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Risk of hospital admission for patients with SARS-CoV-2 variant B.1.1.7: cohort analysis.
BMJ. 2021 06 15; 373:n1412.BMJ

Abstract

OBJECTIVE

To evaluate the relation between diagnosis of covid-19 with SARS-CoV-2 variant B.1.1.7 (also known as variant of concern 202012/01) and the risk of hospital admission compared with diagnosis with wild-type SARS-CoV-2 variants.

DESIGN

Retrospective cohort analysis.

SETTING

Community based SARS-CoV-2 testing in England, individually linked with hospital admission data.

PARTICIPANTS

839 278 patients with laboratory confirmed covid-19, of whom 36 233 had been admitted to hospital within 14 days, tested between 23 November 2020 and 31 January 2021 and analysed at a laboratory with an available TaqPath assay that enables assessment of S-gene target failure (SGTF), a proxy test for the B.1.1.7 variant. Patient data were stratified by age, sex, ethnicity, deprivation, region of residence, and date of positive test.

MAIN OUTCOME MEASURES

Hospital admission between one and 14 days after the first positive SARS-CoV-2 test.

RESULTS

27 710 (4.7%) of 592 409 patients with SGTF variants and 8523 (3.5%) of 246 869 patients without SGTF variants had been admitted to hospital within one to 14 days. The stratum adjusted hazard ratio of hospital admission was 1.52 (95% confidence interval 1.47 to 1.57) for patients with covid-19 infected with SGTF variants, compared with those infected with non-SGTF variants. The effect was modified by age (P<0.001), with hazard ratios of 0.93-1.21 in patients younger than 20 years with versus without SGTF variants, 1.29 in those aged 20-29, and 1.45-1.65 in those aged ≥30 years. The adjusted absolute risk of hospital admission within 14 days was 4.7% (95% confidence interval 4.6% to 4.7%) for patients with SGTF variants and 3.5% (3.4% to 3.5%) for those with non-SGTF variants.

CONCLUSIONS

The results suggest that the risk of hospital admission is higher for people infected with the B.1.1.7 variant compared with wild-type SARS-CoV-2, likely reflecting a more severe disease. The higher severity may be specific to adults older than 30 years.

Authors+Show Affiliations

MRC Biostatistics Unit, University of Cambridge, Cambridge, UK tommy.nyberg@mrc-bsu.cam.ac.uk.COVID-19 National Epidemiology Cell, Public Health England, London, UK.National Infection Service, Public Health England, London, UK.MRC Biostatistics Unit, University of Cambridge, Cambridge, UK.COVID-19 National Epidemiology Cell, Public Health England, London, UK.COVID-19 National Epidemiology Cell, Public Health England, London, UK.National Infection Service, Public Health England, London, UK.MRC Biostatistics Unit, University of Cambridge, Cambridge, UK. National Infection Service, Public Health England, London, UK.COVID-19 National Epidemiology Cell, Public Health England, London, UK.MRC Biostatistics Unit, University of Cambridge, Cambridge, UK.

Pub Type(s)

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

Language

eng

PubMed ID

34130987

Citation

Nyberg, Tommy, et al. "Risk of Hospital Admission for Patients With SARS-CoV-2 Variant B.1.1.7: Cohort Analysis." BMJ (Clinical Research Ed.), vol. 373, 2021, pp. n1412.
Nyberg T, Twohig KA, Harris RJ, et al. Risk of hospital admission for patients with SARS-CoV-2 variant B.1.1.7: cohort analysis. BMJ. 2021;373:n1412.
Nyberg, T., Twohig, K. A., Harris, R. J., Seaman, S. R., Flannagan, J., Allen, H., Charlett, A., De Angelis, D., Dabrera, G., & Presanis, A. M. (2021). Risk of hospital admission for patients with SARS-CoV-2 variant B.1.1.7: cohort analysis. BMJ (Clinical Research Ed.), 373, n1412. https://doi.org/10.1136/bmj.n1412
Nyberg T, et al. Risk of Hospital Admission for Patients With SARS-CoV-2 Variant B.1.1.7: Cohort Analysis. BMJ. 2021 06 15;373:n1412. PubMed PMID: 34130987.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Risk of hospital admission for patients with SARS-CoV-2 variant B.1.1.7: cohort analysis. AU - Nyberg,Tommy, AU - Twohig,Katherine A, AU - Harris,Ross J, AU - Seaman,Shaun R, AU - Flannagan,Joe, AU - Allen,Hester, AU - Charlett,Andre, AU - De Angelis,Daniela, AU - Dabrera,Gavin, AU - Presanis,Anne M, Y1 - 2021/06/15/ PY - 2021/6/16/entrez PY - 2021/6/17/pubmed PY - 2021/6/17/medline SP - n1412 EP - n1412 JF - BMJ (Clinical research ed.) JO - BMJ VL - 373 N2 - OBJECTIVE: To evaluate the relation between diagnosis of covid-19 with SARS-CoV-2 variant B.1.1.7 (also known as variant of concern 202012/01) and the risk of hospital admission compared with diagnosis with wild-type SARS-CoV-2 variants. DESIGN: Retrospective cohort analysis. SETTING: Community based SARS-CoV-2 testing in England, individually linked with hospital admission data. PARTICIPANTS: 839 278 patients with laboratory confirmed covid-19, of whom 36 233 had been admitted to hospital within 14 days, tested between 23 November 2020 and 31 January 2021 and analysed at a laboratory with an available TaqPath assay that enables assessment of S-gene target failure (SGTF), a proxy test for the B.1.1.7 variant. Patient data were stratified by age, sex, ethnicity, deprivation, region of residence, and date of positive test. MAIN OUTCOME MEASURES: Hospital admission between one and 14 days after the first positive SARS-CoV-2 test. RESULTS: 27 710 (4.7%) of 592 409 patients with SGTF variants and 8523 (3.5%) of 246 869 patients without SGTF variants had been admitted to hospital within one to 14 days. The stratum adjusted hazard ratio of hospital admission was 1.52 (95% confidence interval 1.47 to 1.57) for patients with covid-19 infected with SGTF variants, compared with those infected with non-SGTF variants. The effect was modified by age (P<0.001), with hazard ratios of 0.93-1.21 in patients younger than 20 years with versus without SGTF variants, 1.29 in those aged 20-29, and 1.45-1.65 in those aged ≥30 years. The adjusted absolute risk of hospital admission within 14 days was 4.7% (95% confidence interval 4.6% to 4.7%) for patients with SGTF variants and 3.5% (3.4% to 3.5%) for those with non-SGTF variants. CONCLUSIONS: The results suggest that the risk of hospital admission is higher for people infected with the B.1.1.7 variant compared with wild-type SARS-CoV-2, likely reflecting a more severe disease. The higher severity may be specific to adults older than 30 years. SN - 1756-1833 UR - https://www.unboundmedicine.com/medline/citation/34130987/Risk_of_hospital_admission_for_patients_with_SARS_CoV_2_variant_B_1_1_7:_cohort_analysis_ L2 - http://www.bmj.com/lookup/pmidlookup?view=long&amp;pmid=34130987 DB - PRIME DP - Unbound Medicine ER -