Paredes Miguel I, Lunn Stephanie M, Famulare Michael, Frisbie Lauren A, Painter Ian, Burstein Roy, Roychoudhury Pavitra, Xie Hong, Mohamed Bakhash Shah A, Perez Ricardo, Lukes Maria, Ellis Sean, Sathees Saraswathi, Mathias Patrick C, Greninger Alexander, Starita Lea M, Frazar Chris D, Ryke Erica, Zhong Weizhi, Gamboa Luis, Threlkeld Machiko, Lee Jover, McDermot Evan, Truong Melissa, Nickerson Deborah A, Bates Daniel L, Hartman Matthew E, Haugen Eric, Nguyen Truong N, Richards Joshua D, Rodriguez Jacob L, Stamatoyannopoulos John A, Thorland Eric, Melly Geoff, Dykema Philip E, MacKellar Drew C, Gray Hannah K, Singh Avi, Peterson JohnAric M, Russell Denny, Torres Laura Marcela, Lindquist Scott, Bedford Trevor, Allen Krisandra J, Oltean Hanna N
Department of Epidemiology, University of Washington, Seattle, WA, USA.
Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA.
medRxiv. 2022 Feb 16:2021.09.29.21264272. doi: 10.1101/2021.09.29.21264272.
The COVID-19 pandemic is dominated by variant viruses; the resulting impact on disease severity remains unclear. Using a retrospective cohort study, we assessed the hospitalization risk following infection with seven SARS-CoV-2 variants.
Our study includes individuals with positive SARS-CoV-2 RT-PCR in the Washington Disease Reporting System with available viral genome data, from December 1, 2020 to January 14, 2022. The analysis was restricted to cases with specimens collected through sentinel surveillance. Using a Cox proportional hazards model with mixed effects, we estimated hazard ratios (HR) for hospitalization risk following infection with a variant, adjusting for age, sex, calendar week, and vaccination.
58,848 cases were sequenced through sentinel surveillance, of which 1705 (2.9%) were hospitalized due to COVID-19. Higher hospitalization risk was found for infections with Gamma (HR 3.20, 95%CI 2.40-4.26), Beta (HR 2.85, 95%CI 1.56-5.23), Delta (HR 2.28 95%CI 1.56-3.34) or Alpha (HR 1.64, 95%CI 1.29-2.07) compared to infections with ancestral lineages; Omicron (HR 0.92, 95%CI 0.56-1.52) showed no significant difference in risk. Following Alpha, Gamma, or Delta infection, unvaccinated patients show higher hospitalization risk, while vaccinated patients show no significant difference in risk, both compared to unvaccinated, ancestral lineage cases. Hospitalization risk following Omicron infection is lower with vaccination.
Infection with Alpha, Gamma, or Delta results in a higher hospitalization risk, with vaccination attenuating that risk. Our findings support hospital preparedness, vaccination, and genomic surveillance.
Hospitalization risk following infection with SARS-CoV-2 variant remains unclear. We find a higher hospitalization risk in cases infected with Alpha, Beta, Gamma, and Delta, but not Omicron, with vaccination lowering risk. Our findings support hospital preparedness, vaccination, and genomic surveillance.
新冠疫情主要由变异病毒主导；其对疾病严重程度的影响尚不清楚。我们通过一项回顾性队列研究，评估了感染七种新冠病毒变异株后的住院风险。
我们的研究纳入了2020年12月1日至2022年1月14日在华盛顿疾病报告系统中新冠病毒逆转录聚合酶链反应（RT-PCR）检测呈阳性且有可用病毒基因组数据的个体。分析仅限于通过哨点监测收集标本的病例。我们使用具有混合效应的Cox比例风险模型，估计感染变异株后的住院风险比（HR），并对年龄、性别、日历周和疫苗接种情况进行了调整。
通过哨点监测对58848例病例进行了测序，其中1705例（2.9%）因新冠病毒感染住院。与感染原始毒株相比，感染伽马变异株（HR 3.20，95%置信区间2.40 - 4.26）、贝塔变异株（HR 2.85，95%置信区间1.56 - 5.23）、德尔塔变异株（HR 2.28，95%置信区间1.56 - 3.34）或阿尔法变异株（HR 1.64，95%置信区间1.29 - 2.07）的住院风险更高；奥密克戎变异株（HR 0.92，95%置信区间0.56 - 1.52）的风险无显著差异。在感染阿尔法、伽马或德尔塔变异株后，未接种疫苗的患者住院风险更高，而与未接种疫苗的原始毒株感染病例相比，接种疫苗的患者风险无显著差异。接种疫苗后，感染奥密克戎变异株后的住院风险较低。
感染阿尔法、伽马或德尔塔变异株会导致更高的住院风险，接种疫苗可降低该风险。我们的研究结果支持医院准备、疫苗接种和基因组监测。
感染新冠病毒变异株后的住院风险尚不清楚。我们发现感染阿尔法、贝塔、伽马和德尔塔变异株的病例住院风险较高，但奥密克戎变异株并非如此，接种疫苗可降低风险。我们的研究结果支持医院准备、疫苗接种和基因组监测。
