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A standardised protocol for relative SARS-CoV-2 variant severity assessment, applied to Omicron BA.1 and Delta in six European countries, October 2021 to February 2022.

Published version
Peer-reviewed

Repository DOI


Change log

Authors

Bager, Peter 
Svalgaard, Ingrid Bech 
Bejko, Dritan 
Bundle, Nick 

Abstract

Several SARS-CoV-2 variants that evolved during the COVID-19 pandemic have appeared to differ in severity, based on analyses of single-country datasets. With decreased testing and sequencing, international collaborative studies will become increasingly important for timely assessment of the severity of new variants. Therefore, a joint WHO Regional Office for Europe and ECDC working group was formed to produce and pilot a standardised study protocol to estimate relative case-severity of SARS-CoV-2 variants during periods when two variants were co-circulating. The study protocol and its associated statistical analysis code was applied by investigators in Denmark, England, Luxembourg, Norway, Portugal and Scotland to assess the severity of cases with the Omicron BA.1 virus variant relative to Delta. After pooling estimates using meta-analysis methods (random effects estimates), the risk of hospital admission (adjusted hazard ratio (aHR) = 0.41; 95% confidence interval (CI): 0.31-0.54), admission to intensive care unit (aHR = 0.12; 95% CI: 0.05-0.27) and death (aHR = 0.31; 95% CI: 0.28-0.35) was lower for Omicron BA.1 compared with Delta cases. The aHRs varied by age group and vaccination status. In conclusion, this study demonstrates the feasibility of conducting variant severity analyses in a multinational collaborative framework and adds evidence for the reduced severity of the Omicron BA.1 variant.

Description

Keywords

COVID-19, SARS-CoV-2, severity, study protocol, variant of concern, virulence, Humans, SARS-CoV-2, COVID-19, Pandemics, Europe, Meta-Analysis as Topic

Journal Title

Euro Surveill

Conference Name

Journal ISSN

1025-496X
1560-7917

Volume Title

28

Publisher

European Centre for Disease Control and Prevention (ECDC)
Sponsorship
This work was supported by the World Health Organization (WHO) Regional Office for Europe (TN, AMP); UK Research and Innovation (UKRI) Medical Research Council (MRC) (AMP: [Unit Programme number MC/UU/00002/11]); UKRI MRC/Department of Health and Social Care (DHSC) National Institute for Health and Care Research (NIHR) COVID-19 rapid response call (TN, AMP: [MC/PC/19074]).