Changing character and waning impact of COVID-19 at a tertiary centre in Cape Town, South Africa.
Changing character and waning impact of COVID-19 at a tertiary centre in Cape Town, South Africa.
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DOI：
10.4102/sajid.v38i1.550
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发表时间：
2023
影响因子：
0.9
通讯作者：
Wasserman S
中科院分区：
文献类型：
--
作者：
Hermans LE;Booysen P;Boloko L;Adriaanse M;de Wet TJ;Lifson AR;Wadee N;Papavarnavas N;Marais G;Hsiao NY;Rosslee MJ;Symons G;Calligaro GL;Iranzadeh A;Wilkinson RJ;Ntusi NAB;Williamson C;Davies MA;Meintjes G;Wasserman S
在基于人群的研究中，SARS-CoV-2 基因变异的出现与 2019 年冠状病毒病 (COVID-19) 大流行期间流行病学特征的变化有关。关于非洲国家不同 SARS-CoV-2 变体感染的临床特征的个体层面数据记录较少。描述观察到的各种值得关注的 SARS-CoV-2 变体不断变化的临床差异，并将 Omicron 驱动的感染波与之前的 Delta 驱动的感染波进行比较。我们对南非一家转诊医院收治的 COVID-19 肺炎患者进行了一项回顾性观察队列研究。患者按流行病学波期进行分层，在一个子集中，与每个波期相关的变异通过基因组测序得到确认。通过 Cox 比例风险模型分析结果。我们纳入了 1689 名患者，代表主要由祖先、Beta、Delta 和 Omicron BA1/BA2 和 BA4/BA5 变体驱动的感染波。 Omicron 波时期的 28 天粗死亡率为 25.8% (34/133)，而 Delta 波时期为 37.1% (138/374)（风险比 [HR] 0.68 [95% CI 0.47–1.00] p = 0.049）；在调整年龄、性别、HIV 状况和心血管疾病的存在后，这种效应仍然存在（调整后的 HR [aHR] 0.43 [95% CI 0.28–0.67] p < 0.001）。 Delta 波期间全医院 SARS-CoV-2 入院率和死亡人数最高，此后 SARS-CoV-2 死亡人数与总体死亡人数脱钩。与之前的 Delta 波相比，Omicron 驱动波期间的院内死亡率较低，尽管 Omicron 波期间入院的患者风险较高。本研究总结了南非一家三级医院在 COVID-19 大流行期间与 SARS-CoV-2 变体相关的临床特征，表明尽管新变体引发了流行浪潮，但随着时间的推移，COVID-19 对医疗保健服务的影响逐渐减弱。研究结果表明，后来的变体没有增加毒力，也没有受到群体和个体水平免疫的保护。
The emergence of genetic variants of SARS-CoV-2 was associated with changing epidemiological characteristics throughout coronavirus disease 2019 (COVID-19) pandemic in population-based studies. Individual-level data on the clinical characteristics of infection with different SARS-CoV-2 variants in African countries is less well documented. To describe the evolving clinical differences observed with the various SARS-CoV-2 variants of concern and compare the Omicron-driven wave in infections to the previous Delta-driven wave. We performed a retrospective observational cohort study among patients admitted to a South African referral hospital with COVID-19 pneumonia. Patients were stratified by epidemiological wave period, and in a subset, the variants associated with each wave were confirmed by genomic sequencing. Outcomes were analysed by Cox proportional hazard models. We included 1689 patients were included, representing infection waves driven predominantly by ancestral, Beta, Delta and Omicron BA1/BA2 & BA4/BA5 variants. Crude 28-day mortality was 25.8% (34/133) in the Omicron wave period versus 37.1% (138/374) in the Delta wave period (hazard ratio [HR] 0.68 [95% CI 0.47–1.00] p = 0.049); this effect persisted after adjustment for age, gender, HIV status and presence of cardiovascular disease (adjusted HR [aHR] 0.43 [95% CI 0.28–0.67] p < 0.001). Hospital-wide SARS-CoV-2 admissions and deaths were highest during the Delta wave period, with a decoupling of SARS-CoV-2 deaths and overall deaths thereafter. There was lower in-hospital mortality during Omicron-driven waves compared with the prior Delta wave, despite patients admitted during the Omicron wave being at higher risk. This study summarises clinical characteristics associated with SARS-CoV-2 variants during the COVID-19 pandemic at a South African tertiary hospital, demonstrating a waning impact of COVID-19 on healthcare services over time despite epidemic waves driven by new variants. Findings suggest the absence of increasing virulence from later variants and protection from population and individual-level immunity.
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DOI：
10.1016/s0140-6736(22)00017-4
发表时间：
2022-01-29
期刊：
Lancet (London, England)
影响因子：
--
作者：
Wolter N;Jassat W;Walaza S;Welch R;Moultrie H;Groome M;Amoako DG;Everatt J;Bhiman JN;Scheepers C;Tebeila N;Chiwandire N;du Plessis M;Govender N;Ismail A;Glass A;Mlisana K;Stevens W;Treurnicht FK;Makatini Z;Hsiao NY;Parboosing R;Wadula J;Hussey H;Davies MA;Boulle A;von Gottberg A;Cohen C
通讯作者：
Cohen C
影响因子：
34.3
作者：
Jassat, Waasila;Karim, Salim S. Abdool;Mudara, Caroline;Welch, Richard;Ozougwu, Lovelyn;Groome, Michelle J.;Govender, Nevashan;von Gottberg, Anne;Wolter, Nicole;Wolmarans, Milani;Rousseau, Petro;Blumberg, Lucille;Cohen, Cheryl
通讯作者：
Cohen, Cheryl
影响因子：
105.7
作者：
Ward, Isobel L.;Bermingham, Charlotte;Ayoubkhani, Daniel;Gethings, Owen J.;Pouwels, Koen B.;Yates, Thomas;Khunti, Kamlesh;Hippisley-Cox, Julia;Banerjee, Amitava;Walker, Ann Sarah;Nafilyan, Vahe
通讯作者：
Nafilyan, Vahe
DOI：
10.7196/samj.2020.v110i10.15157
发表时间：
2020-09-01
期刊：
SAMJ: South African Medical Journal
影响因子：
--
作者：
Mendelson, M;Booyens, L;Wasserman, S
通讯作者：
Wasserman, S
DOI：
10.1016/s2352-3018(21)00151-x
发表时间：
2021-09
期刊：
The lancet. HIV
影响因子：
--
作者：
Jassat W;Cohen C;Tempia S;Masha M;Goldstein S;Kufa T;Murangandi P;Savulescu D;Walaza S;Bam JL;Davies MA;Prozesky HW;Naude J;Mnguni AT;Lawrence CA;Mathema HT;Zamparini J;Black J;Mehta R;Parker A;Chikobvu P;Dawood H;Muvhango N;Strydom R;Adelekan T;Mdlovu B;Moodley N;Namavhandu EL;Rheeder P;Venturas J;Magula N;Blumberg L;DATCOV author group
通讯作者：
DATCOV author group