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Risk of mortality in patients infected with SARS-CoV-2 variant of concern 202012/1 : matched cohort study

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Challen, Robert, Brooks-Pollock, Ellen, Read, Jonathan M., Dyson, Louise, Tsaneva-Atanasova, Krasimira and Danon, Leon (2021) Risk of mortality in patients infected with SARS-CoV-2 variant of concern 202012/1 : matched cohort study. BMJ, 372 . n579. doi:10.1136/bmj.n579

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Official URL: http://dx.doi.org/10.1136/bmj.n579

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Abstract

Objective: To establish whether there is any change in mortality from infection with a new variant of SARS-CoV-2, designated a variant of concern (VOC-202012/1) in December 2020, compared with circulating SARS-CoV-2 variants.

Design: Matched cohort study.

Setting: Community based (pillar 2) covid-19 testing centres in the UK using the TaqPath assay (a proxy measure of VOC-202012/1 infection).

Participants: 54 906 matched pairs of participants who tested positive for SARS-CoV-2 in pillar 2 between 1 October 2020 and 29 January 2021, followed-up until 12 February 2021. Participants were matched on age, sex, ethnicity, index of multiple deprivation, lower tier local authority region, and sample date of positive specimens, and differed only by detectability of the spike protein gene using the TaqPath assay.

Main outcome: measure Death within 28 days of the first positive SARS-CoV-2 test result.

Results: The mortality hazard ratio associated with infection with VOC-202012/1 compared with infection with previously circulating variants was 1.64 (95% confidence interval 1.32 to 2.04) in patients who tested positive for covid-19 in the community. In this comparatively low risk group, this represents an increase in deaths from 2.5 to 4.1 per 1000 detected cases.

Conclusions: The probability that the risk of mortality is increased by infection with VOC-202012/01 is high. If this finding is generalisable to other populations, infection with VOC-202012/1 has the potential to cause substantial additional mortality compared with previously circulating variants. Healthcare capacity planning and national and international control policies are all impacted by this finding, with increased mortality lending weight to the argument that further coordinated and stringent measures are justified to reduce deaths from SARS-CoV-2.

Item Type: Journal Article
Subjects: R Medicine > RA Public aspects of medicine
Divisions: Faculty of Science > Life Sciences (2010- )
Faculty of Science > Mathematics
Library of Congress Subject Headings (LCSH): COVID-19 Pandemic, 2020-, COVID-19 (Disease) -- Mortality, COVID-19 (Disease) -- England -- Statistics, Mortality -- England -- Statistics, COVID-19 (Disease) -- Genetics, Public health
Journal or Publication Title: BMJ
Publisher: BMJ Publishing Group Ltd.
ISSN: 0959-535X
Official Date: 10 March 2021
Dates:
DateEvent
10 March 2021Published
25 February 2021Accepted
Volume: 372
Article Number: n579
DOI: 10.1136/bmj.n579
Status: Peer Reviewed
Publication Status: Published
Access rights to Published version: Open Access
RIOXX Funder/Project Grant:
Project/Grant IDRIOXX Funder NameFunder ID
EP/N014391/1[EPSRC] Engineering and Physical Sciences Research Councilhttp://dx.doi.org/10.13039/501100000266
EP/T017856/1[EPSRC] Engineering and Physical Sciences Research Councilhttp://dx.doi.org/10.13039/501100000266
EP/N510129/1[EPSRC] Engineering and Physical Sciences Research Councilhttp://dx.doi.org/10.13039/501100000266
MC/PC/19067[MRC] Medical Research Councilhttp://dx.doi.org/10.13039/501100000265
EP/N014499/1[EPSRC] Engineering and Physical Sciences Research Councilhttp://dx.doi.org/10.13039/501100000266
MR/S004793/1[MRC] Medical Research Councilhttp://dx.doi.org/10.13039/501100000265
MR/V028456/1[MRC] Medical Research Councilhttp://dx.doi.org/10.13039/501100000265
UNSPECIFIED[NIHR] National Institute for Health Researchhttp://dx.doi.org/10.13039/501100000272
MR/V038613/1[MRC] Medical Research Councilhttp://dx.doi.org/10.13039/501100000265
EP/V051555/1[EPSRC] Engineering and Physical Sciences Research Councilhttp://dx.doi.org/10.13039/501100000266
MR/V009761/1[MRC] Medical Research Councilhttp://dx.doi.org/10.13039/501100000265

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