Directions of change in intrinsic case severity across successive SARS-CoV-2 variant waves have been inconsistent
Abstract
Objectives To determine how the intrinsic severity of successively dominant SARS-CoV-2 variants changed over the course of the pandemic. Methods A retrospective cohort analysis in the NHS Greater Glasgow and Clyde (NHS GGC) Health Board. All sequenced non-nosocomial adult COVID-19 cases in NHS GGC with relevant SARS-CoV-2 lineages (B.1.177/Alpha, Alpha/Delta, AY.4.2 Delta/non-AY.4.2 Delta, non-AY.4.2 Delta/Omicron, and BA.1 Omicron/BA.2 Omicron) during analysis periods were included. Outcome measures were hospital admission, ICU admission, or death within 28 days of positive COVID-19 test. We report the cumulative odds ratio; the ratio of the odds that an individual experiences a severity event of a given level vs all lower severity levels for the resident and the replacement variant after adjustment. Results After adjustment for covariates, the cumulative odds ratio was 1.51 (95% CI: 1.08-2.11) for Alpha versus B.1.177, 2.09 (95% CI: 1.42-3.08) for Delta versus Alpha, 0.99 (95% CI: 0.76-1.27) for AY.4.2 Delta versus non-AY.4.2 Delta, 0.49 (95% CI: 0.22-1.06) for Omicron versus non-AY.4.2 Delta, and 0.86 (95% CI: 0.68-1.09) for BA.2 Omicron versus BA.1 Omicron. Conclusions The direction of change in intrinsic severity between successively emerging SARS-CoV-2 variants was inconsistent, reminding us that the intrinsic severity of future SARS-CoV-2 variants remains uncertain.
Citation
Pascall , D J , Vink , E , Blacow , R , Bulteel , N , Campbell , A , Campbell , R , Clifford , S , Davis , C , da Silva Filipe , A , El Sakka , N , Fjodorova , L , Forrest , R , Goldstein , E , Gunson , R , Haughney , J , Holden , M T G , Honour , P , Hughes , J , James , E , Lewis , T , MacLean , O , McHugh , M , Mollett , G , Nyberg , T , Onishi , Y , Parcell , B , Ray , S , Robertson , D L , Seaman , S R , Shabaan , S , Shepherd , J G , Smollett , K , Templeton , K , Wastnedge , E , Wilkie , C , Williams , T , The COVID-19 Genomics UK (COG-UK) Consortium & Thomson , E C 2023 , ' Directions of change in intrinsic case severity across successive SARS-CoV-2 variant waves have been inconsistent ' , Journal of Infection , vol. 87 , no. 2 , pp. 128-135 . https://doi.org/10.1016/j.jinf.2023.05.019
Publication
Journal of Infection
Status
Peer reviewed
ISSN
0163-4453Type
Journal article
Description
Funding: This work was supported by UKRI through the JUNIPER consortium (grant number MR/V038613/1, https://maths.org/juniper/); the Medical Research Council (MRC) (grant number MC UU 12014/12, grant number MC UU 00002/11, https://www.ukri.org/councils/mrc/); the G2P-UK National Virology Consortium (grant number MR/W005611/1, https://www.ukri.org).Collections
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