Risk of mortality in patients infected with SARS-CoV-2 variant of concern 202012/1: matched cohort study

Abstract

Objective To establish whether there is any change in mortality from infection with a new variant of SARS-CoV-2, designated a variant of concern (VOC-202012/1) in December 2020, compared with circulating SARS-CoV-2 variants. Design Matched cohort study. Setting Community based (pillar 2) covid-19 testing centres in the UK using the TaqPath assay (a proxy measure of VOC-202012/1 infection). Participants 54 906 matched pairs of participants who tested positive for SARS-CoV-2 in pillar 2 between 1 October 2020 and 29 January 2021, followed-up until 12 February 2021. Participants were matched on age, sex, ethnicity, index of multiple deprivation, lower tier local authority region, and sample date of positive specimens, and differed only by detectability of the spike protein gene using the TaqPath assay. Main outcome measure Death within 28 days of the first positive SARS-CoV-2 test result. Results The mortality hazard ratio associated with infection with VOC-202012/1 compared with infection with previously circulating variants was 1.64 (95% confidence interval 1.32 to 2.04) in patients who tested positive for covid-19 in the community. In this comparatively low risk group, this represents an increase in deaths from 2.5 to 4.1 per 1000 detected cases. Conclusions The probability that the risk of mortality is increased by infection with VOC-202012/01 is high. If this finding is generalisable to other populations, infection with VOC-202012/1 has the potential to cause substantial additional mortality compared with previously circulating variants. Healthcare capacity planning and national and international control policies are all impacted by this finding, with increased mortality lending weight to the argument that further coordinated and stringent measures are justified to reduce deaths from SARS-CoV-2.

Case fatality risk of the SARS-CoV-2 variant of concern B.1.1.7 in England, 16 November to 5 February

“…For every three deaths in a population with the previously circulating virus we would expect five deaths in a similar population with VOC. Other studies have assessed the relative mortality of the VOC with similar conclusions [7][8][9][10], however, our results are the first to include detailed information on the presence of comorbidities. Interestingly, the effects of age and comorbidities appear to be collinear as adjustment for comorbidities did not alter the findings after adjustment for age.…”

Sudden rise in COVID-19 case fatality among young and middle-aged adults in the south of Brazil after identification of the novel B.1.1.28.1 (P.1) SARS-CoV-2 strain: analysis of data from the state of Parana

“…While limited clinical data is available on the P.1 strain, data on variants carrying some of the same mutations, such as B.1.1.7, are associated with increased mortality. 15 However, it is difficult to decipher from epidemiologic data alone what role a new strain may be directly playing in the observed increase in CFR. Though the P.1 strain was formally detected in only the middle of February in Parana, by March 3 rd it has already accounted for ~70% of tested specimens, suggesting that circulation likely began weeks earlier than when officially detected, further clouding the epidemiological timeline.…”

Increased transmissibility of the B.1.1.7 SARS-CoV-2 variant: Evidence from contact tracing data in Oslo, January to February 2021

“…The B.1.1.7 lineage that emerged in the United Kingdom (UK) in September 2020 [1] and subsequently spread to other countries and is reported to be more transmissible than the previously circulating lineages [2,3]. There is also evidence of higher risk of hospitalisation for the B.1.1.7 variant [4,5]. Though our study is not the first to estimate the relative transmissibility of B.1.1.7, local estimates are imperative due to differences in infection control measures, population behaviour, and other circulating variants.…”