tetano
Editor, Senior Moderator
Front Med (Lausanne)
. 2021 Dec 9;8:780611.
doi: 10.3389/fmed.2021.780611. eCollection 2021.
Is the Infection of the SARS-CoV-2 Delta Variant Associated With the Outcomes of COVID-19 Patients?
Gunadi[SUP] 1 [/SUP], Mohamad Saifudin Hakim[SUP] 2 [/SUP], Hendra Wibawa[SUP] 3 [/SUP], Marcellus[SUP] 1 [/SUP], Vivi Setiawaty[SUP] 4 [/SUP], Slamet[SUP] 4 [/SUP], Ika Trisnawati[SUP] 5 [/SUP], Endah Supriyati[SUP] 6 [/SUP], Riat El Khair[SUP] 7 [/SUP], Kristy Iskandar[SUP] 8 [/SUP], Afiahayati[SUP] 9 [/SUP], Siswanto[SUP] 10 [/SUP], Irene[SUP] 11 [/SUP], Nungki Anggorowati[SUP] 12 [/SUP], Edwin Widyanto Daniwijaya[SUP] 2 [/SUP], Dwi Aris Agung Nugrahaningsih[SUP] 13 [/SUP], Yunika Puspadewi[SUP] 7 [/SUP], Dyah Ayu Puspitarani[SUP] 1 [/SUP], Irene Tania[SUP] 1 [/SUP], Khanza Adzkia Vujira[SUP] 1 [/SUP], Muhammad Buston Ardlyamustaqim[SUP] 1 [/SUP], Gita Christy Gabriela[SUP] 1 [/SUP], Laudria Stella Eryvinka[SUP] 1 [/SUP], Bunga Citta Nirmala[SUP] 1 [/SUP], Esensi Tarian Geometri[SUP] 1 [/SUP], Abirafdi Amajida Darutama[SUP] 1 [/SUP], Anisa Adityarini Kuswandani[SUP] 1 [/SUP], Lestari[SUP] 3 [/SUP], Sri Handayani Irianingsih[SUP] 3 [/SUP], Siti Khoiriyah[SUP] 14 [/SUP], Ina Lestari[SUP] 14 [/SUP], Nur Rahmi Ananda[SUP] 5 [/SUP], Eggi Arguni[SUP] 8 [/SUP], Titik Nuryastuti[SUP] 2 [/SUP], Tri Wibawa[SUP] 2 [/SUP]
Affiliations
Abstract
Background: Severe acute respiratory syndrome Coronavirus 2 (SARS-CoV-2) Delta variant (B.1.617.2) has been responsible for the current increase in Coronavirus disease 2019 (COVID-19) infectivity rate worldwide. We compared the impact of the Delta variant and non-Delta variant on the COVID-19 outcomes in patients from Yogyakarta and Central Java provinces, Indonesia. Methods: In this cross-sectional study, we ascertained 161 patients, 69 with the Delta variant and 92 with the non-Delta variant. The Illumina MiSeq next-generation sequencer was used to perform the whole-genome sequences of SARS-CoV-2. Results: The mean age of patients with the Delta variant and the non-Delta variant was 27.3 ± 20.0 and 43.0 ± 20.9 (p = 3 × 10[SUP]-6[/SUP]). The patients with Delta variant consisted of 23 males and 46 females, while the patients with the non-Delta variant involved 56 males and 36 females (p = 0.001). The Ct value of the Delta variant (18.4 ± 2.9) was significantly lower than that of the non-Delta variant (19.5 ± 3.8) (p = 0.043). There was no significant difference in the hospitalization and mortality of patients with Delta and non-Delta variants (p = 0.80 and 0.29, respectively). None of the prognostic factors were associated with the hospitalization, except diabetes with an OR of 3.6 (95% CI = 1.02-12.5; p = 0.036). Moreover, the patients with the following factors have been associated with higher mortality rate than the patients without the factors: age ≥65 years, obesity, diabetes, hypertension, and cardiovascular disease with the OR of 11 (95% CI = 3.4-36; p = 8 × 10[SUP]-5[/SUP]), 27 (95% CI = 6.1-118; p = 1 × 10[SUP]-5[/SUP]), 15.6 (95% CI = 5.3-46; p = 6 × 10[SUP]-7[/SUP]), 12 (95% CI = 4-35.3; p = 1.2 × 10[SUP]-5[/SUP]), and 6.8 (95% CI = 2.1-22.1; p = 0.003), respectively. Multivariate analysis showed that age ≥65 years, obesity, diabetes, and hypertension were the strong prognostic factors for the mortality of COVID-19 patients with the OR of 3.6 (95% CI = 0.58-21.9; p = 0.028), 16.6 (95% CI = 2.5-107.1; p = 0.003), 5.5 (95% CI = 1.3-23.7; p = 0.021), and 5.8 (95% CI = 1.02-32.8; p = 0.047), respectively. Conclusions: We show that the patients infected by the SARS-CoV-2 Delta variant have a lower Ct value than the patients infected by the non-Delta variant, implying that the Delta variant has a higher viral load, which might cause a more transmissible virus among humans. However, the Delta variant does not affect the COVID-19 outcomes in our patients. Our study also confirms that older age and comorbidity increase the mortality rate of patients with COVID-19.
Keywords: Ct value; SARS-CoV-2; comorbidity; delta variant; hospitalization; mortality; viral load; whole genome sequencing.
. 2021 Dec 9;8:780611.
doi: 10.3389/fmed.2021.780611. eCollection 2021.
Is the Infection of the SARS-CoV-2 Delta Variant Associated With the Outcomes of COVID-19 Patients?
Gunadi[SUP] 1 [/SUP], Mohamad Saifudin Hakim[SUP] 2 [/SUP], Hendra Wibawa[SUP] 3 [/SUP], Marcellus[SUP] 1 [/SUP], Vivi Setiawaty[SUP] 4 [/SUP], Slamet[SUP] 4 [/SUP], Ika Trisnawati[SUP] 5 [/SUP], Endah Supriyati[SUP] 6 [/SUP], Riat El Khair[SUP] 7 [/SUP], Kristy Iskandar[SUP] 8 [/SUP], Afiahayati[SUP] 9 [/SUP], Siswanto[SUP] 10 [/SUP], Irene[SUP] 11 [/SUP], Nungki Anggorowati[SUP] 12 [/SUP], Edwin Widyanto Daniwijaya[SUP] 2 [/SUP], Dwi Aris Agung Nugrahaningsih[SUP] 13 [/SUP], Yunika Puspadewi[SUP] 7 [/SUP], Dyah Ayu Puspitarani[SUP] 1 [/SUP], Irene Tania[SUP] 1 [/SUP], Khanza Adzkia Vujira[SUP] 1 [/SUP], Muhammad Buston Ardlyamustaqim[SUP] 1 [/SUP], Gita Christy Gabriela[SUP] 1 [/SUP], Laudria Stella Eryvinka[SUP] 1 [/SUP], Bunga Citta Nirmala[SUP] 1 [/SUP], Esensi Tarian Geometri[SUP] 1 [/SUP], Abirafdi Amajida Darutama[SUP] 1 [/SUP], Anisa Adityarini Kuswandani[SUP] 1 [/SUP], Lestari[SUP] 3 [/SUP], Sri Handayani Irianingsih[SUP] 3 [/SUP], Siti Khoiriyah[SUP] 14 [/SUP], Ina Lestari[SUP] 14 [/SUP], Nur Rahmi Ananda[SUP] 5 [/SUP], Eggi Arguni[SUP] 8 [/SUP], Titik Nuryastuti[SUP] 2 [/SUP], Tri Wibawa[SUP] 2 [/SUP]
Affiliations
- PMID: 34957154
- PMCID: PMC8695874
- DOI: 10.3389/fmed.2021.780611
Abstract
Background: Severe acute respiratory syndrome Coronavirus 2 (SARS-CoV-2) Delta variant (B.1.617.2) has been responsible for the current increase in Coronavirus disease 2019 (COVID-19) infectivity rate worldwide. We compared the impact of the Delta variant and non-Delta variant on the COVID-19 outcomes in patients from Yogyakarta and Central Java provinces, Indonesia. Methods: In this cross-sectional study, we ascertained 161 patients, 69 with the Delta variant and 92 with the non-Delta variant. The Illumina MiSeq next-generation sequencer was used to perform the whole-genome sequences of SARS-CoV-2. Results: The mean age of patients with the Delta variant and the non-Delta variant was 27.3 ± 20.0 and 43.0 ± 20.9 (p = 3 × 10[SUP]-6[/SUP]). The patients with Delta variant consisted of 23 males and 46 females, while the patients with the non-Delta variant involved 56 males and 36 females (p = 0.001). The Ct value of the Delta variant (18.4 ± 2.9) was significantly lower than that of the non-Delta variant (19.5 ± 3.8) (p = 0.043). There was no significant difference in the hospitalization and mortality of patients with Delta and non-Delta variants (p = 0.80 and 0.29, respectively). None of the prognostic factors were associated with the hospitalization, except diabetes with an OR of 3.6 (95% CI = 1.02-12.5; p = 0.036). Moreover, the patients with the following factors have been associated with higher mortality rate than the patients without the factors: age ≥65 years, obesity, diabetes, hypertension, and cardiovascular disease with the OR of 11 (95% CI = 3.4-36; p = 8 × 10[SUP]-5[/SUP]), 27 (95% CI = 6.1-118; p = 1 × 10[SUP]-5[/SUP]), 15.6 (95% CI = 5.3-46; p = 6 × 10[SUP]-7[/SUP]), 12 (95% CI = 4-35.3; p = 1.2 × 10[SUP]-5[/SUP]), and 6.8 (95% CI = 2.1-22.1; p = 0.003), respectively. Multivariate analysis showed that age ≥65 years, obesity, diabetes, and hypertension were the strong prognostic factors for the mortality of COVID-19 patients with the OR of 3.6 (95% CI = 0.58-21.9; p = 0.028), 16.6 (95% CI = 2.5-107.1; p = 0.003), 5.5 (95% CI = 1.3-23.7; p = 0.021), and 5.8 (95% CI = 1.02-32.8; p = 0.047), respectively. Conclusions: We show that the patients infected by the SARS-CoV-2 Delta variant have a lower Ct value than the patients infected by the non-Delta variant, implying that the Delta variant has a higher viral load, which might cause a more transmissible virus among humans. However, the Delta variant does not affect the COVID-19 outcomes in our patients. Our study also confirms that older age and comorbidity increase the mortality rate of patients with COVID-19.
Keywords: Ct value; SARS-CoV-2; comorbidity; delta variant; hospitalization; mortality; viral load; whole genome sequencing.