Spread of the SARS-CoV-2 UK-variant in the South East of France: impact on COVID-19 patients’ age, comorbidity profiles and clinical presentation

Abstract

Objectives: The variant 20I/501Y.V1, associated to a higher risk of transmissibility, emerged in Nice city (South East of France, French Riviera) during January 2021. The pandemic has resumed late December 2020 in this aera. A high incidence rate together with a fast turn-over of the main circulating variants, provided us the opportunity to analyze modifications in clinical profile and outcome traits. Methods: Observational study in the University hospital of Nice from December 2020 to February 2021. We analyzed data of sequencing of SARS-CoV-2 from the sewage collector and PCR screening from all positive samples at the hospital. Then, we described the characteristics of all COVID-19 patients admitted in the emergency department (ED) (n=1247) and those hospitalized in the infectious diseases ward or ICU (n=232). Demographic data, clinical signs and severity were documented by the NEWS-2, SAPS-2 and SOFA scores were recorded and analyzed. Results: the UK-variant was absent in the area in December, then increasingly spread in January representing 59% of the PCR screening performed mid-February. The rate of patients over 65 years admitted to the ED decreased from 63% to 50% (p=0.001). The mean age of hospitalized patients in the infectious diseases ward decreased from 70.7 to 59.2 (p<0.001) while the proportion of patients without comorbidity increased from 16% to 42% (p=0.007). Neither the NEWS-2 score nor the main signs of clinical severity have changed over time. Conclusion: Spread of the UK-variant in the South East of France affects younger and healthier patients.

Public Health and Health Systems Impacts of SARS-CoV-2 Variants of Concern: A Rapid Scoping Review

“…Courjon et al conducted an observational study in France (Nice) with 232 patients hospitalized in the infectious disease ward and ICU to analyze modification in clinical profile and outcome traits. 30 They found no significant difference between percentage of COVID-19 hospitalized patients admitted to the ICU before B.1.1.7 was dominate (23% [December 7-21, 2021]) compared to after (26% [January 24-February 7, 2021] and 35% [February 8-22, 2021]), p=0.374. For ICU patients, neither the severity score at admission (SAPSII) nor the depth of the respiratory distress seemed to increase with B.1.1.7.…”

“…Courjon et al conducted an observational study in France (Nice) with 1,247 patients admitted to the emergency department to analyze changes in clinical profile and outcomes. 30 Of those admitted by February 22 nd , 29 had B.1.1.7 (12.5%). This reflects the prevalence of B.1.1.7 in the area, which increased from 2.6% in December 2020 to 79.1% in February.…”

“…Overall, 13 studies related to health system impacts were eligible for critical appraisal. Two were appraised as low quality, 38, 39 seven as medium, 28, 30–35 and four as high. 24–27…”

“…Four studies scored 80% or higher, [24][25][26][27] indicating high quality. The majority (n=8) scored 50-80%, [28][29][30][31][32][33][34][35] suggesting medium quality, while four studies were considered low quality, scoring 10-44%. [36][37][38][39] Twelve of the 33 studies were pre-prints, meaning they had not yet been peer reviewed.…”

“…Overall, 13 studies related to health system impacts were eligible for critical appraisal. Two were appraised as low quality, 38,39 seven as medium, 28,[30][31][32][33][34][35] and four as high. [24][25][26][27] Question 2A: Adjusting capacity planning to accommodate changes in the risk of re-infection and the risk of severe disease (e.g., hospitalization, admission to ICU, and death).…”