A emergência da nova variante P.1 do SARS-CoV-2 no Amazonas (Brasil) foi temporalmente associada a uma mudança no perfil da mortalidade devido a COVID-19, segundo sexo e idade

Freitas, André Ricardo Ribas; Beckedorff, Otto Albuquerque; Cavalcanti, Luciano Pamplona de Góes; Siqueira, André; Castro, Daniel Barros de; Costa, Cristiano Fernandes da; Lemos, Daniele Rocha Queiróz; Barros, Eliana Nogueira Castro de

doi:10.1590/scielopreprints.2030

Cited by 14 publications

(20 citation statements)

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“…Our studies reinforce previous findings that indicate that a P.1 variant appears to be more lethal than the previous one, especially among young patients[2,4,13]. In a previous study in Amazonas, we found that in the subgroup of female patients, the difference in risk of death was greater than in the male population, in the present study we found similar results[2].…”

Section: Discussionsupporting

confidence: 92%

“…This variant probably emerged between late November and early December 2020 in Amazonas, northern Brazil, with rapid dissemination to other regions and other countries[1]. The introduction of this variant was temporally associated with increased transmissibility of covid-19 causing a critical epidemiological scenario in different places where it was detected as the Amazonas, in the north region, and the Paraná and the Rio Grande do Sul (RS) states, in the south of the country[2–5]. In the Amazonas state, a collapse of the health system was observed, which made it difficult to assess the real impact of the P.1 variant on the lethality by covid-19, which may have increased due to the overload of the health system and not exclusively by the intrinsic characteristics of the variant[2].…”

Section: Introductionmentioning

confidence: 99%

“…The introduction of this variant was temporally associated with increased transmissibility of covid-19 causing a critical epidemiological scenario in different places where it was detected as the Amazonas, in the north region, and the Paraná and the Rio Grande do Sul (RS) states, in the south of the country[2–5]. In the Amazonas state, a collapse of the health system was observed, which made it difficult to assess the real impact of the P.1 variant on the lethality by covid-19, which may have increased due to the overload of the health system and not exclusively by the intrinsic characteristics of the variant[2]. The emergence of variant P.1 in the RS state was confirmed by the virus identification from a patient with no travel history and presenting symptoms beginning on January 29 (EW 4/2021)[6].…”

Section: Introductionmentioning

confidence: 99%

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The increase in the risk of severity and fatality rate of covid-19 in southern Brazil after the emergence of the Variant of Concern (VOC) SARS-CoV-2 P.1 was greater among young adults without pre-existing risk conditions

Freitas

Drq

Beckedorff

et al. 2021

Preprint

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Background The SARS-CoV-2 P.1 variant has been considered as variant of concern (VOC) since the end of 2020 when it was firstly identified in the Brazilian state of Amazonas and from there spread to other regions of Brazil. This variant was associated with an increase in transmissibility and worsening of the epidemiological situation in the places where it was detected. The aim of this study was to analyze the severity profile of covid-19 cases in the Rio Grande do Sul state, southern region of Brazil, before and after the emergence of the P.1 variant, considering also the context of the hospitals overload and the collapse of health services. Methods We analyzed data from the Influenza Epidemiological Surveillance Information System, SIVEP-Gripe (Sistema de Informacao de Vigilancia Epidemiologica da Gripe) and compare two epidemiological periods: the first wave comprised by cases occurred during November and December 2020 (EW 45 to 53) and the second wave with cases occurred in February 2021 (EW 5 to 8), considering that in this month there was a predominance of the new variant P.1. We calculated the proportion of severe forms among the total cases of covid-19, the case fatality rates (CFR) and hospital case fatality rate (hCFR) over both waves time set using the date of onset of symptoms as a reference. We analyzed separately the patients without pre-existing conditions of risk, by age and sex. For comparison between periods, we calculated the Risk Ratio (RR) with their respective 95% confidence intervals and the p-values. Findings We observed that in the second wave there were an increase in the proportion of severe cases and covid-19 deaths among younger age groups and patients without pre-existing conditions of risk. The proportion of people under the age of 60 among the cases that evolved to death raised from 18% (670 deaths) in November and December (1st wave) to 28% (1370 deaths) in February (2nd wave). A higher proportion of patients without pre-existing risk conditions was also observed among those who evolved to death due to covid-19 in the second wave (22%, 1,077 deaths) than in the first one (13%, 489 deaths). The CFR for covid-19 increased overall and in different age groups, in both sexes. The increase occurred in a greatest intensity in the population between 20 and 59 years old and among patients without pre-existing risk conditions. Female 20 to 39 years old, with no pre-existing risk conditions, were at risk of death 5.65 times higher in February (95%CI = 2.9 - 11.03; p <0.0001) and in the age group of 40 and 59 years old, this risk was 7.7 times higher (95%CI = 5.01-11.83; p <0.0001) comparing with November-December. Interpretation Our findings showed an increase in the proportion of young people and people without previous illnesses among severe cases and deaths in the state of RS after the identification of the local transmission of variant P.1 in the state. There was also an increase in the proportion of severe cases and in the CFR, in almost all subgroups analyzed, this increase was heterogeneous in different age groups and sex. As far as we know, these are the first evidences that the P.1 variant can disproportionately increase the risk of severity and deaths among population without pre-existing diseases, suggesting related changes in pathogenicity and virulence profiles. New studies still need to be done to confirm and deepen these findings.

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Section: Discussionsupporting

confidence: 92%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The increase in the risk of severity and fatality rate of covid-19 in southern Brazil after the emergence of the Variant of Concern (VOC) SARS-CoV-2 P.1 was greater among young adults without pre-existing risk conditions

Freitas

Drq

Beckedorff

et al. 2021

Preprint

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“…Prioritizing the vaccination of elderly people might have had a strong impact on reducing the mortality of this group [33], though it does not explain the rise in mortality in younger ages. Thus, it is plausible to assume that the evolution of new viral phenotypes are correlated to the rejuvenation in mortality observed in the third stage [34][35][36][37].…”

Section: Discussionmentioning

confidence: 99%

Turnover of SARS-CoV-2 lineages shaped the pandemic and enabled the emergence of new variants in the state of Rio de Janeiro, Brazil

Júnior

Lamarca

Almeida

et al. 2021

Preprint

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In the present study, we provide a retrospective genomic epidemiology analysis of the SARS-CoV-2 pandemic in the state of Rio de Janeiro, Brazil. We gathered publicly available data from GISAD and sequenced more 1,927 new genomes sampled periodically from March 2021 to June 2021 from 91 out of the 92 cities of the state. Our results showed that the pandemic was characterized by three different phases driven by a successive replacement of lineages. All stages occurred in distinct mortality and mobility contexts, with higher evidence of social distancing measures being observed in early pandemic and relaxed in the last two phases. Interestingly, we noticed that viral supercarriers accounted for the overwhelming majority of the circulating virus (> 90%) among symptomatic individuals in the state. Moreover, SARS-CoV-2 genomic surveillance also revealed the emergence and spread of two new variants (P.5 and P.1.2) firstly reported in this study. Altogether, our findings provided important lessons learned from the different epidemiological aspects of the SARS-CoV-2 dynamic in the state of Rio de Janeiro that have a strong potential to shape future decisions aiming to improve public health management and understanding mechanisms underlying virus dispersion.

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“…The B.1.1.7 variant Increased transmissibility by 40% (Gan et al, 2021). Three-fold increase in death rate in people between 20 and 39 years (Freitas et al, 2021). Evades protective immunity after viral infection and post-vaccination (Beltran et al, 2021).…”

Section: S (Johnson and Johnsonmentioning

confidence: 99%

Facing the wrath of enigmatic mutations: a review on the emergence of severe acute respiratory syndrome coronavirus 2 variants amid coronavirus disease‐19 pandemic

Chadha

Khullar

Mittal

2021

Environmental Microbiology

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The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is an emerging respiratory virus responsible for the ongoing coronavirus disease 19 (COVID-19) pandemic. More than a year into this pandemic, the COVID-19 fatigue is still escalating and takes hold of the entire world population. Driven by the ongoing geographical expansion and upcoming mutations, the COVID-19 pandemic has taken a new shape in the form of emerging SARS-CoV-2 variants. These mutations in the viral spike (S) protein enhance the virulence of SARS-CoV-2 variants by improving viral infectivity, transmissibility and immune evasion abilities. Such variants have resulted in cluster outbreaks and fresh infection waves in various parts of the world with increased disease severity and poor clinical outcomes. Hence, the variants of SARS-CoV-2 pose a threat to human health and public safety. This review enlists the most recent updates regarding the presently characterized variants of SARS-CoV-2 recognized by the global regulatory health authorities (WHO, CDC). Based on the slender literature on SARS-CoV-2 variants, we collate information on the biological implications of these mutations on virus pathology. We also shed light on the efficacy of therapeutics and COVID-19 vaccines against the emerging SARS-CoV-2 variants.

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A emergência da nova variante P.1 do SARS-CoV-2 no Amazonas (Brasil) foi temporalmente associada a uma mudança no perfil da mortalidade devido a COVID-19, segundo sexo e idade

Cited by 14 publications

References 0 publications

The increase in the risk of severity and fatality rate of covid-19 in southern Brazil after the emergence of the Variant of Concern (VOC) SARS-CoV-2 P.1 was greater among young adults without pre-existing risk conditions

The increase in the risk of severity and fatality rate of covid-19 in southern Brazil after the emergence of the Variant of Concern (VOC) SARS-CoV-2 P.1 was greater among young adults without pre-existing risk conditions

Turnover of SARS-CoV-2 lineages shaped the pandemic and enabled the emergence of new variants in the state of Rio de Janeiro, Brazil

Facing the wrath of enigmatic mutations: a review on the emergence of severe acute respiratory syndrome coronavirus 2 variants amid coronavirus disease‐19 pandemic

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