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Risk of mortality in patients infected with SARS-CoV-2 variant of concern 202012/1: matched cohort study.
BMJ. 2021 03 09; 372:n579.BMJ

Abstract

OBJECTIVE

To establish whether there is any change in mortality from infection with a new variant of SARS-CoV-2, designated a variant of concern (VOC-202012/1) in December 2020, compared with circulating SARS-CoV-2 variants.

DESIGN

Matched cohort study.

SETTING

Community based (pillar 2) covid-19 testing centres in the UK using the TaqPath assay (a proxy measure of VOC-202012/1 infection).

PARTICIPANTS

54 906 matched pairs of participants who tested positive for SARS-CoV-2 in pillar 2 between 1 October 2020 and 29 January 2021, followed-up until 12 February 2021. Participants were matched on age, sex, ethnicity, index of multiple deprivation, lower tier local authority region, and sample date of positive specimens, and differed only by detectability of the spike protein gene using the TaqPath assay.

MAIN OUTCOME MEASURE

Death within 28 days of the first positive SARS-CoV-2 test result.

RESULTS

The mortality hazard ratio associated with infection with VOC-202012/1 compared with infection with previously circulating variants was 1.64 (95% confidence interval 1.32 to 2.04) in patients who tested positive for covid-19 in the community. In this comparatively low risk group, this represents an increase in deaths from 2.5 to 4.1 per 1000 detected cases.

CONCLUSIONS

The probability that the risk of mortality is increased by infection with VOC-202012/01 is high. If this finding is generalisable to other populations, infection with VOC-202012/1 has the potential to cause substantial additional mortality compared with previously circulating variants. Healthcare capacity planning and national and international control policies are all impacted by this finding, with increased mortality lending weight to the argument that further coordinated and stringent measures are justified to reduce deaths from SARS-CoV-2.

Authors+Show Affiliations

College of Engineering, Mathematics and Physical Sciences, University of Exeter, Exeter, UK rc538@exeter.ac.uk. Somerset NHS Foundation Trust, Taunton, UK. Joint Universities Pandemic and Epidemiological Research (JUNIPER consortium).Joint Universities Pandemic and Epidemiological Research (JUNIPER consortium). University of Bristol, Bristol Veterinary School, Langford, Bristol, UK. Bristol Medical School, Population Health Sciences, University of Bristol, Bristol, UK.Joint Universities Pandemic and Epidemiological Research (JUNIPER consortium). Lancaster Medical School, Lancaster University, Bailrigg, Lancaster, UK.Joint Universities Pandemic and Epidemiological Research (JUNIPER consortium). The Zeeman Institute for Systems Biology and Infectious Disease Epidemiology Research, School of Life Sciences and Mathematics Institute, University of Warwick, Coventry, UK.College of Engineering, Mathematics and Physical Sciences, University of Exeter, Exeter, UK. The Alan Turing Institute, British Library, London, UK.Joint Universities Pandemic and Epidemiological Research (JUNIPER consortium). Bristol Medical School, Population Health Sciences, University of Bristol, Bristol, UK. The Alan Turing Institute, British Library, London, UK. Department of Engineering Mathematics, University of Bristol, Bristol, UK.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

33687922

Citation

Challen, Robert, et al. "Risk of Mortality in Patients Infected With SARS-CoV-2 Variant of Concern 202012/1: Matched Cohort Study." BMJ (Clinical Research Ed.), vol. 372, 2021, pp. n579.
Challen R, Brooks-Pollock E, Read JM, et al. Risk of mortality in patients infected with SARS-CoV-2 variant of concern 202012/1: matched cohort study. BMJ. 2021;372:n579.
Challen, R., Brooks-Pollock, E., Read, J. M., Dyson, L., Tsaneva-Atanasova, K., & Danon, L. (2021). Risk of mortality in patients infected with SARS-CoV-2 variant of concern 202012/1: matched cohort study. BMJ (Clinical Research Ed.), 372, n579. https://doi.org/10.1136/bmj.n579
Challen R, et al. Risk of Mortality in Patients Infected With SARS-CoV-2 Variant of Concern 202012/1: Matched Cohort Study. BMJ. 2021 03 9;372:n579. PubMed PMID: 33687922.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Risk of mortality in patients infected with SARS-CoV-2 variant of concern 202012/1: matched cohort study. AU - Challen,Robert, AU - Brooks-Pollock,Ellen, AU - Read,Jonathan M, AU - Dyson,Louise, AU - Tsaneva-Atanasova,Krasimira, AU - Danon,Leon, Y1 - 2021/03/09/ PY - 2021/3/10/entrez PY - 2021/3/11/pubmed PY - 2021/3/16/medline SP - n579 EP - n579 JF - BMJ (Clinical research ed.) JO - BMJ VL - 372 N2 - OBJECTIVE: To establish whether there is any change in mortality from infection with a new variant of SARS-CoV-2, designated a variant of concern (VOC-202012/1) in December 2020, compared with circulating SARS-CoV-2 variants. DESIGN: Matched cohort study. SETTING: Community based (pillar 2) covid-19 testing centres in the UK using the TaqPath assay (a proxy measure of VOC-202012/1 infection). PARTICIPANTS: 54 906 matched pairs of participants who tested positive for SARS-CoV-2 in pillar 2 between 1 October 2020 and 29 January 2021, followed-up until 12 February 2021. Participants were matched on age, sex, ethnicity, index of multiple deprivation, lower tier local authority region, and sample date of positive specimens, and differed only by detectability of the spike protein gene using the TaqPath assay. MAIN OUTCOME MEASURE: Death within 28 days of the first positive SARS-CoV-2 test result. RESULTS: The mortality hazard ratio associated with infection with VOC-202012/1 compared with infection with previously circulating variants was 1.64 (95% confidence interval 1.32 to 2.04) in patients who tested positive for covid-19 in the community. In this comparatively low risk group, this represents an increase in deaths from 2.5 to 4.1 per 1000 detected cases. CONCLUSIONS: The probability that the risk of mortality is increased by infection with VOC-202012/01 is high. If this finding is generalisable to other populations, infection with VOC-202012/1 has the potential to cause substantial additional mortality compared with previously circulating variants. Healthcare capacity planning and national and international control policies are all impacted by this finding, with increased mortality lending weight to the argument that further coordinated and stringent measures are justified to reduce deaths from SARS-CoV-2. SN - 1756-1833 UR - https://www.unboundmedicine.com/medline/citation/33687922/full_citation L2 - http://www.bmj.com/lookup/pmidlookup?view=long&pmid=33687922 DB - PRIME DP - Unbound Medicine ER -