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Hospital admission and emergency care attendance risk for SARS-CoV-2 delta (B.1.617.2) compared with alpha (B.1.1.7) variants of concern: a cohort study
The Lancet Infectious Diseases, Volume: 22, Issue: 1, Pages: 35 - 42
Swansea University Author:
Ronan Lyons
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DOI (Published version): 10.1016/s1473-3099(21)00475-8
Abstract
BackgroundThe SARS-CoV-2 delta (B.1.617.2) variant was first detected in England in March, 2021. It has since rapidly become the predominant lineage, owing to high transmissibility. It is suspected that the delta variant is associated with more severe disease than the previously dominant alpha (B.1....
Published in: | The Lancet Infectious Diseases |
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ISSN: | 1473-3099 |
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Elsevier BV
2022
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URI: | https://cronfa.swan.ac.uk/Record/cronfa66419 |
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<?xml version="1.0" encoding="utf-8"?><rfc1807 xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xmlns:xsd="http://www.w3.org/2001/XMLSchema"><bib-version>v2</bib-version><id>66419</id><entry>2024-05-14</entry><title>Hospital admission and emergency care attendance risk for SARS-CoV-2 delta (B.1.617.2) compared with alpha (B.1.1.7) variants of concern: a cohort study</title><swanseaauthors><author><sid>83efcf2a9dfcf8b55586999d3d152ac6</sid><ORCID>0000-0001-5225-000X</ORCID><firstname>Ronan</firstname><surname>Lyons</surname><name>Ronan Lyons</name><active>true</active><ethesisStudent>false</ethesisStudent></author></swanseaauthors><date>2024-05-14</date><deptcode>MEDS</deptcode><abstract>BackgroundThe SARS-CoV-2 delta (B.1.617.2) variant was first detected in England in March, 2021. It has since rapidly become the predominant lineage, owing to high transmissibility. It is suspected that the delta variant is associated with more severe disease than the previously dominant alpha (B.1.1.7) variant. We aimed to characterise the severity of the delta variant compared with the alpha variant by determining the relative risk of hospital attendance outcomes.MethodsThis cohort study was done among all patients with COVID-19 in England between March 29 and May 23, 2021, who were identified as being infected with either the alpha or delta SARS-CoV-2 variant through whole-genome sequencing. Individual-level data on these patients were linked to routine health-care datasets on vaccination, emergency care attendance, hospital admission, and mortality (data from Public Health England's Second Generation Surveillance System and COVID-19-associated deaths dataset; the National Immunisation Management System; and NHS Digital Secondary Uses Services and Emergency Care Data Set). The risk for hospital admission and emergency care attendance were compared between patients with sequencing-confirmed delta and alpha variants for the whole cohort and by vaccination status subgroups. Stratified Cox regression was used to adjust for age, sex, ethnicity, deprivation, recent international travel, area of residence, calendar week, and vaccination status.FindingsIndividual-level data on 43 338 COVID-19-positive patients (8682 with the delta variant, 34 656 with the alpha variant; median age 31 years [IQR 17–43]) were included in our analysis. 196 (2·3%) patients with the delta variant versus 764 (2·2%) patients with the alpha variant were admitted to hospital within 14 days after the specimen was taken (adjusted hazard ratio [HR] 2·26 [95% CI 1·32–3·89]). 498 (5·7%) patients with the delta variant versus 1448 (4·2%) patients with the alpha variant were admitted to hospital or attended emergency care within 14 days (adjusted HR 1·45 [1·08–1·95]). Most patients were unvaccinated (32 078 [74·0%] across both groups). The HRs for vaccinated patients with the delta variant versus the alpha variant (adjusted HR for hospital admission 1·94 [95% CI 0·47–8·05] and for hospital admission or emergency care attendance 1·58 [0·69–3·61]) were similar to the HRs for unvaccinated patients (2·32 [1·29–4·16] and 1·43 [1·04–1·97]; p=0·82 for both) but the precision for the vaccinated subgroup was low.InterpretationThis large national study found a higher hospital admission or emergency care attendance risk for patients with COVID-19 infected with the delta variant compared with the alpha variant. Results suggest that outbreaks of the delta variant in unvaccinated populations might lead to a greater burden on health-care services than the alpha variant.</abstract><type>Journal Article</type><journal>The Lancet Infectious Diseases</journal><volume>22</volume><journalNumber>1</journalNumber><paginationStart>35</paginationStart><paginationEnd>42</paginationEnd><publisher>Elsevier BV</publisher><placeOfPublication/><isbnPrint/><isbnElectronic/><issnPrint>1473-3099</issnPrint><issnElectronic/><keywords/><publishedDay>1</publishedDay><publishedMonth>1</publishedMonth><publishedYear>2022</publishedYear><publishedDate>2022-01-01</publishedDate><doi>10.1016/s1473-3099(21)00475-8</doi><url/><notes/><college>COLLEGE NANME</college><department>Medical School</department><CollegeCode>COLLEGE CODE</CollegeCode><DepartmentCode>MEDS</DepartmentCode><institution>Swansea University</institution><apcterm/><funders>Medical Research Council; UK Research and Innovation; Department of Health and Social Care; and National Institute for Health Research.</funders><projectreference/><lastEdited>2024-06-24T12:22:37.4280948</lastEdited><Created>2024-05-14T15:43:00.0904800</Created><path><level id="1">Faculty of Medicine, Health and Life Sciences</level><level id="2">Swansea University Medical School - Health Data Science</level></path><authors><author><firstname>Katherine A</firstname><surname>Twohig</surname><orcid>0000-0001-9514-0097</orcid><order>1</order></author><author><firstname>Tommy</firstname><surname>Nyberg</surname><orcid>0000-0002-9436-0626</orcid><order>2</order></author><author><firstname>Asad</firstname><surname>Zaidi</surname><orcid>0000-0002-6420-2539</orcid><order>3</order></author><author><firstname>Simon</firstname><surname>Thelwall</surname><orcid>0000-0002-0434-2724</orcid><order>4</order></author><author><firstname>Mary A</firstname><surname>Sinnathamby</surname><orcid>0000-0001-6212-4672</orcid><order>5</order></author><author><firstname>Shirin</firstname><surname>Aliabadi</surname><orcid>0000-0003-3611-7377</orcid><order>6</order></author><author><firstname>Shaun R</firstname><surname>Seaman</surname><orcid>0000-0003-3726-5937</orcid><order>7</order></author><author><firstname>Ross J</firstname><surname>Harris</surname><orcid>0000-0003-3190-7281</orcid><order>8</order></author><author><firstname>Russell</firstname><surname>Hope</surname><orcid>0000-0003-2838-6833</orcid><order>9</order></author><author><firstname>Jamie</firstname><surname>Lopez-Bernal</surname><orcid>0000-0002-1301-5653</orcid><order>10</order></author><author><firstname>Eileen</firstname><surname>Gallagher</surname><order>11</order></author><author><firstname>Andre</firstname><surname>Charlett</surname><orcid>0000-0001-7154-0432</orcid><order>12</order></author><author><firstname>Daniela 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Martinez</firstname><surname>Nunez</surname><order>178</order></author><author><firstname>Jenifer</firstname><surname>Mason</surname><order>179</order></author><author><firstname>Trevor</firstname><surname>Robinson</surname><order>180</order></author><author><firstname>Elaine</firstname><surname>O'Toole</surname><order>181</order></author><author><firstname>Joanne</firstname><surname>Watts</surname><order>182</order></author><author><firstname>Cassie</firstname><surname>Breen</surname><order>183</order></author><author><firstname>Angela</firstname><surname>Cowell</surname><order>184</order></author><author><firstname>Graciela</firstname><surname>Sluga</surname><order>185</order></author><author><firstname>Nicholas</firstname><surname>Machin</surname><order>186</order></author><author><firstname>Shazaad</firstname><surname>Ahmad</surname><order>187</order></author><author><firstname>Ryan</firstname><surname>George</surname><order>188</order></author><author><firstname>Fenella</firstname><surname>Halstead</surname><order>189</order></author><author><firstname>Venkat</firstname><surname>Sivaprakasam</surname><order>190</order></author><author><firstname>Wendy</firstname><surname>Hogsden</surname><order>191</order></author><author><firstname>Chris</firstname><surname>Illingworth</surname><order>192</order></author><author><firstname>Chris</firstname><surname>Jackson</surname><order>193</order></author><author><firstname>Emma</firstname><surname>Thomson</surname><order>194</order></author><author><firstname>James</firstname><surname>Shepherd</surname><order>195</order></author><author><firstname>Patawee</firstname><surname>Asamaphan</surname><order>196</order></author><author><firstname>Marc</firstname><surname>Niebel</surname><order>197</order></author><author><firstname>Kathy</firstname><surname>Li</surname><order>198</order></author><author><firstname>Rajiv</firstname><surname>Shah</surname><order>199</order></author><author><firstname>Natasha</firstname><surname>Jesudason</surname><order>200</order></author><author><firstname>Lily</firstname><surname>Tong</surname><order>201</order></author><author><firstname>Alice</firstname><surname>Broos</surname><order>202</order></author><author><firstname>Daniel</firstname><surname>Mair</surname><order>203</order></author><author><firstname>Jenna</firstname><surname>Nichols</surname><order>204</order></author><author><firstname>Stephen</firstname><surname>Carmichael</surname><order>205</order></author><author><firstname>Kyriaki</firstname><surname>Nomikou</surname><order>206</order></author><author><firstname>Elihu</firstname><surname>Aranday-Cortes</surname><order>207</order></author><author><firstname>Natasha</firstname><surname>Johnson</surname><order>208</order></author><author><firstname>Igor</firstname><surname>Starinskij</surname><order>209</order></author><author><firstname>Ana da Silva</firstname><surname>Filipe</surname><order>210</order></author><author><firstname>David</firstname><surname>Robertson</surname><order>211</order></author><author><firstname>Richard</firstname><surname>Orton</surname><order>212</order></author><author><firstname>Joseph</firstname><surname>Hughes</surname><order>213</order></author><author><firstname>Sreenu</firstname><surname>Vattipally</surname><order>214</order></author><author><firstname>Joshua</firstname><surname>Singer</surname><order>215</order></author><author><firstname>Seema</firstname><surname>Nickbakhsh</surname><order>216</order></author><author><firstname>Antony</firstname><surname>Hale</surname><order>217</order></author><author><firstname>Louissa</firstname><surname>Macfarlane-Smith</surname><order>218</order></author><author><firstname>Katherine</firstname><surname>Harper</surname><order>219</order></author><author><firstname>Holli</firstname><surname>Carden</surname><order>220</order></author><author><firstname>Yusri</firstname><surname>Taha</surname><order>221</order></author><author><firstname>Brendan</firstname><surname>Payne</surname><order>222</order></author><author><firstname>Shirelle</firstname><surname>Burton-Fanning</surname><order>223</order></author><author><firstname>Sheila</firstname><surname>Waugh</surname><order>224</order></author><author><firstname>Jennifer</firstname><surname>Collins</surname><order>225</order></author><author><firstname>Gary</firstname><surname>Eltringham</surname><order>226</order></author><author><firstname>Steven</firstname><surname>Rushton</surname><order>227</order></author><author><firstname>Sarah</firstname><surname>O'Brien</surname><order>228</order></author><author><firstname>Amanda</firstname><surname>Bradley</surname><order>229</order></author><author><firstname>Alasdair</firstname><surname>Maclean</surname><order>230</order></author><author><firstname>Guy</firstname><surname>Mollett</surname><order>231</order></author><author><firstname>Rachel</firstname><surname>Blacow</surname><order>232</order></author><author><firstname>Kate</firstname><surname>Templeton</surname><order>233</order></author><author><firstname>Martin</firstname><surname>McHugh</surname><order>234</order></author><author><firstname>Rebecca</firstname><surname>Dewar</surname><order>235</order></author><author><firstname>Elizabeth</firstname><surname>Wastenge</surname><order>236</order></author><author><firstname>Samir</firstname><surname>Dervisevic</surname><order>237</order></author><author><firstname>Rachael</firstname><surname>Stanley</surname><order>238</order></author><author><firstname>Emma</firstname><surname>Meader</surname><order>239</order></author><author><firstname>Lindsay</firstname><surname>Coupland</surname><order>240</order></author><author><firstname>Louise</firstname><surname>Smith</surname><order>241</order></author><author><firstname>Clive</firstname><surname>Graham</surname><order>242</order></author><author><firstname>Edward</firstname><surname>Barton</surname><order>243</order></author><author><firstname>Debra</firstname><surname>Padgett</surname><order>244</order></author><author><firstname>Garren</firstname><surname>Scott</surname><order>245</order></author><author><firstname>Emma</firstname><surname>Swindells</surname><order>246</order></author><author><firstname>Jane</firstname><surname>Greenaway</surname><order>247</order></author><author><firstname>Andrew</firstname><surname>Nelson</surname><order>248</order></author><author><firstname>Clare</firstname><surname>McCann</surname><order>249</order></author><author><firstname>Wen</firstname><surname>Yew</surname><order>250</order></author><author><firstname>Monique</firstname><surname>Andersson</surname><order>251</order></author><author><firstname>Timothy</firstname><surname>Peto</surname><order>252</order></author><author><firstname>Anita</firstname><surname>Justice</surname><order>253</order></author><author><firstname>David</firstname><surname>Eyre</surname><order>254</order></author><author><firstname>Derrick</firstname><surname>Crook</surname><order>255</order></author><author><firstname>Tim</firstname><surname>Sloan</surname><order>256</order></author><author><firstname>Nichola</firstname><surname>Duckworth</surname><order>257</order></author><author><firstname>Sarah</firstname><surname>Walsh</surname><order>258</order></author><author><firstname>Anoop</firstname><surname>Chauhan</surname><order>259</order></author><author><firstname>Sharon</firstname><surname>Glaysher</surname><order>260</order></author><author><firstname>Kelly</firstname><surname>Bicknell</surname><order>261</order></author><author><firstname>Sarah</firstname><surname>Wyllie</surname><order>262</order></author><author><firstname>Scott</firstname><surname>Elliott</surname><order>263</order></author><author><firstname>Allyson</firstname><surname>Lloyd</surname><order>264</order></author><author><firstname>Robert</firstname><surname>Impey</surname><order>265</order></author><author><firstname>Nick</firstname><surname>Levene</surname><order>266</order></author><author><firstname>Lynn</firstname><surname>Monaghan</surname><order>267</order></author><author><firstname>Declan</firstname><surname>Bradley</surname><order>268</order></author><author><firstname>Tim</firstname><surname>Wyatt</surname><order>269</order></author><author><firstname>Elias</firstname><surname>Allara</surname><order>270</order></author><author><firstname>Clare</firstname><surname>Pearson</surname><order>271</order></author><author><firstname>Husam</firstname><surname>Osman</surname><order>272</order></author><author><firstname>Andrew</firstname><surname>Bosworth</surname><order>273</order></author><author><firstname>Esther</firstname><surname>Robinson</surname><order>274</order></author><author><firstname>Peter</firstname><surname>Muir</surname><order>275</order></author><author><firstname>Ian</firstname><surname>Vipond</surname><order>276</order></author><author><firstname>Richard</firstname><surname>Hopes</surname><order>277</order></author><author><firstname>Hannah</firstname><surname>Pymont</surname><order>278</order></author><author><firstname>Stephanie</firstname><surname>Hutchings</surname><order>279</order></author><author><firstname>Martin</firstname><surname>Curran</surname><order>280</order></author><author><firstname>Surendra</firstname><surname>Parmar</surname><order>281</order></author><author><firstname>Angie</firstname><surname>Lackenby</surname><order>282</order></author><author><firstname>Tamyo</firstname><surname>Mbisa</surname><order>283</order></author><author><firstname>Steven</firstname><surname>Platt</surname><order>284</order></author><author><firstname>Shahjahan</firstname><surname>Miah</surname><order>285</order></author><author><firstname>David</firstname><surname>Bibby</surname><order>286</order></author><author><firstname>Carmen</firstname><surname>Manso</surname><order>287</order></author><author><firstname>Jonathan</firstname><surname>Hubb</surname><order>288</order></author><author><firstname>Meera</firstname><surname>Chand</surname><order>289</order></author><author><firstname>Gavin</firstname><surname>Dabrera</surname><order>290</order></author><author><firstname>Mary</firstname><surname>Ramsay</surname><order>291</order></author><author><firstname>Daniel</firstname><surname>Bradshaw</surname><order>292</order></author><author><firstname>Alicia</firstname><surname>Thornton</surname><order>293</order></author><author><firstname>Richard</firstname><surname>Myers</surname><order>294</order></author><author><firstname>Ulf</firstname><surname>Schaefer</surname><order>295</order></author><author><firstname>Natalie</firstname><surname>Groves</surname><order>296</order></author><author><firstname>Eileen</firstname><surname>Gallagher</surname><order>297</order></author><author><firstname>David</firstname><surname>Lee</surname><order>298</order></author><author><firstname>David</firstname><surname>Williams</surname><order>299</order></author><author><firstname>Nicholas</firstname><surname>Ellaby</surname><order>300</order></author><author><firstname>Ian</firstname><surname>Harrison</surname><order>301</order></author><author><firstname>Hassan</firstname><surname>Hartman</surname><order>302</order></author><author><firstname>Nikos</firstname><surname>Manesis</surname><order>303</order></author><author><firstname>Vineet</firstname><surname>Patel</surname><order>304</order></author><author><firstname>Chloe</firstname><surname>Bishop</surname><order>305</order></author><author><firstname>Vicki</firstname><surname>Chalker</surname><order>306</order></author><author><firstname>Juan</firstname><surname>Ledesma</surname><order>307</order></author><author><firstname>Katherine</firstname><surname>Twohig</surname><order>308</order></author><author><firstname>Matthew</firstname><surname>Holden</surname><order>309</order></author><author><firstname>Sharif</firstname><surname>Shaaban</surname><order>310</order></author><author><firstname>Alec</firstname><surname>Birchley</surname><order>311</order></author><author><firstname>Alexander</firstname><surname>Adams</surname><order>312</order></author><author><firstname>Alisha</firstname><surname>Davies</surname><order>313</order></author><author><firstname>Amy</firstname><surname>Gaskin</surname><order>314</order></author><author><firstname>Amy</firstname><surname>Plimmer</surname><order>315</order></author><author><firstname>Bree</firstname><surname>Gatica-Wilcox</surname><order>316</order></author><author><firstname>Caoimhe</firstname><surname>McKerr</surname><order>317</order></author><author><firstname>Catherine</firstname><surname>Moore</surname><order>318</order></author><author><firstname>Chris</firstname><surname>Williams</surname><order>319</order></author><author><firstname>David</firstname><surname>Heyburn</surname><order>320</order></author><author><firstname>Elen De</firstname><surname>Lacy</surname><order>321</order></author><author><firstname>Ember</firstname><surname>Hilvers</surname><order>322</order></author><author><firstname>Fatima</firstname><surname>Downing</surname><order>323</order></author><author><firstname>Giri</firstname><surname>Shankar</surname><order>324</order></author><author><firstname>Hannah</firstname><surname>Jones</surname><order>325</order></author><author><firstname>Hibo</firstname><surname>Asad</surname><order>326</order></author><author><firstname>Jason</firstname><surname>Coombes</surname><order>327</order></author><author><firstname>Joanne</firstname><surname>Watkins</surname><order>328</order></author><author><firstname>Johnathan</firstname><surname>Evans</surname><order>329</order></author><author><firstname>Laia</firstname><surname>Fina</surname><order>330</order></author><author><firstname>Laura</firstname><surname>Gifford</surname><order>331</order></author><author><firstname>Lauren</firstname><surname>Gilbert</surname><order>332</order></author><author><firstname>Lee</firstname><surname>Graham</surname><order>333</order></author><author><firstname>Malorie</firstname><surname>Perry</surname><order>334</order></author><author><firstname>Mari</firstname><surname>Morgan</surname><order>335</order></author><author><firstname>Matthew</firstname><surname>Bull</surname><order>336</order></author><author><firstname>Michelle</firstname><surname>Cronin</surname><order>337</order></author><author><firstname>Nicole</firstname><surname>Pacchiarini</surname><order>338</order></author><author><firstname>Noel</firstname><surname>Craine</surname><order>339</order></author><author><firstname>Rachel</firstname><surname>Jones</surname><order>340</order></author><author><firstname>Robin</firstname><surname>Howe</surname><order>341</order></author><author><firstname>Sally</firstname><surname>Corden</surname><order>342</order></author><author><firstname>Sara</firstname><surname>Rey</surname><order>343</order></author><author><firstname>Sara</firstname><surname>Kumziene-SummerhaYes</surname><order>344</order></author><author><firstname>Sarah</firstname><surname>Taylor</surname><order>345</order></author><author><firstname>Simon</firstname><surname>Cottrell</surname><order>346</order></author><author><firstname>Sophie</firstname><surname>Jones</surname><order>347</order></author><author><firstname>Sue</firstname><surname>Edwards</surname><order>348</order></author><author><firstname>Justin</firstname><surname>O'Grady</surname><order>349</order></author><author><firstname>Andrew</firstname><surname>Page</surname><order>350</order></author><author><firstname>Alison</firstname><surname>Mather</surname><order>351</order></author><author><firstname>David</firstname><surname>Baker</surname><order>352</order></author><author><firstname>Steven</firstname><surname>Rudder</surname><order>353</order></author><author><firstname>Alp</firstname><surname>Aydin</surname><order>354</order></author><author><firstname>Gemma</firstname><surname>Kay</surname><order>355</order></author><author><firstname>Alexander</firstname><surname>Trotter</surname><order>356</order></author><author><firstname>Nabil-Fareed</firstname><surname>Alikhan</surname><order>357</order></author><author><firstname>Leonardo de Oliveira</firstname><surname>Martins</surname><order>358</order></author><author><firstname>Thanh</firstname><surname>Le-Viet</surname><order>359</order></author><author><firstname>Lizzie</firstname><surname>Meadows</surname><order>360</order></author><author><firstname>Anna</firstname><surname>Casey</surname><order>361</order></author><author><firstname>Liz</firstname><surname>Ratcliffe</surname><order>362</order></author><author><firstname>David</firstname><surname>Simpson</surname><order>363</order></author><author><firstname>Zoltan</firstname><surname>Molnar</surname><order>364</order></author><author><firstname>Thomas</firstname><surname>Thompson</surname><order>365</order></author><author><firstname>Erwan</firstname><surname>Acheson</surname><order>366</order></author><author><firstname>Jane</firstname><surname>Masoli</surname><order>367</order></author><author><firstname>Bridget</firstname><surname>Knight</surname><order>368</order></author><author><firstname>Sian</firstname><surname>Ellard</surname><order>369</order></author><author><firstname>Cressida</firstname><surname>Auckland</surname><order>370</order></author><author><firstname>Christopher</firstname><surname>Jones</surname><order>371</order></author><author><firstname>Tabitha</firstname><surname>Mahungu</surname><order>372</order></author><author><firstname>Dianne</firstname><surname>Irish-Tavares</surname><order>373</order></author><author><firstname>Tanzina</firstname><surname>Haque</surname><order>374</order></author><author><firstname>Jennifer</firstname><surname>Hart</surname><order>375</order></author><author><firstname>Eric</firstname><surname>Witele</surname><order>376</order></author><author><firstname>Melisa</firstname><surname>Fenton</surname><order>377</order></author><author><firstname>Ashok</firstname><surname>Dadrah</surname><order>378</order></author><author><firstname>Amanda</firstname><surname>Symmonds</surname><order>379</order></author><author><firstname>Tranprit</firstname><surname>Saluja</surname><order>380</order></author><author><firstname>Yann</firstname><surname>Bourgeois</surname><order>381</order></author><author><firstname>Garry</firstname><surname>Scarlett</surname><order>382</order></author><author><firstname>Katie</firstname><surname>Loveson</surname><order>383</order></author><author><firstname>Salman</firstname><surname>Goudarzi</surname><order>384</order></author><author><firstname>Christopher</firstname><surname>Fearn</surname><order>385</order></author><author><firstname>Kate</firstname><surname>Cook</surname><order>386</order></author><author><firstname>Hannah</firstname><surname>Dent</surname><order>387</order></author><author><firstname>Hannah</firstname><surname>Paul</surname><order>388</order></author><author><firstname>David</firstname><surname>Partridge</surname><order>389</order></author><author><firstname>Mohammad</firstname><surname>Raza</surname><order>390</order></author><author><firstname>Cariad</firstname><surname>Evans</surname><order>391</order></author><author><firstname>Kate</firstname><surname>Johnson</surname><order>392</order></author><author><firstname>Steven</firstname><surname>Liggett</surname><order>393</order></author><author><firstname>Paul</firstname><surname>Baker</surname><order>394</order></author><author><firstname>Stephen</firstname><surname>Bonner</surname><order>395</order></author><author><firstname>Sarah</firstname><surname>Essex</surname><order>396</order></author><author><firstname>Ronan</firstname><surname>Lyons</surname><order>397</order></author><author><firstname>Kordo</firstname><surname>Saeed</surname><order>398</order></author><author><firstname>Adhyana</firstname><surname>Mahanama</surname><order>399</order></author><author><firstname>Buddhini</firstname><surname>Samaraweera</surname><order>400</order></author><author><firstname>Siona</firstname><surname>Silveira</surname><order>401</order></author><author><firstname>Emanuela</firstname><surname>Pelosi</surname><order>402</order></author><author><firstname>Eleri</firstname><surname>Wilson-Davies</surname><order>403</order></author><author><firstname>Rachel</firstname><surname>Williams</surname><order>404</order></author><author><firstname>Mark</firstname><surname>Kristiansen</surname><order>405</order></author><author><firstname>Sunando</firstname><surname>Roy</surname><order>406</order></author><author><firstname>Charlotte</firstname><surname>Williams</surname><order>407</order></author><author><firstname>Marius</firstname><surname>Cotic</surname><order>408</order></author><author><firstname>Nadua</firstname><surname>Bayzid</surname><order>409</order></author><author><firstname>Adam</firstname><surname>Westhorpe</surname><order>410</order></author><author><firstname>John</firstname><surname>Hartley</surname><order>411</order></author><author><firstname>Riaz</firstname><surname>Jannoo</surname><order>412</order></author><author><firstname>Helen</firstname><surname>Lowe</surname><order>413</order></author><aut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v2 66419 2024-05-14 Hospital admission and emergency care attendance risk for SARS-CoV-2 delta (B.1.617.2) compared with alpha (B.1.1.7) variants of concern: a cohort study 83efcf2a9dfcf8b55586999d3d152ac6 0000-0001-5225-000X Ronan Lyons Ronan Lyons true false 2024-05-14 MEDS BackgroundThe SARS-CoV-2 delta (B.1.617.2) variant was first detected in England in March, 2021. It has since rapidly become the predominant lineage, owing to high transmissibility. It is suspected that the delta variant is associated with more severe disease than the previously dominant alpha (B.1.1.7) variant. We aimed to characterise the severity of the delta variant compared with the alpha variant by determining the relative risk of hospital attendance outcomes.MethodsThis cohort study was done among all patients with COVID-19 in England between March 29 and May 23, 2021, who were identified as being infected with either the alpha or delta SARS-CoV-2 variant through whole-genome sequencing. Individual-level data on these patients were linked to routine health-care datasets on vaccination, emergency care attendance, hospital admission, and mortality (data from Public Health England's Second Generation Surveillance System and COVID-19-associated deaths dataset; the National Immunisation Management System; and NHS Digital Secondary Uses Services and Emergency Care Data Set). The risk for hospital admission and emergency care attendance were compared between patients with sequencing-confirmed delta and alpha variants for the whole cohort and by vaccination status subgroups. Stratified Cox regression was used to adjust for age, sex, ethnicity, deprivation, recent international travel, area of residence, calendar week, and vaccination status.FindingsIndividual-level data on 43 338 COVID-19-positive patients (8682 with the delta variant, 34 656 with the alpha variant; median age 31 years [IQR 17–43]) were included in our analysis. 196 (2·3%) patients with the delta variant versus 764 (2·2%) patients with the alpha variant were admitted to hospital within 14 days after the specimen was taken (adjusted hazard ratio [HR] 2·26 [95% CI 1·32–3·89]). 498 (5·7%) patients with the delta variant versus 1448 (4·2%) patients with the alpha variant were admitted to hospital or attended emergency care within 14 days (adjusted HR 1·45 [1·08–1·95]). Most patients were unvaccinated (32 078 [74·0%] across both groups). The HRs for vaccinated patients with the delta variant versus the alpha variant (adjusted HR for hospital admission 1·94 [95% CI 0·47–8·05] and for hospital admission or emergency care attendance 1·58 [0·69–3·61]) were similar to the HRs for unvaccinated patients (2·32 [1·29–4·16] and 1·43 [1·04–1·97]; p=0·82 for both) but the precision for the vaccinated subgroup was low.InterpretationThis large national study found a higher hospital admission or emergency care attendance risk for patients with COVID-19 infected with the delta variant compared with the alpha variant. Results suggest that outbreaks of the delta variant in unvaccinated populations might lead to a greater burden on health-care services than the alpha variant. Journal Article The Lancet Infectious Diseases 22 1 35 42 Elsevier BV 1473-3099 1 1 2022 2022-01-01 10.1016/s1473-3099(21)00475-8 COLLEGE NANME Medical School COLLEGE CODE MEDS Swansea University Medical Research Council; UK Research and Innovation; Department of Health and Social Care; and National Institute for Health Research. 2024-06-24T12:22:37.4280948 2024-05-14T15:43:00.0904800 Faculty of Medicine, Health and Life Sciences Swansea University Medical School - Health Data Science Katherine A Twohig 0000-0001-9514-0097 1 Tommy Nyberg 0000-0002-9436-0626 2 Asad Zaidi 0000-0002-6420-2539 3 Simon Thelwall 0000-0002-0434-2724 4 Mary A Sinnathamby 0000-0001-6212-4672 5 Shirin Aliabadi 0000-0003-3611-7377 6 Shaun R Seaman 0000-0003-3726-5937 7 Ross J Harris 0000-0003-3190-7281 8 Russell Hope 0000-0003-2838-6833 9 Jamie Lopez-Bernal 0000-0002-1301-5653 10 Eileen Gallagher 11 Andre Charlett 0000-0001-7154-0432 12 Daniela De Angelis 0000-0001-6619-6112 13 Anne M Presanis 0000-0003-3078-4427 14 Gavin Dabrera 15 Cherian Koshy 16 Amy Ash 17 Emma Wise 18 Nathan Moore 19 Matilde Mori 20 Nick Cortes 21 Jessica Lynch 22 Stephen Kidd 23 Derek Fairley 24 Tanya Curran 25 James McKenna 26 Helen Adams 27 Christophe Fraser 28 Tanya Golubchik 29 David Bonsall 30 Mohammed Hassan-Ibrahim 31 Cassandra Malone 32 Benjamin Cogger 33 Michelle Wantoch 34 Nicola Reynolds 35 Ben Warne 36 Joshua Maksimovic 37 Karla Spellman 38 Kathryn McCluggage 39 Michaela John 40 Robert Beer 41 Safiah Afifi 42 Sian Morgan 43 Angela Marchbank 44 Anna Price 45 Christine Kitchen 46 Huw Gulliver 47 Ian Merrick 48 Joel Southgate 49 Martyn Guest 50 Robert Munn 51 Trudy Workman 52 Thomas Connor 53 William Fuller 54 Catherine Bresner 55 Luke Snell 56 Amita Patel 57 Themoula Charalampous 58 Gaia Nebbia 59 Rahul Batra 60 Jonathan Edgeworth 61 Samuel Robson 62 Angela Beckett 63 David Aanensen 64 Anthony Underwood 65 Corin Yeats 66 Khalil Abudahab 67 Ben Taylor 68 Mirko Menegazzo 69 Gemma Clark 70 Wendy Smith 71 Manjinder Khakh 72 Vicki Fleming 73 Michelle Lister 74 Hannah Howson-Wells 75 Louise Berry 76 Tim Boswell 77 Amelia Joseph 78 Iona Willingham 79 Carl Jones 80 Christopher Holmes 81 Paul Bird 82 Thomas Helmer 83 Karlie Fallon 84 Julian Tang 85 Veena Raviprakash 86 Sharon Campbell 87 Nicola Sheriff 88 Victoria Blakey 89 Lesley-Anne Williams 90 Matthew Loose 91 Nadine Holmes 92 Christopher Moore 93 Matthew Carlile 94 Victoria Wright 95 Fei Sang 96 Johnny Debebe 97 Francesc Coll 98 Adrian Signell 99 Gilberto Betancor 100 Harry Wilson 101 Sahar Eldirdiri 102 Anita Kenyon 103 Thomas Davis 104 Oliver Pybus 105 Louis du Plessis 106 Alex Zarebski 107 Jayna Raghwani 108 Moritz Kraemer 109 Sarah Francois 110 Stephen Attwood 111 Tetyana Vasylyeva 112 Marina Escalera Zamudio 113 Bernardo Gutierrez 114 M. Estee Torok 115 William Hamilton 116 Ian Goodfellow 117 Grant Hall 118 Aminu Jahun 119 Yasmin Chaudhry 120 Myra Hosmillo 121 Malte Pinckert 122 Iliana Georgana 123 Samuel Moses 124 Hannah Lowe 125 Luke Bedford 126 Jonathan Moore 127 Susanne Stonehouse 128 Chloe Fisher 129 Ali Awan 130 John BoYes 131 Judith Breuer 132 Kathryn Harris 133 Julianne Brown 134 Divya Shah 135 Laura Atkinson 136 Jack Lee 137 Nathaniel Storey 138 Flavia Flaviani 139 Adela Alcolea-Medina 140 Rebecca Williams 141 Gabrielle Vernet 142 Michael Chapman 143 Lisa Levett 144 Judith Heaney 145 Wendy Chatterton 146 Monika Pusok 147 Li Xu-McCrae 148 Darren Smith 149 Matthew Bashton 150 Gregory Young 151 Alison Holmes 152 Paul Randell 153 Alison Cox 154 Pinglawathee Madona 155 Frances Bolt 156 James Price 157 Siddharth Mookerjee 158 Manon Ragonnet-Cronin 159 Fabricia F. Nascimento 160 David Jorgensen 161 Igor Siveroni 162 Rob Johnson 163 Olivia Boyd 164 Lily Geidelberg 165 Erik Volz 166 Aileen Rowan 167 Graham Taylor 168 Katherine Smollett 169 Nicholas Loman 170 Joshua Quick 171 Claire McMurray 172 Joanne Stockton 173 Sam Nicholls 174 Will Rowe 175 Radoslaw Poplawski 176 Alan McNally 177 Rocio Martinez Nunez 178 Jenifer Mason 179 Trevor Robinson 180 Elaine O'Toole 181 Joanne Watts 182 Cassie Breen 183 Angela Cowell 184 Graciela Sluga 185 Nicholas Machin 186 Shazaad Ahmad 187 Ryan George 188 Fenella Halstead 189 Venkat Sivaprakasam 190 Wendy Hogsden 191 Chris Illingworth 192 Chris Jackson 193 Emma Thomson 194 James Shepherd 195 Patawee Asamaphan 196 Marc Niebel 197 Kathy Li 198 Rajiv Shah 199 Natasha Jesudason 200 Lily Tong 201 Alice Broos 202 Daniel Mair 203 Jenna Nichols 204 Stephen Carmichael 205 Kyriaki Nomikou 206 Elihu Aranday-Cortes 207 Natasha Johnson 208 Igor Starinskij 209 Ana da Silva Filipe 210 David Robertson 211 Richard Orton 212 Joseph Hughes 213 Sreenu Vattipally 214 Joshua Singer 215 Seema Nickbakhsh 216 Antony Hale 217 Louissa Macfarlane-Smith 218 Katherine Harper 219 Holli Carden 220 Yusri Taha 221 Brendan Payne 222 Shirelle Burton-Fanning 223 Sheila Waugh 224 Jennifer Collins 225 Gary Eltringham 226 Steven Rushton 227 Sarah O'Brien 228 Amanda Bradley 229 Alasdair Maclean 230 Guy Mollett 231 Rachel Blacow 232 Kate Templeton 233 Martin McHugh 234 Rebecca Dewar 235 Elizabeth Wastenge 236 Samir Dervisevic 237 Rachael Stanley 238 Emma Meader 239 Lindsay Coupland 240 Louise Smith 241 Clive Graham 242 Edward Barton 243 Debra Padgett 244 Garren Scott 245 Emma Swindells 246 Jane Greenaway 247 Andrew Nelson 248 Clare McCann 249 Wen Yew 250 Monique Andersson 251 Timothy Peto 252 Anita Justice 253 David Eyre 254 Derrick Crook 255 Tim Sloan 256 Nichola Duckworth 257 Sarah Walsh 258 Anoop Chauhan 259 Sharon Glaysher 260 Kelly Bicknell 261 Sarah Wyllie 262 Scott Elliott 263 Allyson Lloyd 264 Robert Impey 265 Nick Levene 266 Lynn Monaghan 267 Declan Bradley 268 Tim Wyatt 269 Elias Allara 270 Clare Pearson 271 Husam Osman 272 Andrew Bosworth 273 Esther Robinson 274 Peter Muir 275 Ian Vipond 276 Richard Hopes 277 Hannah Pymont 278 Stephanie Hutchings 279 Martin Curran 280 Surendra Parmar 281 Angie Lackenby 282 Tamyo Mbisa 283 Steven Platt 284 Shahjahan Miah 285 David Bibby 286 Carmen Manso 287 Jonathan Hubb 288 Meera Chand 289 Gavin Dabrera 290 Mary Ramsay 291 Daniel Bradshaw 292 Alicia Thornton 293 Richard Myers 294 Ulf Schaefer 295 Natalie Groves 296 Eileen Gallagher 297 David Lee 298 David Williams 299 Nicholas Ellaby 300 Ian Harrison 301 Hassan Hartman 302 Nikos Manesis 303 Vineet Patel 304 Chloe Bishop 305 Vicki Chalker 306 Juan Ledesma 307 Katherine Twohig 308 Matthew Holden 309 Sharif Shaaban 310 Alec Birchley 311 Alexander Adams 312 Alisha Davies 313 Amy Gaskin 314 Amy Plimmer 315 Bree Gatica-Wilcox 316 Caoimhe McKerr 317 Catherine Moore 318 Chris Williams 319 David Heyburn 320 Elen De Lacy 321 Ember Hilvers 322 Fatima Downing 323 Giri Shankar 324 Hannah Jones 325 Hibo Asad 326 Jason Coombes 327 Joanne Watkins 328 Johnathan Evans 329 Laia Fina 330 Laura Gifford 331 Lauren Gilbert 332 Lee Graham 333 Malorie Perry 334 Mari Morgan 335 Matthew Bull 336 Michelle Cronin 337 Nicole Pacchiarini 338 Noel Craine 339 Rachel Jones 340 Robin Howe 341 Sally Corden 342 Sara Rey 343 Sara Kumziene-SummerhaYes 344 Sarah Taylor 345 Simon Cottrell 346 Sophie Jones 347 Sue Edwards 348 Justin O'Grady 349 Andrew Page 350 Alison Mather 351 David Baker 352 Steven Rudder 353 Alp Aydin 354 Gemma Kay 355 Alexander Trotter 356 Nabil-Fareed Alikhan 357 Leonardo de Oliveira Martins 358 Thanh Le-Viet 359 Lizzie Meadows 360 Anna Casey 361 Liz Ratcliffe 362 David Simpson 363 Zoltan Molnar 364 Thomas Thompson 365 Erwan Acheson 366 Jane Masoli 367 Bridget Knight 368 Sian Ellard 369 Cressida Auckland 370 Christopher Jones 371 Tabitha Mahungu 372 Dianne Irish-Tavares 373 Tanzina Haque 374 Jennifer Hart 375 Eric Witele 376 Melisa Fenton 377 Ashok Dadrah 378 Amanda Symmonds 379 Tranprit Saluja 380 Yann Bourgeois 381 Garry Scarlett 382 Katie Loveson 383 Salman Goudarzi 384 Christopher Fearn 385 Kate Cook 386 Hannah Dent 387 Hannah Paul 388 David Partridge 389 Mohammad Raza 390 Cariad Evans 391 Kate Johnson 392 Steven Liggett 393 Paul Baker 394 Stephen Bonner 395 Sarah Essex 396 Ronan Lyons 397 Kordo Saeed 398 Adhyana Mahanama 399 Buddhini Samaraweera 400 Siona Silveira 401 Emanuela Pelosi 402 Eleri Wilson-Davies 403 Rachel Williams 404 Mark Kristiansen 405 Sunando Roy 406 Charlotte Williams 407 Marius Cotic 408 Nadua Bayzid 409 Adam Westhorpe 410 John Hartley 411 Riaz Jannoo 412 Helen Lowe 413 Angeliki Karamani 414 Leah Ensell 415 Jacqui Prieto 416 Sarah Jeremiah 417 Dimitris Grammatopoulos 418 Sarojini Pandey 419 Lisa Berry 420 Katie Jones 421 Alex Richter 422 Andrew Beggs 423 Angus Best 424 Benita Percival 425 Jeremy Mirza 426 Oliver Megram 427 Megan Mayhew 428 Liam Crawford 429 Fiona Ashcroft 430 Emma Moles-Garcia 431 Nicola Cumley 432 Colin Smith 433 Giselda Bucca 434 Andrew Hesketh 435 Beth Blane 436 Sophia Girgis 437 Danielle Leek 438 Sushmita Sridhar 439 Sally Forrest 440 Claire Cormie 441 Harmeet Gill 442 Joana Dias 443 Ellen Higginson 444 Mailis Maes 445 Jamie Young 446 Leanne Kermack 447 Ravi Gupta 448 Catherine Ludden 449 Sharon Peacock 450 Sophie Palmer 451 Carol Churcher 452 Nazreen Hadjirin 453 Alessandro Carabelli 454 Ellena Brooks 455 Kim Smith 456 Katerina Galai 457 Georgina McManus 458 Chris Ruis 459 Rose Davidson 460 Andrew Rambaut 461 Thomas Williams 462 Carlos Balcazar 463 Michael Gallagher 464 Áine O'Toole 465 Stefan Rooke 466 Verity Hill 467 Kathleen Williamson 468 Thomas Stanton 469 Stephen Michell 470 Claire Bewshea 471 Ben Temperton 472 Michelle Michelsen 473 Joanna Warwick-Dugdale 474 Robin Manley 475 Audrey Farbos 476 James Harrison 477 Christine Sambles 478 David Studholme 479 Aaron Jeffries 480 Leigh Jackson 481 Alistair Darby 482 Julian Hiscox 483 Steve Paterson 484 Miren Iturriza-Gomara 485 Kathryn Jackson 486 Anita Lucaci 487 Edith Vamos 488 Margaret Hughes 489 Lucille Rainbow 490 Richard Eccles 491 Charlotte Nelson 492 Mark Whitehead 493 Lance Turtle 494 Sam Haldenby 495 Richard Gregory 496 Matthew Gemmell 497 Claudia Wierzbicki 498 Hermione Webster 499 Thushan de Silva 500 Nikki Smith 501 Adrienn Angyal 502 Benjamin Lindsey 503 Danielle Groves 504 Luke Green 505 Dennis Wang 506 Timothy Freeman 507 Matthew Parker 508 Alexander Keeley 509 Paul Parsons 510 Rachel Tucker 511 Rebecca Brown 512 Matthew Wyles 513 Max Whiteley 514 Peijun Zhang 515 Marta Gallis 516 Stavroula Louka 517 Chrystala Constantinidou 518 Meera Unnikrishnan 519 Sascha Ott 520 Jeffrey Cheng 521 Hannah Bridgewater 522 Lucy Frost 523 Grace Taylor-Joyce 524 Richard Stark 525 Laura Baxter 526 Mohammad Alam 527 Paul Brown 528 Dinesh Aggarwal 529 Alberto Cerda 530 Tammy Merrill 531 Rebekah Wilson 532 Patrick McClure 533 Joseph Chappell 534 Theocharis Tsoleridis 535 Jonathan Ball 536 David Buck 537 John Todd 538 Angie Green 539 Amy Trebes 540 George MacIntyre-Cockett 541 Mariateresa de Cesare 542 Alex Alderton 543 Roberto Amato 544 Cristina Ariani 545 Mathew Beale 546 Charlotte Beaver 547 Katherine Bellis 548 Emma Betteridge 549 James Bonfield 550 John Danesh 551 Matthew Dorman 552 Eleanor Drury 553 Ben Farr 554 Luke Foulser 555 Sonia Goncalves 556 Scott Goodwin 557 Marina Gourtovaia 558 Ewan Harrison 559 David Jackson 560 Dorota Jamrozy 561 Ian Johnston 562 Leanne Kane 563 Sally Kay 564 Jon-Paul Keatley 565 Dominic Kwiatkowski 566 Cordelia Langford 567 Mara Lawniczak 568 Laura Letchford 569 Rich Livett 570 Stephanie Lo 571 Inigo Martincorena 572 Samantha McGuigan 573 Rachel Nelson 574 Steve Palmer 575 Naomi Park 576 Minal Patel 577 Liam Prestwood 578 Christoph Puethe 579 Michael Quail 580 Shavanthi Rajatileka 581 Carol Scott 582 Lesley Shirley 583 John Sillitoe 584 Michael Spencer Chapman 585 Scott Thurston 586 Gerry Tonkin-Hill 587 Danni Weldon 588 Diana Rajan 589 Iraad Bronner 590 Louise Aigrain 591 Nicholas Redshaw 592 Stefanie Lensing 593 Robert Davies 594 Andrew Whitwham 595 Jennifier Liddle 596 Kevin Lewis 597 Jaime Tovar-Corona 598 Steven Leonard 599 Jillian Durham 600 Andrew Bassett 601 Shane McCarthy 602 Robin Moll 603 Keith James 604 Karen Oliver 605 Alex Makunin 606 Jeff Barrett 607 Rory Gunson 608 Ronan Lyons 0000-0001-5225-000X 609 66419__30365__41cb3ef989bf4049a60d85a90c73c16b.pdf 66419.pdf 2024-05-14T15:46:30.8340514 Output 283692 application/pdf Version of Record true This is an Open Access article under the CC BY 4.0 license. true eng https://creativecommons.org/licenses/by/4.0/ |
title |
Hospital admission and emergency care attendance risk for SARS-CoV-2 delta (B.1.617.2) compared with alpha (B.1.1.7) variants of concern: a cohort study |
spellingShingle |
Hospital admission and emergency care attendance risk for SARS-CoV-2 delta (B.1.617.2) compared with alpha (B.1.1.7) variants of concern: a cohort study Ronan Lyons |
title_short |
Hospital admission and emergency care attendance risk for SARS-CoV-2 delta (B.1.617.2) compared with alpha (B.1.1.7) variants of concern: a cohort study |
title_full |
Hospital admission and emergency care attendance risk for SARS-CoV-2 delta (B.1.617.2) compared with alpha (B.1.1.7) variants of concern: a cohort study |
title_fullStr |
Hospital admission and emergency care attendance risk for SARS-CoV-2 delta (B.1.617.2) compared with alpha (B.1.1.7) variants of concern: a cohort study |
title_full_unstemmed |
Hospital admission and emergency care attendance risk for SARS-CoV-2 delta (B.1.617.2) compared with alpha (B.1.1.7) variants of concern: a cohort study |
title_sort |
Hospital admission and emergency care attendance risk for SARS-CoV-2 delta (B.1.617.2) compared with alpha (B.1.1.7) variants of concern: a cohort study |
author_id_str_mv |
83efcf2a9dfcf8b55586999d3d152ac6 |
author_id_fullname_str_mv |
83efcf2a9dfcf8b55586999d3d152ac6_***_Ronan Lyons |
author |
Ronan Lyons |
author2 |
Katherine A Twohig Tommy Nyberg Asad Zaidi Simon Thelwall Mary A Sinnathamby Shirin Aliabadi Shaun R Seaman Ross J Harris Russell Hope Jamie Lopez-Bernal Eileen Gallagher Andre Charlett Daniela De Angelis Anne M Presanis Gavin Dabrera Cherian Koshy Amy Ash Emma Wise Nathan Moore Matilde Mori Nick Cortes Jessica Lynch Stephen Kidd Derek Fairley Tanya Curran James McKenna Helen Adams Christophe Fraser Tanya Golubchik David Bonsall Mohammed Hassan-Ibrahim Cassandra Malone Benjamin Cogger Michelle Wantoch Nicola Reynolds Ben Warne Joshua Maksimovic Karla Spellman Kathryn McCluggage Michaela John Robert Beer Safiah Afifi Sian Morgan Angela Marchbank Anna Price Christine Kitchen Huw Gulliver Ian Merrick Joel Southgate Martyn Guest Robert Munn Trudy Workman Thomas Connor William Fuller Catherine Bresner Luke Snell Amita Patel Themoula Charalampous Gaia Nebbia Rahul Batra Jonathan Edgeworth Samuel Robson Angela Beckett David Aanensen Anthony Underwood Corin Yeats Khalil Abudahab Ben Taylor Mirko Menegazzo Gemma Clark Wendy Smith Manjinder Khakh Vicki Fleming Michelle Lister Hannah Howson-Wells Louise Berry Tim Boswell Amelia Joseph Iona Willingham Carl Jones Christopher Holmes Paul Bird Thomas Helmer Karlie Fallon Julian Tang Veena Raviprakash Sharon Campbell Nicola Sheriff Victoria Blakey Lesley-Anne Williams Matthew Loose Nadine Holmes Christopher Moore Matthew Carlile Victoria Wright Fei Sang Johnny Debebe Francesc Coll Adrian Signell Gilberto Betancor Harry Wilson Sahar Eldirdiri Anita Kenyon Thomas Davis Oliver Pybus Louis du Plessis Alex Zarebski Jayna Raghwani Moritz Kraemer Sarah Francois Stephen Attwood Tetyana Vasylyeva Marina Escalera Zamudio Bernardo Gutierrez M. Estee Torok William Hamilton Ian Goodfellow Grant Hall Aminu Jahun Yasmin Chaudhry Myra Hosmillo Malte Pinckert Iliana Georgana Samuel Moses Hannah Lowe Luke Bedford Jonathan Moore Susanne Stonehouse Chloe Fisher Ali Awan John BoYes Judith Breuer Kathryn Harris Julianne Brown Divya Shah Laura Atkinson Jack Lee Nathaniel Storey Flavia Flaviani Adela Alcolea-Medina Rebecca Williams Gabrielle Vernet Michael Chapman Lisa Levett Judith Heaney Wendy Chatterton Monika Pusok Li Xu-McCrae Darren Smith Matthew Bashton Gregory Young Alison Holmes Paul Randell Alison Cox Pinglawathee Madona Frances Bolt James Price Siddharth Mookerjee Manon Ragonnet-Cronin Fabricia F. Nascimento David Jorgensen Igor Siveroni Rob Johnson Olivia Boyd Lily Geidelberg Erik Volz Aileen Rowan Graham Taylor Katherine Smollett Nicholas Loman Joshua Quick Claire McMurray Joanne Stockton Sam Nicholls Will Rowe Radoslaw Poplawski Alan McNally Rocio Martinez Nunez Jenifer Mason Trevor Robinson Elaine O'Toole Joanne Watts Cassie Breen Angela Cowell Graciela Sluga Nicholas Machin Shazaad Ahmad Ryan George Fenella Halstead Venkat Sivaprakasam Wendy Hogsden Chris Illingworth Chris Jackson Emma Thomson James Shepherd Patawee Asamaphan Marc Niebel Kathy Li Rajiv Shah Natasha Jesudason Lily Tong Alice Broos Daniel Mair Jenna Nichols Stephen Carmichael Kyriaki Nomikou Elihu Aranday-Cortes Natasha Johnson Igor Starinskij Ana da Silva Filipe David Robertson Richard Orton Joseph Hughes Sreenu Vattipally Joshua Singer Seema Nickbakhsh Antony Hale Louissa Macfarlane-Smith Katherine Harper Holli Carden Yusri Taha Brendan Payne Shirelle Burton-Fanning Sheila Waugh Jennifer Collins Gary Eltringham Steven Rushton Sarah O'Brien Amanda Bradley Alasdair Maclean Guy Mollett Rachel Blacow Kate Templeton Martin McHugh Rebecca Dewar Elizabeth Wastenge Samir Dervisevic Rachael Stanley Emma Meader Lindsay Coupland Louise Smith Clive Graham Edward Barton Debra Padgett Garren Scott Emma Swindells Jane Greenaway Andrew Nelson Clare McCann Wen Yew Monique Andersson Timothy Peto Anita Justice David Eyre Derrick Crook Tim Sloan Nichola Duckworth Sarah Walsh Anoop Chauhan Sharon Glaysher Kelly Bicknell Sarah Wyllie Scott Elliott Allyson Lloyd Robert Impey Nick Levene Lynn Monaghan Declan Bradley Tim Wyatt Elias Allara Clare Pearson Husam Osman Andrew Bosworth Esther Robinson Peter Muir Ian Vipond Richard Hopes Hannah Pymont Stephanie Hutchings Martin Curran Surendra Parmar Angie Lackenby Tamyo Mbisa Steven Platt Shahjahan Miah David Bibby Carmen Manso Jonathan Hubb Meera Chand Gavin Dabrera Mary Ramsay Daniel Bradshaw Alicia Thornton Richard Myers Ulf Schaefer Natalie Groves Eileen Gallagher David Lee David Williams Nicholas Ellaby Ian Harrison Hassan Hartman Nikos Manesis Vineet Patel Chloe Bishop Vicki Chalker Juan Ledesma Katherine Twohig Matthew Holden Sharif Shaaban Alec Birchley Alexander Adams Alisha Davies Amy Gaskin Amy Plimmer Bree Gatica-Wilcox Caoimhe McKerr Catherine Moore Chris Williams David Heyburn Elen De Lacy Ember Hilvers Fatima Downing Giri Shankar Hannah Jones Hibo Asad Jason Coombes Joanne Watkins Johnathan Evans Laia Fina Laura Gifford Lauren Gilbert Lee Graham Malorie Perry Mari Morgan Matthew Bull Michelle Cronin Nicole Pacchiarini Noel Craine Rachel Jones Robin Howe Sally Corden Sara Rey Sara Kumziene-SummerhaYes Sarah Taylor Simon Cottrell Sophie Jones Sue Edwards Justin O'Grady Andrew Page Alison Mather David Baker Steven Rudder Alp Aydin Gemma Kay Alexander Trotter Nabil-Fareed Alikhan Leonardo de Oliveira Martins Thanh Le-Viet Lizzie Meadows Anna Casey Liz Ratcliffe David Simpson Zoltan Molnar Thomas Thompson Erwan Acheson Jane Masoli Bridget Knight Sian Ellard Cressida Auckland Christopher Jones Tabitha Mahungu Dianne Irish-Tavares Tanzina Haque Jennifer Hart Eric Witele Melisa Fenton Ashok Dadrah Amanda Symmonds Tranprit Saluja Yann Bourgeois Garry Scarlett Katie Loveson Salman Goudarzi Christopher Fearn Kate Cook Hannah Dent Hannah Paul David Partridge Mohammad Raza Cariad Evans Kate Johnson Steven Liggett Paul Baker Stephen Bonner Sarah Essex Ronan Lyons Kordo Saeed Adhyana Mahanama Buddhini Samaraweera Siona Silveira Emanuela Pelosi Eleri Wilson-Davies Rachel Williams Mark Kristiansen Sunando Roy Charlotte Williams Marius Cotic Nadua Bayzid Adam Westhorpe John Hartley Riaz Jannoo Helen Lowe Angeliki Karamani Leah Ensell Jacqui Prieto Sarah Jeremiah Dimitris Grammatopoulos Sarojini Pandey Lisa Berry Katie Jones Alex Richter Andrew Beggs Angus Best Benita Percival Jeremy Mirza Oliver Megram Megan Mayhew Liam Crawford Fiona Ashcroft Emma Moles-Garcia Nicola Cumley Colin Smith Giselda Bucca Andrew Hesketh Beth Blane Sophia Girgis Danielle Leek Sushmita Sridhar Sally Forrest Claire Cormie Harmeet Gill Joana Dias Ellen Higginson Mailis Maes Jamie Young Leanne Kermack Ravi Gupta Catherine Ludden Sharon Peacock Sophie Palmer Carol Churcher Nazreen Hadjirin Alessandro Carabelli Ellena Brooks Kim Smith Katerina Galai Georgina McManus Chris Ruis Rose Davidson Andrew Rambaut Thomas Williams Carlos Balcazar Michael Gallagher Áine O'Toole Stefan Rooke Verity Hill Kathleen Williamson Thomas Stanton Stephen Michell Claire Bewshea Ben Temperton Michelle Michelsen Joanna Warwick-Dugdale Robin Manley Audrey Farbos James Harrison Christine Sambles David Studholme Aaron Jeffries Leigh Jackson Alistair Darby Julian Hiscox Steve Paterson Miren Iturriza-Gomara Kathryn Jackson Anita Lucaci Edith Vamos Margaret Hughes Lucille Rainbow Richard Eccles Charlotte Nelson Mark Whitehead Lance Turtle Sam Haldenby Richard Gregory Matthew Gemmell Claudia Wierzbicki Hermione Webster Thushan de Silva Nikki Smith Adrienn Angyal Benjamin Lindsey Danielle Groves Luke Green Dennis Wang Timothy Freeman Matthew Parker Alexander Keeley Paul Parsons Rachel Tucker Rebecca Brown Matthew Wyles Max Whiteley Peijun Zhang Marta Gallis Stavroula Louka Chrystala Constantinidou Meera Unnikrishnan Sascha Ott Jeffrey Cheng Hannah Bridgewater Lucy Frost Grace Taylor-Joyce Richard Stark Laura Baxter Mohammad Alam Paul Brown Dinesh Aggarwal Alberto Cerda Tammy Merrill Rebekah Wilson Patrick McClure Joseph Chappell Theocharis Tsoleridis Jonathan Ball David Buck John Todd Angie Green Amy Trebes George MacIntyre-Cockett Mariateresa de Cesare Alex Alderton Roberto Amato Cristina Ariani Mathew Beale Charlotte Beaver Katherine Bellis Emma Betteridge James Bonfield John Danesh Matthew Dorman Eleanor Drury Ben Farr Luke Foulser Sonia Goncalves Scott Goodwin Marina Gourtovaia Ewan Harrison David Jackson Dorota Jamrozy Ian Johnston Leanne Kane Sally Kay Jon-Paul Keatley Dominic Kwiatkowski Cordelia Langford Mara Lawniczak Laura Letchford Rich Livett Stephanie Lo Inigo Martincorena Samantha McGuigan Rachel Nelson Steve Palmer Naomi Park Minal Patel Liam Prestwood Christoph Puethe Michael Quail Shavanthi Rajatileka Carol Scott Lesley Shirley John Sillitoe Michael Spencer Chapman Scott Thurston Gerry Tonkin-Hill Danni Weldon Diana Rajan Iraad Bronner Louise Aigrain Nicholas Redshaw Stefanie Lensing Robert Davies Andrew Whitwham Jennifier Liddle Kevin Lewis Jaime Tovar-Corona Steven Leonard Jillian Durham Andrew Bassett Shane McCarthy Robin Moll Keith James Karen Oliver Alex Makunin Jeff Barrett Rory Gunson Ronan Lyons |
format |
Journal article |
container_title |
The Lancet Infectious Diseases |
container_volume |
22 |
container_issue |
1 |
container_start_page |
35 |
publishDate |
2022 |
institution |
Swansea University |
issn |
1473-3099 |
doi_str_mv |
10.1016/s1473-3099(21)00475-8 |
publisher |
Elsevier BV |
college_str |
Faculty of Medicine, Health and Life Sciences |
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|
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facultyofmedicinehealthandlifesciences |
hierarchy_top_title |
Faculty of Medicine, Health and Life Sciences |
hierarchy_parent_id |
facultyofmedicinehealthandlifesciences |
hierarchy_parent_title |
Faculty of Medicine, Health and Life Sciences |
department_str |
Swansea University Medical School - Health Data Science{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}Swansea University Medical School - Health Data Science |
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description |
BackgroundThe SARS-CoV-2 delta (B.1.617.2) variant was first detected in England in March, 2021. It has since rapidly become the predominant lineage, owing to high transmissibility. It is suspected that the delta variant is associated with more severe disease than the previously dominant alpha (B.1.1.7) variant. We aimed to characterise the severity of the delta variant compared with the alpha variant by determining the relative risk of hospital attendance outcomes.MethodsThis cohort study was done among all patients with COVID-19 in England between March 29 and May 23, 2021, who were identified as being infected with either the alpha or delta SARS-CoV-2 variant through whole-genome sequencing. Individual-level data on these patients were linked to routine health-care datasets on vaccination, emergency care attendance, hospital admission, and mortality (data from Public Health England's Second Generation Surveillance System and COVID-19-associated deaths dataset; the National Immunisation Management System; and NHS Digital Secondary Uses Services and Emergency Care Data Set). The risk for hospital admission and emergency care attendance were compared between patients with sequencing-confirmed delta and alpha variants for the whole cohort and by vaccination status subgroups. Stratified Cox regression was used to adjust for age, sex, ethnicity, deprivation, recent international travel, area of residence, calendar week, and vaccination status.FindingsIndividual-level data on 43 338 COVID-19-positive patients (8682 with the delta variant, 34 656 with the alpha variant; median age 31 years [IQR 17–43]) were included in our analysis. 196 (2·3%) patients with the delta variant versus 764 (2·2%) patients with the alpha variant were admitted to hospital within 14 days after the specimen was taken (adjusted hazard ratio [HR] 2·26 [95% CI 1·32–3·89]). 498 (5·7%) patients with the delta variant versus 1448 (4·2%) patients with the alpha variant were admitted to hospital or attended emergency care within 14 days (adjusted HR 1·45 [1·08–1·95]). Most patients were unvaccinated (32 078 [74·0%] across both groups). The HRs for vaccinated patients with the delta variant versus the alpha variant (adjusted HR for hospital admission 1·94 [95% CI 0·47–8·05] and for hospital admission or emergency care attendance 1·58 [0·69–3·61]) were similar to the HRs for unvaccinated patients (2·32 [1·29–4·16] and 1·43 [1·04–1·97]; p=0·82 for both) but the precision for the vaccinated subgroup was low.InterpretationThis large national study found a higher hospital admission or emergency care attendance risk for patients with COVID-19 infected with the delta variant compared with the alpha variant. Results suggest that outbreaks of the delta variant in unvaccinated populations might lead to a greater burden on health-care services than the alpha variant. |
published_date |
2022-01-01T12:22:39Z |
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1802741386582163456 |
score |
11.021648 |