Impact of the Alpha VOC on disease severity in SARS-CoV-2-positive adults in Sweden

Published:August 30, 2021DOI:https://doi.org/10.1016/j.jinf.2021.08.043
      Variants of concern (VOC) have rapidly become the dominating SARS-CoV-2 viruses worldwide.
      • Campbell F.
      • Archer B.
      • Laurenson-Schafer H.
      • Jinnai Y.
      • Konings F.
      • Batra N.
      • et al.
      Increased transmissibility and global spread of SARS-CoV-2 variants of concern as at June 2021.
      ,

      European Centre for Disease Prevention and Control (ECDC). Data on SARS-CoV-2 variants in the EU/EEA. Sept. 2, 2021. https://www.ecdc.europa.eu/en/publications-data/data-virus-variants-covid-19-eueea (accessed Sept. 2, 2021).

      Concerns have been raised that VOC may cause more severe disease than non-VOC.
      • Cevik M.
      • Mishra S.
      SARS-CoV-2 variants and considerations of inferring causality on disease severity.
      Cevik and Mishra
      • Cevik M.
      • Mishra S.
      SARS-CoV-2 variants and considerations of inferring causality on disease severity.
      concluded that Alpha VOC (lineage B.1.1.7) positivity was associated with increased risk for hospitalization in four of five, and for death in five of six community-based studies, but was not associated with increased mortality in 3 hospital-based studies. Two of these hospital-based studies
      • Patone M.
      • Thomas K.
      • Hatch R.
      • San Tan P.
      • Coupland C.
      • Liao W.
      • et al.
      Mortality and critical unit admission associated with the SARS-CoV-2 lineage B.1.1.7 in England: an observational cohort study.
      ,
      • Frampton D.
      • Ramling T.
      • Cross A.
      • Bailey H.
      • Heaney J.
      • Byott M.
      • et al.
      Genomic characteristics and clinical effect of the emergent SARS-CoV-2 B1.1.7 lineage in London, UK: a whole-genome sequencing and hospital-based cohort study.
      also evaluated disease severity and did not find an association with Alpha VOC. Accordingly, in this journal, Whittaker et al.
      • Whittaker R.
      • Bråthen Kristofferson A.
      • Seppälä E.
      • Valcarcel Salamanca B.
      • Veneti L.
      • Larsdatter Storm M.
      • et al.
      reported no difference between hospitalised patients infected with Alpha VOC and those infected with non-VOC, regarding length of stay in hospital, length of stay in the intensive care unit (ICU), and mortality.
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        Increased transmissibility and global spread of SARS-CoV-2 variants of concern as at June 2021.
        Eurosurveill. 2021; 262100509
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