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dc.contributor.authorStirrup, Oliver
dc.contributor.authorBoshier, Florencia
dc.contributor.authorVenturini, Cristina
dc.contributor.authorGuerra-Assunção, José Afonso
dc.contributor.authorAlcolea-Medina, Adela
dc.contributor.authorBeckett, Angela
dc.contributor.authorCharalampous, Themoula
dc.contributor.authorda Silva Filipe, Ana
dc.contributor.authorGlaysher, Sharon
dc.contributor.authorKhan, Tabassum
dc.contributor.authorKulasegaran Shylini, Raghavendran
dc.contributor.authorKele, Beatrix
dc.contributor.authorMonahan, Irene
dc.contributor.authorMollett, Guy
dc.contributor.authorParker, Matthew
dc.contributor.authorPelosi, Emanuela
dc.contributor.authorRandell, Paul
dc.contributor.authorRoy, Sunando
dc.contributor.authorTaylor, Joshua
dc.contributor.authorWeller, Sophie
dc.contributor.authorWilson-Davies, Eleri
dc.contributor.authorWade, Phillip
dc.contributor.authorWilliams, Rachel
dc.contributor.authorCOG-UK-HOCI Variant substudy consortium
dc.contributor.authorCOVID-19 Genomics UK (COG-UK) consortium
dc.contributor.authorCopas, Andrew
dc.contributor.authorCutino-Moguel, Maria-Teresa
dc.contributor.authorFreemantle, Nick
dc.contributor.authorHayward, Andrew C
dc.contributor.authorHolmes, Alison
dc.contributor.authorHughes, Joseph
dc.contributor.authorMahungu, Tabitha
dc.contributor.authorNebbia, Gaia
dc.contributor.authorPartridge, David
dc.contributor.authorPope, Cassie
dc.contributor.authorPrice, James
dc.contributor.authorRobson, Samuel
dc.contributor.authorSaeed, Kordo
dc.contributor.authorde Silva, Thushan
dc.contributor.authorSnell, Luke
dc.contributor.authorThomson, Emma
dc.contributor.authorWitney, Adam A
dc.contributor.authorBreuer, Judith
dc.description.abstractBACKGROUND: 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.
dc.description.sponsorshipThis 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.
dc.rightsAttribution 4.0 International
dc.subjectCOG-UK-HOCI Variant substudy consortium
dc.subjectCOVID-19 Genomics UK (COG-UK) consortium
dc.titleSARS-CoV-2 lineage B.1.1.7 is associated with greater disease severity among hospitalised women but not men: multicentre cohort study.
prism.publicationNameBMJ Open Respir Res
dc.contributor.orcidStirrup, Oliver [0000-0002-8705-3281]
dc.contributor.orcidKulasegaran Shylini, Raghavendran [0000-0003-4303-5716]
dc.contributor.orcidPrice, James [0000-0003-2541-8545]
rioxxterms.typeJournal Article/Review
pubs.funder-project-idMRC (MC_PC_19027)
pubs.funder-project-idMedical Research Council (MC_PC_19027)

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Attribution 4.0 International
Except where otherwise noted, this item's licence is described as Attribution 4.0 International