Health system impacts of SARS-CoV - 2 variants of concern: a rapid review.
Health system impact
Rapid review
SARS-CoV − 2
Variants of concern
Journal
BMC health services research
ISSN: 1472-6963
Titre abrégé: BMC Health Serv Res
Pays: England
ID NLM: 101088677
Informations de publication
Date de publication:
23 Apr 2022
23 Apr 2022
Historique:
received:
25
06
2021
accepted:
21
03
2022
entrez:
24
4
2022
pubmed:
25
4
2022
medline:
27
4
2022
Statut:
epublish
Résumé
As of November 25th 2021, four SARS-CoV - 2 variants of concern (VOC: Alpha (B.1.1.7), Beta (B.1.351), Gamma (P.1), and Delta (B.1.617.2)) have been detected. Variable degrees of increased transmissibility of the VOC have been documented, with potential implications for hospital and health system capacity and control measures. This rapid review aimed to provide a synthesis of evidence related to health system responses to the emergence of VOC worldwide. Seven databases were searched up to September 27, 2021, for terms related to VOC. Titles, abstracts, and full-text documents were screened independently by two reviewers. Data were extracted independently by two reviewers using a standardized form. Studies were included if they reported on at least one of the VOC and health system outcomes. Of the 4877 articles retrieved, 59 studies were included, which used a wide range of designs and methods. Most of the studies reported on Alpha, and all except two reported on impacts for capacity planning related to hospitalization, intensive care admissions, and mortality. Most studies (73.4%) observed an increase in hospitalization, but findings on increased admission to intensive care units were mixed (50%). Most studies (63.4%) that reported mortality data found an increased risk of death due to VOC, although health system capacity may influence this. No studies reported on screening staff and visitors or cohorting patients based on VOC. While the findings should be interpreted with caution as most of the sources identified were preprints, evidence is trending towards an increased risk of hospitalization and, potentially, mortality due to VOC compared to wild-type SARS-CoV - 2. There is little evidence on the need for, and the effect of, changes to health system arrangements in response to VOC transmission.
Sections du résumé
BACKGROUND
BACKGROUND
As of November 25th 2021, four SARS-CoV - 2 variants of concern (VOC: Alpha (B.1.1.7), Beta (B.1.351), Gamma (P.1), and Delta (B.1.617.2)) have been detected. Variable degrees of increased transmissibility of the VOC have been documented, with potential implications for hospital and health system capacity and control measures. This rapid review aimed to provide a synthesis of evidence related to health system responses to the emergence of VOC worldwide.
METHODS
METHODS
Seven databases were searched up to September 27, 2021, for terms related to VOC. Titles, abstracts, and full-text documents were screened independently by two reviewers. Data were extracted independently by two reviewers using a standardized form. Studies were included if they reported on at least one of the VOC and health system outcomes.
RESULTS
RESULTS
Of the 4877 articles retrieved, 59 studies were included, which used a wide range of designs and methods. Most of the studies reported on Alpha, and all except two reported on impacts for capacity planning related to hospitalization, intensive care admissions, and mortality. Most studies (73.4%) observed an increase in hospitalization, but findings on increased admission to intensive care units were mixed (50%). Most studies (63.4%) that reported mortality data found an increased risk of death due to VOC, although health system capacity may influence this. No studies reported on screening staff and visitors or cohorting patients based on VOC.
CONCLUSION
CONCLUSIONS
While the findings should be interpreted with caution as most of the sources identified were preprints, evidence is trending towards an increased risk of hospitalization and, potentially, mortality due to VOC compared to wild-type SARS-CoV - 2. There is little evidence on the need for, and the effect of, changes to health system arrangements in response to VOC transmission.
Identifiants
pubmed: 35461246
doi: 10.1186/s12913-022-07847-0
pii: 10.1186/s12913-022-07847-0
pmc: PMC9034743
doi:
Types de publication
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
544Informations de copyright
© 2022. The Author(s).
Références
J Clin Med. 2021 Aug 12;10(16):
pubmed: 34441844
Lancet Infect Dis. 2021 Nov;21(11):1518-1528
pubmed: 34171232
Lancet Public Health. 2021 May;6(5):e335-e345
pubmed: 33857453
BMJ. 2021 Mar 9;372:n579
pubmed: 33687922
Science. 2021 Apr 9;372(6538):
pubmed: 33658326
Clin Infect Dis. 2021 Sep 06;:
pubmed: 34487522
Microorganisms. 2021 Jul 15;9(7):
pubmed: 34361951
Int J Environ Res Public Health. 2021 May 12;18(10):
pubmed: 34065832
J Clin Epidemiol. 2021 Feb;130:13-22
pubmed: 33068715
BMJ. 2021 Jun 15;373:n1412
pubmed: 34130987
J Infect. 2021 Oct;83(4):e14-e17
pubmed: 34329674
Lancet Infect Dis. 2021 Sep;21(9):1246-1256
pubmed: 33857406
Int J Infect Dis. 2021 Oct;111:47-54
pubmed: 34390857
Lancet Infect Dis. 2021 Nov;21(11):1507-1517
pubmed: 34171231
Int J Environ Res Public Health. 2021 Apr 29;18(9):
pubmed: 33947087
Int J Infect Dis. 2022 Feb;115:178-184
pubmed: 34902584
J Mark Access Health Policy. 2021 Nov 11;9(1):2002008
pubmed: 34790342
PLoS One. 2021 Oct 11;16(10):e0258513
pubmed: 34634066
J Infect. 2021 Oct;83(4):e21-e23
pubmed: 33932449
BMJ. 2021 Mar 29;372:n71
pubmed: 33782057
BMC Med. 2021 Aug 27;19(1):211
pubmed: 34446011
Acta Microbiol Immunol Hung. 2021 Aug 11;:
pubmed: 34383706
BMJ. 2015 Jan 02;350:g7647
pubmed: 25555855
BMJ. 2021 Jun 15;373:n1513
pubmed: 34130949
J Clin Epidemiol. 2016 Jul;75:40-6
pubmed: 27005575
Environ Res. 2021 Nov;202:111809
pubmed: 34333010
Crit Care Med. 2021 Nov 1;49(11):1895-1900
pubmed: 34259660
Lancet Glob Health. 2021 Sep;9(9):e1216-e1225
pubmed: 34252381
bioRxiv. 2021 Mar 01;:
pubmed: 33501446
Nature. 2021 May;593(7858):270-274
pubmed: 33723411
Clin Infect Dis. 2021 Aug 23;:
pubmed: 34423834
Sci Rep. 2021 Sep 16;11(1):18456
pubmed: 34531412
Viruses. 2021 Apr 08;13(4):
pubmed: 33918060
Acta Biomed. 2020 Mar 19;91(1):157-160
pubmed: 32191675
Anaesth Crit Care Pain Med. 2021 Aug;40(4):100890
pubmed: 34033926
Euro Surveill. 2021 Apr;26(16):
pubmed: 33890566
Infection. 2022 Apr;50(2):457-465
pubmed: 34674158
Sci Rep. 2022 May 24;12(1):8747
pubmed: 35610307
Clin Infect Dis. 2021 Oct 17;:
pubmed: 34657152
Euro Surveill. 2021 Apr;26(15):
pubmed: 33860748
Am J Obstet Gynecol. 2022 Jan;226(1):149-151
pubmed: 34529957
Lancet. 2021 May 15;397(10287):1819-1829
pubmed: 33964222
BMJ Open Respir Res. 2021 Sep;8(1):
pubmed: 34544733
Lancet Infect Dis. 2022 Jan;22(1):35-42
pubmed: 34461056
BMJ Open. 2021 Dec 2;11(12):e055781
pubmed: 34857582