Descriptive comparison of admission characteristics between pandemic waves and multivariable analysis of the association of the Alpha variant (B.1.1.7 lineage) of SARS-CoV-2 with disease severity in inner London. Issue 2 (8th February 2022)

• Record Type: Journal Article
• Authors: Snell, Luke B; Wang, Wenjuan; Alcolea-Medina, Adela; Charalampous, Themoula; Batra, Rahul; de Jongh, Leonardo; Higgins, Finola; Nebbia, Gaia; Wang, Yanzhong; Edgeworth, Jonathan; Curcin, Vasa
• Other Names: author non-byline.; Cutino-Moguel Teresa author non-byline.; Khan Tabassum author non-byline.; Kele Beatrix author non-byline.; Kulasegaran-Shylini Raghavendran author non-byline.; Broad Claire E. author non-byline.; Owoyemi Dola author non-byline.; Harrington David author non-byline.; Coffey Clare author non-byline.; Cummins Martina author non-byline.; Riddell Anna author non-byline.; D'Souza Tyrra author non-byline.; Mollett Guy author non-byline.; Thomson Emma author non-byline.; Peters Christine author non-byline.; Marek Aleks author non-byline.; Gunson Rory author non-byline.; Goldstein Emily author non-byline.; Shepherd Emilie author non-byline.; Shepherd James author non-byline.; Robertson David author non-byline.; Smollett Katherine author non-byline.; Filipe Ana da Silva author non-byline.; Broos Alice author non-byline.; Carmichael Stephen author non-byline.; Suarez Nicholas author non-byline.; Davis Chris author non-byline.; Vattipally Sreenu author non-byline.; Hughes Joseph author non-byline.; Tsatsani Ioulia author non-byline.; McTaggart Jacqueline author non-byline.; McEnhill Stephanie author non-byline.; Medina Adela author non-byline.; Charalampous Themoula author non-byline.; Patel Bindi author non-byline.; Flaviani Flavia author non-byline.; Saßmannshausen Jörg author non-byline.; Rabuya May author non-byline.; Gurung Sulekha author non-byline.; Augustine Anu author non-byline.; Batra Rahul author non-byline.; Snell Luke author non-byline.; Nebbia Gaia author non-byline.; Holmes Alison author non-byline.; Mookerjee Sid author non-byline.; Price James author non-byline.; Randell Paul author non-byline.; Johnson Krystal author non-byline.; Thaventhiran Thilipan author non-byline.; Mine Damien author non-byline.; Hunter Sophie author non-byline.; Ahmad Isa author non-byline.; Ramanathan Anitha author non-byline.; Chawla Anu author non-byline.; Derby Alistair author non-byline.; Haldenby Sam author non-byline.; Taylor Becky author non-byline.; Morris Keith author non-byline.; Numbere Charles author non-byline.; Hopkins Mark author non-byline.; Mason Jenifer author non-byline.; Bailey Alexandra author non-byline.; Machin Nicholas author non-byline.; Ahmad Shazaad author non-byline.; Cawthorne Julie author non-byline.; George Ryan author non-byline.; Montgomery James author non-byline.; McKew Deborah author non-byline.; Taha Yusri author non-byline.; Cobb Angela author non-byline.; Ramsay Michelle author non-byline.; Leader Maria author non-byline.; Burton-Fanning Shirelle author non-byline.; Samuel Julie author non-byline.; Francis Sarah author non-byline.; Taylor Lydia author non-byline.; Smith Darren author non-byline.; Bashton Matthew author non-byline.; Crown Matthew author non-byline.; Mahida Nikunj author non-byline.; Loose Matthew author non-byline.; McClure Patrick author non-byline.; Clarke Mitch author non-byline.; Baxter Elaine author non-byline.; Yates Carl author non-byline.; Aslam Irfan author non-byline.; Fleming Vicki author non-byline.; Lister Michelle author non-byline.; Debebe Johnny author non-byline.; Holmes Nadine author non-byline.; Moore Christopher author non-byline.; Carlile Matt author non-byline.; Mahungu Tabitha author non-byline.; Weller Sophie author non-byline.; Haque Tanzina author non-byline.; Hart Jennifer author non-byline.; Irish-Tavares Dianne author non-byline.; Witele Eric author non-byline.; Mesa Mia De author non-byline.; Pang Vicky author non-byline.; Heaphy Jelena author non-byline.; Chatterton Wendy author non-byline.; Pusok Monika author non-byline.; Saluja Tranprit author non-byline.; Maqsood Zahira author non-byline.; Williams Angie author non-byline.; Devonport Debbie author non-byline.; Palinkas Lucy author non-byline.; Thomlinson Diane author non-byline.; Booth Julie author non-byline.; Dadrah Ashok author non-byline.; Symonds Amanda author non-byline.; Craig Cassandra author non-byline.; Kumar Abhinav author non-byline.; Silva Thushan de author non-byline.; Parker Matthew D author non-byline.; Zhang Peijun author non-byline.; Whiteley Max author non-byline.; Lindsey Benjamin B author non-byline.; Wolverson Paige author non-byline.; Foulkes Benjamin H author non-byline.; Green Luke author non-byline.; Ramalho Marta Gallis author non-byline.; Louka Stavroula F author non-byline.; Angyal Adrienn author non-byline.; Smith Nikki author non-byline.; Partridge David G author non-byline.; Evans Cariad author non-byline.; Raza Mohammad author non-byline.; Colton Hayley author non-byline.; Gregory Rebecca author non-byline.; Ravencroft Phillip author non-byline.; Johnson Katie author non-byline.; Hsu Sharon author non-byline.; Keeley Alexander J author non-byline.; Cope Alison author non-byline.; State Amy author non-byline.; Ali Nasar author non-byline.; Raghei Rasha author non-byline.; Heffer Joe author non-byline.; Christou Stella author non-byline.; Hansford Samantha E author non-byline.; Hornsby Hailey R author non-byline.; Wade Phil author non-byline.; Cawthron Kay author non-byline.; Khan Maqsood author non-byline.; Ford Amber author non-byline.; Wilson Imogen author non-byline.; Harrington Kate author non-byline.; Tinker Nic author non-byline.; Nyinza Sally author non-byline.; Saeed Kordo author non-byline.; Prieto Jacqui author non-byline.; Mahanama Adhyana author non-byline.; Samaraweera Buddhini author non-byline.; Silviera Siona author non-byline.; Pelosi Emanuela author non-byline.; Wilson-Davies Eleri author non-byline.; Jeremiah Sarah author non-byline.; Wheeler Helen author non-byline.; Harvey Matthew author non-byline.; Sass Thea author non-byline.; Umpleby Helen author non-byline.; Aplin Stephen author non-byline.; Robson Samuel author non-byline.; Glaysher Sharon author non-byline.; Elliott Scott author non-byline.; Cook Kate author non-byline.; Fearn Christopher author non-byline.; Goudarzi Salman author non-byline.; Loveson Katie author non-byline.; Laing Kenneth author non-byline.; Monahan Irene author non-byline.; Witney Adam author non-byline.; Taylor Joshua author non-byline.; Tan NgeeKeong author non-byline.; Pope Cassie author non-byline.; Pereira Claudia Cardosa author non-byline.; Malik Vaz author non-byline.; Shin Gee Yen author non-byline.; Nastouli Eleni author non-byline.; Houlihan Catherine author non-byline.; Heaney Judith author non-byline.; Byott Matt author non-byline.; Frampton Dan author non-byline.; Martinez-Garcia Gema author non-byline.; Hail Leila author non-byline.; Atang Ndifreke author non-byline.; Francis Helen author non-byline.; Rajkov Milica author non-byline.; Breuer Judith author non-byline.; Williams Rachel author non-byline.; Roy Sunando author non-byline.; Williams Charlotte author non-byline.; Bayzid Nadua author non-byline.; Cotic Marius author non-byline.; Blackstone James author non-byline.; Hockey Leanne author non-byline.; McComish Rachel author non-byline.; MacNeil Alyson author non-byline.; Panca Monica author non-byline.; Marley Georgia author non-byline.; Copas Andrew author non-byline.; Stirrup Oliver author non-byline.; Mapp Fiona author non-byline.; Tamuri Alif author non-byline.; Piatek Stefan author non-byline.; Flowers Paul author non-byline.;
• Is Part Of: BMJ open. Volume 12:Issue 2(2022)
• Publication Date: 2022-02-08
• Subjects: virology -- epidemiology -- epidemiology -- public health; Medicine -- Research -- Periodicals; 610.72
• DOI: 10.1136/bmjopen-2021-055474
• Languages: English
• ISSNs: 2044-6055

Abstract

Abstract : Background: The Alpha variant (B.1.1.7 lineage) of SARS-CoV-2 emerged and became the dominant circulating variant in the UK in late 2020. Current literature is unclear on whether the Alpha variant is associated with increased severity. We linked clinical data with viral genome sequence data to compare admitted cases between SARS-CoV-2 waves in London and to investigate the association between the Alpha variant and the severity of disease. Methods: Clinical, demographic, laboratory and viral sequence data from electronic health record systems were collected for all cases with a positive SARS-CoV-2 RNA test between 13 March 2020 and 17 February 2021 in a multisite London healthcare institution. Multivariate analysis using logistic regression assessed risk factors for severity as defined by hypoxia at admission. Results: There were 5810 SARS-CoV-2 RNA-positive cases of which 2341 were admitted (838 in wave 1 and 1503 in wave 2). Both waves had a temporally aligned rise in nosocomial cases (96 in wave 1 and 137 in wave 2). The Alpha variant was first identified on 15 November 2020 and increased rapidly to comprise 400/472 (85%) of sequenced isolates from admitted cases in wave 2. A multivariate analysis identified risk factors for severity on admission, such as age (OR 1.02, 95% CI 1.01 to 1.03, for every year older; p<0.001), obesity (OR 1.70, 95% CI 1.28 to 2.26; p<0.001) and infection with the Alpha variant (OR 1.68, 95% CI 1.26 to 2.24; p<0.001). Conclusions: Our analysis is the first in hospitalised cohorts to show increased severity of disease associated with the Alpha variant. The number of nosocomial cases was similar in both waves despite the introduction of many infection control interventions before wave 2.