Risk of hospitalisation associated with infection with SARS-CoV-2 omicron variant versus delta variant in Denmark: an observational cohort study.
Risk of hospitalisation associated with infection with SARS-CoV-2 omicron variant versus delta variant in Denmark: an observational cohort study.
复制标题
DOI：
10.1016/s1473-3099(22)00154-2
复制
发表时间：
2022-07
影响因子：
56.3
通讯作者：
Krause, Tyra Grove
中科院分区：
文献类型：
--
作者：
Bager, Peter;Wohlfahrt, Jan;Bhatt, Samir;Stegger, Marc;Legarth, Rebecca;Moller, Camilla Holten;Skov, Robert Leo;Valentiner-Branth, Palle;Voldstedlund, Marianne;Fischer, Thea K.;Simonsen, Lone;Kirkby, Nikolai Soren;Thomsen, Marianne Kragh;Spiess, Katja;Marving, Ellinor;Larsen, Nicolai Balle;Lillebaek, Troels;Ullum, Henrik;Molbak, Kare;Krause, Tyra Grove
对SARS-CoV-2 OMICRON变种(B.1.1.529)的严重程度的估计对于评估其在全球迅速传播对公共卫生的影响至关重要。在丹麦，我们与Delta变种病毒(B.1.617.2)相比，估计了感染奥美康后与SARS-CoV-2相关住院的风险。丹麦是一个拥有高mRNA疫苗接种覆盖率和广泛的免费PCR检测能力的国家。在这项观察性队列研究中，我们包括了丹麦所有经RT-PCR确认的SARS-CoV-2感染病例，样本采集时间为11月21日(第一个Omicron阳性样本的日期)至2021年12月19日。个人是在国家新冠肺炎监测系统数据库中确定的，该数据库包括检测奥米克龙病例的变种特异性RT-PCR结果，以及与SARS-CoV-2相关的住院数据(研究的主要结果)。我们在Poisson回归模型中计算了感染奥美康后住院的风险比(RR)，总体上和按接种状况分层，并调整了再感染状况、性别、年龄、地区、合并症和时间段的先验。在2021年11月21日至12月19日期间，在188SARS980例 -CoV2感染者中，有38例 669(20.5%)存在OMICRON变异。在研究期间，与SARS-CoV-2相关的住院和奥美康病例增加。总体而言，在188名 980人中有124名 313人(65.8%)接种了疫苗，与未接种或仅接种一剂疫苗的患者相比，接种疫苗与较低的住院风险(调整后的RR为0·24，95%CI为0·22-0·26)相关。与Delta型感染相比，Omicron感染与调整后的住院RR为0·(95%可信区间为0·56~0·75；38例 6 69例中的2 2 2例[0·6%]与15 0例 311例中的2 2 13例[1·5%])相关。按接种状况进行相似比较，未接种或仅接种一剂疫苗的患者的住院RR为0·57(0·44-0·75)，接种两剂疫苗的患者住院RR为0·71(0·60-0·86)，接种三剂疫苗的患者住院RR为0·50(0·32-0·76)。我们发现，在接种疫苗和未接种疫苗的个体中，与Delta感染相比，奥米克隆感染住院的风险显著降低，这表明奥米克隆的严重程度与生俱来地降低了。我们的结果可以指导建模正在进行的全球欧米克龙浪潮的影响，从而指导卫生保健系统的准备工作。没有。
Estimates of the severity of the SARS-CoV-2 omicron variant (B.1.1.529) are crucial to assess the public health impact associated with its rapid global dissemination. We estimated the risk of SARS-CoV-2-related hospitalisations after infection with omicron compared with the delta variant (B.1.617.2) in Denmark, a country with high mRNA vaccination coverage and extensive free-of-charge PCR testing capacity. In this observational cohort study, we included all RT-PCR-confirmed cases of SARS-CoV-2 infection in Denmark, with samples taken between Nov 21 (date of first omicron-positive sample) and Dec 19, 2021. Individuals were identified in the national COVID-19 surveillance system database, which included results of a variant-specific RT-PCR that detected omicron cases, and data on SARS-CoV-2-related hospitalisations (primary outcome of the study). We calculated the risk ratio (RR) of hospitalisation after infection with omicron compared with delta, overall and stratified by vaccination status, in a Poisson regression model with robust SEs, adjusted a priori for reinfection status, sex, age, region, comorbidities, and time period. Between Nov 21 and Dec 19, 2021, among the 188 980 individuals with SARS-CoV-2 infection, 38 669 (20·5%) had the omicron variant. SARS-CoV-2-related hospitalisations and omicron cases increased during the study period. Overall, 124 313 (65·8%) of 188 980 individuals were vaccinated, and vaccination was associated with a lower risk of hospitalisation (adjusted RR 0·24, 95% CI 0·22–0·26) compared with cases with no doses or only one dose of vaccine. Compared with delta infection, omicron infection was associated with an adjusted RR of hospitalisation of 0·64 (95% CI 0·56–0·75; 222 [0·6%] of 38 669 omicron cases admitted to hospital vs 2213 [1·5%] of 150 311 delta cases). For a similar comparison by vaccination status, the RR of hospitalisation was 0·57 (0·44–0·75) among cases with no or only one dose of vaccine, 0·71 (0·60–0·86) among those who received two doses, and 0·50 (0·32–0·76) among those who received three doses. We found a significantly lower risk of hospitalisation with omicron infection compared with delta infection among both vaccinated and unvaccinated individuals, suggesting an inherent reduced severity of omicron. Our results could guide modelling of the effect of the ongoing global omicron wave and thus health-care system preparedness. None.