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Increased mortality in community-tested cases of SARS-CoV-2 lineage B.1.1.7.
medRxiv. 2021 Mar 05M

Abstract

SARS-CoV-2 lineage B.1.1.7, a variant first detected in the United Kingdom in September 20201, has spread to multiple countries worldwide. Several studies have established that B.1.1.7 is more transmissible than preexisting variants, but have not identified whether it leads to any change in disease severity2. We analyse a dataset linking 2,245,263 positive SARS-CoV-2 community tests and 17,452 COVID-19 deaths in England from 1 September 2020 to 14 February 2021. For 1,146,534 (51%) of these tests, the presence or absence of B.1.1.7 can be identified because of mutations in this lineage preventing PCR amplification of the spike gene target (S gene target failure, SGTF1). Based on 4,945 deaths with known SGTF status, we estimate that the hazard of death associated with SGTF is 55% (95% CI 39-72%) higher after adjustment for age, sex, ethnicity, deprivation, care home residence, local authority of residence and test date. This corresponds to the absolute risk of death for a 55-69-year-old male increasing from 0.6% to 0.9% (95% CI 0.8-1.0%) within 28 days after a positive test in the community. Correcting for misclassification of SGTF and missingness in SGTF status, we estimate a 61% (42-82%) higher hazard of death associated with B.1.1.7. Our analysis suggests that B.1.1.7 is not only more transmissible than preexisting SARS-CoV-2 variants, but may also cause more severe illness.

Authors+Show Affiliations

Centre for Mathematical Modelling of Infectious Diseases, London School of Hygiene and Tropical Medicine, London, UK.Centre for Mathematical Modelling of Infectious Diseases, London School of Hygiene and Tropical Medicine, London, UK.No affiliation info availableCentre for Mathematical Modelling of Infectious Diseases, London School of Hygiene and Tropical Medicine, London, UK.Department of Medical Statistics, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK. Centre for Statistical Methodology, London School of Hygiene and Tropical Medicine, London, UK.Department of Medical Statistics, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK. Centre for Statistical Methodology, London School of Hygiene and Tropical Medicine, London, UK.Department of Medical Statistics, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK. Centre for Statistical Methodology, London School of Hygiene and Tropical Medicine, London, UK.

Pub Type(s)

Preprint

Language

eng

PubMed ID

33564794

Citation

Davies, Nicholas G., et al. "Increased Mortality in Community-tested Cases of SARS-CoV-2 Lineage B.1.1.7." MedRxiv : the Preprint Server for Health Sciences, 2021.
Davies NG, Jarvis CI, CMMID COVID-19 Working Group, et al. Increased mortality in community-tested cases of SARS-CoV-2 lineage B.1.1.7. medRxiv. 2021.
Davies, N. G., Jarvis, C. I., Edmunds, W. J., Jewell, N. P., Diaz-Ordaz, K., & Keogh, R. H. (2021). Increased mortality in community-tested cases of SARS-CoV-2 lineage B.1.1.7. MedRxiv : the Preprint Server for Health Sciences. https://doi.org/10.1101/2021.02.01.21250959
Davies NG, et al. Increased Mortality in Community-tested Cases of SARS-CoV-2 Lineage B.1.1.7. medRxiv. 2021 Mar 5; PubMed PMID: 33564794.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Increased mortality in community-tested cases of SARS-CoV-2 lineage B.1.1.7. AU - Davies,Nicholas G, AU - Jarvis,Christopher I, AU - ,, AU - Edmunds,W John, AU - Jewell,Nicholas P, AU - Diaz-Ordaz,Karla, AU - Keogh,Ruth H, Y1 - 2021/03/05/ PY - 2021/2/11/pubmed PY - 2021/2/11/medline PY - 2021/2/10/entrez JF - medRxiv : the preprint server for health sciences JO - medRxiv N2 - SARS-CoV-2 lineage B.1.1.7, a variant first detected in the United Kingdom in September 20201, has spread to multiple countries worldwide. Several studies have established that B.1.1.7 is more transmissible than preexisting variants, but have not identified whether it leads to any change in disease severity2. We analyse a dataset linking 2,245,263 positive SARS-CoV-2 community tests and 17,452 COVID-19 deaths in England from 1 September 2020 to 14 February 2021. For 1,146,534 (51%) of these tests, the presence or absence of B.1.1.7 can be identified because of mutations in this lineage preventing PCR amplification of the spike gene target (S gene target failure, SGTF1). Based on 4,945 deaths with known SGTF status, we estimate that the hazard of death associated with SGTF is 55% (95% CI 39-72%) higher after adjustment for age, sex, ethnicity, deprivation, care home residence, local authority of residence and test date. This corresponds to the absolute risk of death for a 55-69-year-old male increasing from 0.6% to 0.9% (95% CI 0.8-1.0%) within 28 days after a positive test in the community. Correcting for misclassification of SGTF and missingness in SGTF status, we estimate a 61% (42-82%) higher hazard of death associated with B.1.1.7. Our analysis suggests that B.1.1.7 is not only more transmissible than preexisting SARS-CoV-2 variants, but may also cause more severe illness. UR - https://www.unboundmedicine.com/medline/citation/33564794/Increased_hazard_of_death_in_community_tested_cases_of_SARS_CoV_2_Variant_of_Concern_202012/01_ L2 - https://doi.org/10.1101/2021.02.01.21250959 DB - PRIME DP - Unbound Medicine ER -
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