tetano
Editor, Senior Moderator
J Infect Chemother
. 2022 Dec 6;S1341-321X(22)00321-X.
doi: 10.1016/j.jiac.2022.11.014. Online ahead of print.
Clinical outcomes of COVID-19 caused by the Alpha variant compared with one by wild type in Kobe, Japan. A multi-center nested case-control study
Asako Doi[SUP] 1 [/SUP], Kentaro Iwata[SUP] 2 [/SUP], Tadahiro Nakamura[SUP] 3 [/SUP], Koji Oh[SUP] 4 [/SUP], Kenichi Isome[SUP] 5 [/SUP], Kohei Hasegawa[SUP] 6 [/SUP], Hirokazu Kuroda[SUP] 6 [/SUP], Toshikazu Hasuike[SUP] 6 [/SUP], Ryutaro Seo[SUP] 7 [/SUP], Hisato Kohsai[SUP] 8 [/SUP], Noriko Nakanishi[SUP] 9 [/SUP], Ryohei Nomoto[SUP] 9 [/SUP], Riyo Fujiyama[SUP] 8 [/SUP], Nobuya Kusunoki[SUP] 8 [/SUP], Tomotada Iwamoto[SUP] 9 [/SUP], Hiroaki Nishioka[SUP] 6 [/SUP], Keisuke Tomii[SUP] 10 [/SUP], Yasuki Kihara[SUP] 11 [/SUP]
Affiliations
Abstract
Objectives: The emergence of the Alpha variant of novel coronavirus 2019 (SARS-CoV-2) is a concerning issue but their clinical implications have not been investigated fully.
Methods: We conducted a nested case-control study to compare severity and mortality caused by the Alpha variant (B.1.1.7) with the one caused by the wild type as a control from December 2020 to March 2021, using whole-genome sequencing. 28-day mortality and other clinically important outcomes were evaluated.
Results: Infections caused by the Alpha variant were associated with an increase in the use of oxygen (43.4% vs 26.3%. p = 0.017), high flow nasal cannula (21.2% vs 4.0%, p = 0.0007), mechanical ventilation (16.2% vs 6.1%, p = 0.049), ICU care (30.3% vs 14.1%, p = 0.01) and the length of hospital stay (17 vs 10 days, p = 0.031). More patients with the Alpha variant received medications such as dexamethasone. However, the duration of each modality did not differ between the 2 groups. Likewise, there was no difference in 28-day mortality between the 2 groups (12% vs 8%, p = 0.48), even after multiple sensitivity analyses, including propensity score analysis.
Conclusion: The Alpha variant was associated with a severe form of COVID-19, compared with the non-Alpha wild type, but might not be associated with higher mortality.
Keywords: Alpha variant; COVID-19; Clinical outcomes.
. 2022 Dec 6;S1341-321X(22)00321-X.
doi: 10.1016/j.jiac.2022.11.014. Online ahead of print.
Clinical outcomes of COVID-19 caused by the Alpha variant compared with one by wild type in Kobe, Japan. A multi-center nested case-control study
Asako Doi[SUP] 1 [/SUP], Kentaro Iwata[SUP] 2 [/SUP], Tadahiro Nakamura[SUP] 3 [/SUP], Koji Oh[SUP] 4 [/SUP], Kenichi Isome[SUP] 5 [/SUP], Kohei Hasegawa[SUP] 6 [/SUP], Hirokazu Kuroda[SUP] 6 [/SUP], Toshikazu Hasuike[SUP] 6 [/SUP], Ryutaro Seo[SUP] 7 [/SUP], Hisato Kohsai[SUP] 8 [/SUP], Noriko Nakanishi[SUP] 9 [/SUP], Ryohei Nomoto[SUP] 9 [/SUP], Riyo Fujiyama[SUP] 8 [/SUP], Nobuya Kusunoki[SUP] 8 [/SUP], Tomotada Iwamoto[SUP] 9 [/SUP], Hiroaki Nishioka[SUP] 6 [/SUP], Keisuke Tomii[SUP] 10 [/SUP], Yasuki Kihara[SUP] 11 [/SUP]
Affiliations
- PMID: 36494058
- DOI: 10.1016/j.jiac.2022.11.014
Abstract
Objectives: The emergence of the Alpha variant of novel coronavirus 2019 (SARS-CoV-2) is a concerning issue but their clinical implications have not been investigated fully.
Methods: We conducted a nested case-control study to compare severity and mortality caused by the Alpha variant (B.1.1.7) with the one caused by the wild type as a control from December 2020 to March 2021, using whole-genome sequencing. 28-day mortality and other clinically important outcomes were evaluated.
Results: Infections caused by the Alpha variant were associated with an increase in the use of oxygen (43.4% vs 26.3%. p = 0.017), high flow nasal cannula (21.2% vs 4.0%, p = 0.0007), mechanical ventilation (16.2% vs 6.1%, p = 0.049), ICU care (30.3% vs 14.1%, p = 0.01) and the length of hospital stay (17 vs 10 days, p = 0.031). More patients with the Alpha variant received medications such as dexamethasone. However, the duration of each modality did not differ between the 2 groups. Likewise, there was no difference in 28-day mortality between the 2 groups (12% vs 8%, p = 0.48), even after multiple sensitivity analyses, including propensity score analysis.
Conclusion: The Alpha variant was associated with a severe form of COVID-19, compared with the non-Alpha wild type, but might not be associated with higher mortality.
Keywords: Alpha variant; COVID-19; Clinical outcomes.