Associations between SARS-CoV-2 variants and risk of COVID-19 hospitalization among confirmed cases in Washington State: a retrospective cohort study.


Journal

medRxiv : the preprint server for health sciences
Titre abrégé: medRxiv
Pays: United States
ID NLM: 101767986

Informations de publication

Date de publication:
16 Feb 2022
Historique:
pubmed: 4 11 2021
medline: 4 11 2021
entrez: 3 11 2021
Statut: epublish

Résumé

The COVID-19 pandemic is dominated by variant viruses; the resulting impact on disease severity remains unclear. Using a retrospective cohort study, we assessed the hospitalization risk following infection with seven SARS-CoV-2 variants. Our study includes individuals with positive SARS-CoV-2 RT-PCR in the Washington Disease Reporting System with available viral genome data, from December 1, 2020 to January 14, 2022. The analysis was restricted to cases with specimens collected through sentinel surveillance. Using a Cox proportional hazards model with mixed effects, we estimated hazard ratios (HR) for hospitalization risk following infection with a variant, adjusting for age, sex, calendar week, and vaccination. 58,848 cases were sequenced through sentinel surveillance, of which 1705 (2.9%) were hospitalized due to COVID-19. Higher hospitalization risk was found for infections with Gamma (HR 3.20, 95%CI 2.40-4.26), Beta (HR 2.85, 95%CI 1.56-5.23), Delta (HR 2.28 95%CI 1.56-3.34) or Alpha (HR 1.64, 95%CI 1.29-2.07) compared to infections with ancestral lineages; Omicron (HR 0.92, 95%CI 0.56-1.52) showed no significant difference in risk. Following Alpha, Gamma, or Delta infection, unvaccinated patients show higher hospitalization risk, while vaccinated patients show no significant difference in risk, both compared to unvaccinated, ancestral lineage cases. Hospitalization risk following Omicron infection is lower with vaccination. Infection with Alpha, Gamma, or Delta results in a higher hospitalization risk, with vaccination attenuating that risk. Our findings support hospital preparedness, vaccination, and genomic surveillance. Hospitalization risk following infection with SARS-CoV-2 variant remains unclear. We find a higher hospitalization risk in cases infected with Alpha, Beta, Gamma, and Delta, but not Omicron, with vaccination lowering risk. Our findings support hospital preparedness, vaccination, and genomic surveillance.

Sections du résumé

BACKGROUND BACKGROUND
The COVID-19 pandemic is dominated by variant viruses; the resulting impact on disease severity remains unclear. Using a retrospective cohort study, we assessed the hospitalization risk following infection with seven SARS-CoV-2 variants.
METHODS METHODS
Our study includes individuals with positive SARS-CoV-2 RT-PCR in the Washington Disease Reporting System with available viral genome data, from December 1, 2020 to January 14, 2022. The analysis was restricted to cases with specimens collected through sentinel surveillance. Using a Cox proportional hazards model with mixed effects, we estimated hazard ratios (HR) for hospitalization risk following infection with a variant, adjusting for age, sex, calendar week, and vaccination.
FINDINGS RESULTS
58,848 cases were sequenced through sentinel surveillance, of which 1705 (2.9%) were hospitalized due to COVID-19. Higher hospitalization risk was found for infections with Gamma (HR 3.20, 95%CI 2.40-4.26), Beta (HR 2.85, 95%CI 1.56-5.23), Delta (HR 2.28 95%CI 1.56-3.34) or Alpha (HR 1.64, 95%CI 1.29-2.07) compared to infections with ancestral lineages; Omicron (HR 0.92, 95%CI 0.56-1.52) showed no significant difference in risk. Following Alpha, Gamma, or Delta infection, unvaccinated patients show higher hospitalization risk, while vaccinated patients show no significant difference in risk, both compared to unvaccinated, ancestral lineage cases. Hospitalization risk following Omicron infection is lower with vaccination.
CONCLUSION CONCLUSIONS
Infection with Alpha, Gamma, or Delta results in a higher hospitalization risk, with vaccination attenuating that risk. Our findings support hospital preparedness, vaccination, and genomic surveillance.
SUMMARY CONCLUSIONS
Hospitalization risk following infection with SARS-CoV-2 variant remains unclear. We find a higher hospitalization risk in cases infected with Alpha, Beta, Gamma, and Delta, but not Omicron, with vaccination lowering risk. Our findings support hospital preparedness, vaccination, and genomic surveillance.

Identifiants

pubmed: 34729567
doi: 10.1101/2021.09.29.21264272
pmc: PMC8562551
pii:
doi:

Types de publication

Preprint

Langues

eng

Subventions

Organisme : NIAID NIH HHS
ID : P30 AI027757
Pays : United States
Organisme : NIGMS NIH HHS
ID : R35 GM119774
Pays : United States
Organisme : NIH HHS
ID : S10 OD028685
Pays : United States

Commentaires et corrections

Type : UpdateIn

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Auteurs

Miguel I Paredes (MI)

Department of Epidemiology, University of Washington, Seattle, WA, USA.
Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA.

Stephanie M Lunn (SM)

Washington State Department of Health, Shoreline, WA USA.

Michael Famulare (M)

Institute for Disease Modeling, Bill and Melinda Gates Foundation, Seattle, WA USA.

Lauren A Frisbie (LA)

Washington State Department of Health, Shoreline, WA USA.

Ian Painter (I)

Washington State Department of Health, Shoreline, WA USA.

Roy Burstein (R)

Institute for Disease Modeling, Bill and Melinda Gates Foundation, Seattle, WA USA.

Pavitra Roychoudhury (P)

Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA.
Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA, USA.

Hong Xie (H)

Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA, USA.

Shah A Mohamed Bakhash (SA)

Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA, USA.

Ricardo Perez (R)

Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA, USA.

Maria Lukes (M)

Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA, USA.

Sean Ellis (S)

Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA, USA.

Saraswathi Sathees (S)

Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA, USA.

Patrick C Mathias (PC)

Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA, USA.

Alexander Greninger (A)

Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA.
Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA, USA.

Lea M Starita (LM)

Department of Genome Sciences, University of Washington, Seattle, WA, USA.
Brotman Baty Institute for Precision Medicine, Seattle, WA USA.

Chris D Frazar (CD)

Department of Genome Sciences, University of Washington, Seattle, WA, USA.

Erica Ryke (E)

Department of Genome Sciences, University of Washington, Seattle, WA, USA.

Weizhi Zhong (W)

Brotman Baty Institute for Precision Medicine, Seattle, WA USA.

Luis Gamboa (L)

Brotman Baty Institute for Precision Medicine, Seattle, WA USA.

Machiko Threlkeld (M)

Department of Genome Sciences, University of Washington, Seattle, WA, USA.

Jover Lee (J)

Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA.

Evan McDermot (E)

Brotman Baty Institute for Precision Medicine, Seattle, WA USA.

Melissa Truong (M)

Brotman Baty Institute for Precision Medicine, Seattle, WA USA.

Deborah A Nickerson (DA)

Department of Genome Sciences, University of Washington, Seattle, WA, USA.
Brotman Baty Institute for Precision Medicine, Seattle, WA USA.

Daniel L Bates (DL)

Altius Institute for Biomedical Sciences, Seattle, WA USA.

Matthew E Hartman (ME)

Altius Institute for Biomedical Sciences, Seattle, WA USA.
Department of Cardiovascular Services, Swedish Medical Center, Seattle, WA USA.

Eric Haugen (E)

Altius Institute for Biomedical Sciences, Seattle, WA USA.

Truong N Nguyen (TN)

Altius Institute for Biomedical Sciences, Seattle, WA USA.

Joshua D Richards (JD)

Altius Institute for Biomedical Sciences, Seattle, WA USA.

Jacob L Rodriguez (JL)

Altius Institute for Biomedical Sciences, Seattle, WA USA.

John A Stamatoyannopoulos (JA)

Altius Institute for Biomedical Sciences, Seattle, WA USA.

Eric Thorland (E)

Altius Institute for Biomedical Sciences, Seattle, WA USA.

Geoff Melly (G)

Washington State Department of Health, Shoreline, WA USA.

Philip E Dykema (PE)

Washington State Department of Health, Shoreline, WA USA.

Drew C MacKellar (DC)

Washington State Department of Health, Shoreline, WA USA.

Hannah K Gray (HK)

Washington State Department of Health, Shoreline, WA USA.

Avi Singh (A)

Washington State Department of Health, Shoreline, WA USA.

JohnAric M Peterson (JM)

Washington State Department of Health, Shoreline, WA USA.

Denny Russell (D)

Washington State Department of Health, Shoreline, WA USA.

Laura Marcela Torres (LM)

Washington State Department of Health, Shoreline, WA USA.

Scott Lindquist (S)

Washington State Department of Health, Shoreline, WA USA.

Trevor Bedford (T)

Department of Epidemiology, University of Washington, Seattle, WA, USA.
Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA.
Department of Genome Sciences, University of Washington, Seattle, WA, USA.
Howard Hughes Medical Institute, Seattle, WA USA.

Krisandra J Allen (KJ)

Washington State Department of Health, Shoreline, WA USA.

Hanna N Oltean (HN)

Washington State Department of Health, Shoreline, WA USA.

Classifications MeSH