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SARS-CoV-2 lineage B.1.1.7 is associated with greater disease severity among hospitalised women but not men: multicentre cohort study

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posted on 2023-06-10, 02:21 authored by Oliver Stirrup, Florencia Boshier, Cristina Venturini, José Afonso Guerra-Assunção, Adela Alcolea-Medina, Angela Beckett, Themoula Charalampous, Ana Da Silva Filipe, Sharon Glaysher, Tabassum Khan, Raghavendran Kulasegaran Shylini, Beatrix Kele, Irene Monahan, Guy Mollett, J Price, others
Background SARS-CoV-2 lineage B.1.1.7 has been associated with an increased rate of transmission and disease severity among subjects testing positive in the community. Its impact on hospitalised patients is less well documented. Methods We collected viral sequences and clinical data of patients admitted with SARS-CoV-2 and hospital-onset COVID-19 infections (HOCIs), sampled 16 November 2020 to 10 January 2021, from eight hospitals participating in the COG-UK-HOCI study. Associations between the variant and the outcomes of all-cause mortality and intensive therapy unit (ITU) admission were evaluated using mixed effects Cox models adjusted by age, sex, comorbidities, care home residence, pregnancy and ethnicity. Findings Sequences were obtained from 2341 inpatients (HOCI cases=786) and analysis of clinical outcomes was carried out in 2147 inpatients with all data available. The HR for mortality of B.1.1.7 compared with other lineages was 1.01 (95% CI 0.79 to 1.28, p=0.94) and for ITU admission was 1.01 (95% CI 0.75 to 1.37, p=0.96). Analysis of sex-specific effects of B.1.1.7 identified increased risk of mortality (HR 1.30, 95%?CI 0.95 to 1.78, p=0.096) and ITU admission (HR 1.82, 95%?CI 1.15 to 2.90, p=0.011) in females infected with the variant but not males (mortality HR 0.82, 95%?CI 0.61 to 1.10, p=0.177; ITU HR 0.74, 95%?CI 0.52 to 1.04, p=0.086). Interpretation In common with smaller studies of patients hospitalised with SARS-CoV-2, we did not find an overall increase in mortality or ITU admission associated with B.1.1.7 compared with other lineages. However, women with B.1.1.7 may be at an increased risk of admission to intensive care and at modestly increased risk of mortality.

History

Publication status

  • Published

File Version

  • Published version

Journal

BMJ Open Respiratory Research

ISSN

2052-4439

Publisher

BMJ Publishing Group

Issue

1

Volume

8

Page range

1-10

Article number

a001029

Event location

England

Department affiliated with

  • BSMS Publications

Full text available

  • Yes

Peer reviewed?

  • Yes

Legacy Posted Date

2022-01-17

First Open Access (FOA) Date

2022-01-17

First Compliant Deposit (FCD) Date

2022-01-17

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