MRC Biostatistics Unit, University of Cambridge, Cambridge, United Kingdom.
Joint Universities Pandemic and Epidemiological Research (JUNIPER) Consortium, United Kingdom.
PLoS One. 2023 Apr 13;18(4):e0284187. doi: 10.1371/journal.pone.0284187. eCollection 2023.
The SARS-CoV-2 Alpha variant was associated with increased transmission relative to other variants present at the time of its emergence and several studies have shown an association between Alpha variant infection and increased hospitalisation and 28-day mortality. However, none have addressed the impact on maximum severity of illness in the general population classified by the level of respiratory support required, or death. We aimed to do this.
In this retrospective multi-centre clinical cohort sub-study of the COG-UK consortium, 1475 samples from Scottish hospitalised and community cases collected between 1st November 2020 and 30th January 2021 were sequenced. We matched sequence data to clinical outcomes as the Alpha variant became dominant in Scotland and modelled the association between Alpha variant infection and severe disease using a 4-point scale of maximum severity by 28 days: 1. no respiratory support, 2. supplemental oxygen, 3. ventilation and 4. death.
Our cumulative generalised linear mixed model analyses found evidence (cumulative odds ratio: 1.40, 95% CI: 1.02, 1.93) of a positive association between increased clinical severity and lineage (Alpha variant versus pre-Alpha variants).
The Alpha variant was associated with more severe clinical disease in the Scottish population than co-circulating lineages.
SARS-CoV-2 的 Alpha 变体与其他变体相比，在其出现时具有更高的传播性，并且有几项研究表明 Alpha 变体感染与住院和 28 天死亡率增加之间存在关联。然而，没有研究涉及到根据所需呼吸支持水平对一般人群中疾病严重程度的最大程度的影响，也没有研究涉及到死亡。我们旨在解决这个问题。
在 COG-UK 联盟的这项回顾性多中心临床队列子研究中，对 2020 年 11 月 1 日至 2021 年 1 月 30 日期间苏格兰住院和社区病例采集的 1475 个样本进行了测序。我们将序列数据与临床结果相匹配，因为 Alpha 变体在苏格兰占据主导地位，并使用 28 天内的严重程度 4 分制（1.无呼吸支持，2.补充氧气，3.通气，4.死亡）来模拟 Alpha 变体感染与严重疾病之间的关联。
我们的累积广义线性混合模型分析发现了证据（累积优势比：1.40，95%CI：1.02，1.93），表明临床严重程度与谱系（Alpha 变体与前 Alpha 变体）之间存在正相关。
与同时流行的谱系相比，Alpha 变体在苏格兰人群中与更严重的临床疾病相关。
