Risk of mortality in patients infected with SARS-CoV-2 variant of concern 202012/1: matched cohort study.
Risk of mortality in patients infected with SARS-CoV-2 variant of concern 202012/1: matched cohort study.
复制标题
DOI：
10.1136/bmj.n579
复制
发表时间：
2021-03-09
期刊：
影响因子：
--
通讯作者：
Danon L
中科院分区：
文献类型：
--
作者：
Challen R;Brooks-Pollock E;Read JM;Dyson L;Tsaneva-Atanasova K;Danon L
确定2020年12月指定为关注变体（VOC-202012/1）的SARS-CoV-2新变体感染的死亡率与传播的SARS-CoV-2变体相比是否有任何变化。匹配队列研究。英国社区（支柱2）新冠病毒检测中心使用TaqPath检测（VOC-202012/1感染的替代指标）。2020年10月1日至2021年1月29日期间在支柱2中检测出SARS-CoV-2阳性的54906对匹配参与者，随访至2021年2月12日。参与者的年龄，性别，种族，多重剥夺指数，较低级别的地方当局地区，和阳性标本的采样日期相匹配，不同的只是使用TaqPath检测的刺突蛋白基因的可检测性。首次SARS-CoV-2检测结果阳性后28天内死亡。在社区中COVID-19检测呈阳性的患者中，与感染VOC-202012/1相比，感染先前流行的变异体相关的死亡风险比为1.64（95%置信区间为1.32至2.04）。在这一风险相对较低的群体中，死亡人数从每1 000例发现病例2.5例增加到4.1例。VOC-202012/01感染增加死亡风险的可能性很高。如果这一发现可推广到其他人群，则与先前流行的变体相比，VOC-202012/1感染有可能导致显著额外的死亡率。卫生保健能力规划以及国家和国际控制政策都受到这一发现的影响，死亡率的增加支持了进一步协调和严格措施以减少SARS-CoV-2死亡的论点。
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. Matched cohort study. Community based (pillar 2) covid-19 testing centres in the UK using the TaqPath assay (a proxy measure of VOC-202012/1 infection). 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. Death within 28 days of the first positive SARS-CoV-2 test result. 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. 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.
登录
查看更多内容
影响因子：
4.3
作者：
Brazauskas, Ruta;Logan, Brent R.
通讯作者：
Logan, Brent R.
DOI：
10.1126/science.abf2946
发表时间：
2021-02-12
期刊：
Science (New York, N.Y.)
影响因子：
--
作者：
du Plessis L;McCrone JT;Zarebski AE;Hill V;Ruis C;Gutierrez B;Raghwani J;Ashworth J;Colquhoun R;Connor TR;Faria NR;Jackson B;Loman NJ;O'Toole Á;Nicholls SM;Parag KV;Scher E;Vasylyeva TI;Volz EM;Watts A;Bogoch II;Khan K;COVID-19 Genomics UK (COG-UK) Consortium;Aanensen DM;Kraemer MUG;Rambaut A;Pybus OG
通讯作者：
Pybus OG
影响因子：
3.7
作者：
Lacasa L;Challen R;Brooks-Pollock E;Danon L
通讯作者：
Danon L
影响因子：
82.9
作者：
Wibmer, Constantinos Kurt;Ayres, Frances;Moore, Penny L.
通讯作者：
Moore, Penny L.
影响因子：
64.8
作者：
Williamson EJ;Walker AJ;Bhaskaran K;Bacon S;Bates C;Morton CE;Curtis HJ;Mehrkar A;Evans D;Inglesby P;Cockburn J;McDonald HI;MacKenna B;Tomlinson L;Douglas IJ;Rentsch CT;Mathur R;Wong AYS;Grieve R;Harrison D;Forbes H;Schultze A;Croker R;Parry J;Hester F;Harper S;Perera R;Evans SJW;Smeeth L;Goldacre B
通讯作者：
Goldacre B