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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Authors
Boshier, Florencia
Venturini, Cristina
Guerra-Assunção, José Afonso
Alcolea-Medina, Adela
Beckett, Angela
Charalampous, Themoula
da Silva Filipe, Ana
Glaysher, Sharon
Khan, Tabassum
Kele, Beatrix
Monahan, Irene
Mollett, Guy
Parker, Matthew
Pelosi, Emanuela
Randell, Paul
Roy, Sunando
Taylor, Joshua
Weller, Sophie
Wilson-Davies, Eleri
Wade, Phillip
Williams, Rachel
COG-UK-HOCI Variant substudy consortium
COVID-19 Genomics UK (COG-UK) consortium
Copas, Andrew
Cutino-Moguel, Maria-Teresa
Freemantle, Nick
Hayward, Andrew C
Holmes, Alison
Hughes, Joseph
Mahungu, Tabitha
Nebbia, Gaia
Partridge, David
Pope, Cassie
Robson, Samuel
Saeed, Kordo
de Silva, Thushan
Snell, Luke
Thomson, Emma
Witney, Adam A
Breuer, Judith
Publication Date
2021-09Journal Title
BMJ Open Respir Res
ISSN
2052-4439
Publisher
BMJ
Volume
8
Issue
1
Language
eng
Type
Article
This Version
VoR
Physical Medium
Print
Metadata
Show full item recordCitation
Stirrup, O., Boshier, F., Venturini, C., Guerra-Assunção, J. A., Alcolea-Medina, A., Beckett, A., Charalampous, T., et al. (2021). SARS-CoV-2 lineage B.1.1.7 is associated with greater disease severity among hospitalised women but not men: multicentre cohort study.. BMJ Open Respir Res, 8 (1) https://doi.org/10.1136/bmjresp-2021-001029
Abstract
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.
Keywords
COG-UK-HOCI Variant substudy consortium, COVID-19 Genomics UK (COG-UK) consortium
Sponsorship
This report was produced by members of the COG-UK-HOCI Variant
substudy consortium. COG-UK-HOCI is part of COG-UK. COG-UK is supported by funding from the Medical Research Council (MRC) part of UK Research & Innovation (UKRI), the National Institute of Health Research (NIHR) and Genome Research Limited, operating as the Wellcome Sanger Institute.
Funder references
MRC (MC_PC_19027)
Medical Research Council (MC_PC_19027)
Identifiers
External DOI: https://doi.org/10.1136/bmjresp-2021-001029
This record's URL: https://www.repository.cam.ac.uk/handle/1810/329737
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