
Assessment of mortality and hospital admissions associated with confirmed infection with SARS-CoV-2 Alpha variant: a matched cohort and time-to-event analysis, England, October to December 2020
<p class="citation"> <span>Citation style for this article:</span> <span class="meta-value authors"> <a href="/search?value1=Gavin+Dabrera&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Dabrera Gavin</a>, <a href="/search?value1=Hester+Allen&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Allen Hester</a>, <a href="/search?value1=Asad+Zaidi&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Zaidi Asad</a>, <a href="/search?value1=Joe+Flannagan&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Flannagan Joe</a>, <a href="/search?value1=Katherine+Twohig&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Twohig Katherine</a>, <a href="/search?value1=Simon+Thelwall&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Thelwall Simon</a>, <a href="/search?value1=Elizabeth+Marchant&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Marchant Elizabeth</a>, <a href="/search?value1=Nurin+Abdul+Aziz&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Aziz Nurin Abdul</a>, <a href="/search?value1=Theresa+Lamagni&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Lamagni Theresa</a>, <a href="/search?value1=Richard+Myers&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Myers Richard</a>, <a href="/search?value1=Andr%C3%A9+Charlett&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Charlett André</a>, <a href="/search?value1=Fernando+Capelastegui&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Capelastegui Fernando</a>, <a href="/search?value1=Dimple+Chudasama&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Chudasama Dimple</a>, <a href="/search?value1=Tom+Clare&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Clare Tom</a>, <a href="/search?value1=Flavien+Coukan&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Coukan Flavien</a>, <a href="/search?value1=Mary+Sinnathamby&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Sinnathamby Mary</a>, <a href="/search?value1=Neil+Ferguson&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Ferguson Neil</a>, <a href="/search?value1=Susan+Hopkins&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Hopkins Susan</a>, <a href="/search?value1=Meera+Chand&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Chand Meera</a>, <a href="/search?value1=Russell+Hope&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Hope Russell</a>, <a href="/search?value1=Meaghan+Kall&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Kall Meaghan</a>, <a href="/search?value1=on+behalf+of+the++COG-UK+Consortium&option1=author&noRedirect=true" class="nonDisambigAuthorLink">on behalf of the COG-UK Consortium</a></span>. Assessment of mortality and hospital admissions associated with confirmed infection with SARS-CoV-2 Alpha variant: a matched cohort and time-to-event analysis, England, October to December 2020. <a href="/content/ecdc">Euro Surveill.</a> 2022;27(20):pii=2100377. <a href="https://doi.org/10.2807/1560-7917.ES.2022.27.20.2100377" title="doi link" target="_blank">https://doi.org/10.2807/1560-7917.ES.2022.27.20.2100377</a> <span class="ES_Article_citation"> <span class="generated">Received</span>: 23 Mar 2021;&nbsp;&nbsp; <span class="generated">Accepted</span>: 14 Feb 2022 </span> </p>
/content/10.2807/1560-7917.ES.2022.27.20.2100377
/content/10.2807/1560-7917.ES.2022.27.20.2100377
Loading

Data & Media loading...

Submit comment
Close
Comment moderation successfully completed
This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error