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Increased Risk of Hospitalisation Associated with Infection with SARS-CoV-2 Lineage B.1.1.7 in Denmark

16 Pages Posted: 2 Mar 2021

See all articles by Peter Bager

Peter Bager

Statens Serum Institut

Jan Wohlfahrt

Statens Serum Institut

Jannik Fonager

Statens Serum Institut

Mads Albertsen

Aalborg University - Department of Chemistry and Bioscience

Thomas Yssing Michaelsen

Aalborg University - Department of Chemistry and Bioscience

Camilla Holten Møller

Statens Serum Institut

Steen Ethelberg

Statens Serums Institut - Department of Infectious Disease Epidemiology

Rebecca Legarth

Statens Serum Institut

Mia Sara Fischer Button

Statens Serum Institut

Sophie Madeleine Gubbels

Statens Serum Institut - Division of Infectious Disease Preparedness

Marianne Voldstedlund

Statens Serums Institut

Kåre Mølbak

Statens Serums Institut - Department of Infectious Disease Epidemiology

Robert Leo Skov

Statens Serum Institut

Anders Fomsgaard

Statens Serum Institut

Tyra Grove Krause

Statens Serum Institut

More...

Abstract

Background: The more infectious SARS-CoV-2 virus lineage B.1.1.7, rapidly spread in Europe after December 2020, and a concern of B.1.1.7 causing more severe disease has been raised. Denmark has one of Europe´s highest capacities per capita of SARS-CoV-2 reverse transcription polymerase chain reaction (RT PCR) test and whole genome sequencing (WGS). We used national health register-data to explore whether B.1.1.7 increases the risk of COVID-19 hospitalisation. 

Methods and Findings: In an observational cohort study we included all SARS-CoV-2 RT PCR test-positive individuals in Denmark sampled between the 1st January and until the 9th February, 2021, identified in the national COVID-19 surveillance system. The surveillance system includes national individual RT PCR test results and viral WGS analyses and data from national health registers including COVID-19 related hospital admissions defined as first admission within 14 days of the test-positive swab. The odds ratio (OR) of admission according to infection with B.1.1.7, vs other co-existing lineages, was calculated in a logistic regression model adjusted for sex, age, period, follow-up time less than 14 days, region, and comorbidities. A total of 35,887 test-positive individuals were identified, 23,057 (64%) had WGS performed, of whom 18,499 (80%) resulted in a viral genome and a total of 2,155 of these were lineage B.1.1.7. The proportion of individuals with B.1.1.7 increased from 4% in early January to 45% in early February. Among the individuals with viral genome data, B.1.1.7 was associated with a crude OR of admission of 0.87 (95%CI, 0.72-1.05) and an adjusted OR of 1.64 (95%CI, 1.32-2.04) based on 128 admissions after B.1.1.7 infection and 1,107 admissions after infection with other lineages. The adjusted OR was increased in all strata of age and calendar time - the two most important confounders of the crude OR. 

Conclusions:   Infection with lineage B.1.1.7 was associated with an increased risk of hospitalisation compared with other lineages. This finding may have serious public health impact in countries with spread of B.1.1.7 and can support hospital preparedness and modelling of projected impact of the epidemic.

Funding Statement: The authors received no specific funding for this work.

Declaration of Interests: The authors declare that they have no competing interest.

Ethics Approval Statement: This study was conducted on administrative register data. According to Danish law, ethics approval is not needed for such research.

Suggested Citation

Bager, Peter and Wohlfahrt, Jan and Fonager, Jannik and Albertsen, Mads and Yssing Michaelsen, Thomas and Holten Møller, Camilla and Ethelberg, Steen and Legarth, Rebecca and Fischer Button, Mia Sara and Gubbels, Sophie Madeleine and Voldstedlund, Marianne and Mølbak, Kåre and Skov, Robert Leo and Fomsgaard, Anders and Grove Krause, Tyra, Increased Risk of Hospitalisation Associated with Infection with SARS-CoV-2 Lineage B.1.1.7 in Denmark. Available at SSRN: https://ssrn.com/abstract=3792894 or http://dx.doi.org/10.2139/ssrn.3792894

Peter Bager (Contact Author)

Statens Serum Institut

Denmark

Jan Wohlfahrt

Statens Serum Institut

Denmark

Jannik Fonager

Statens Serum Institut

Denmark

Mads Albertsen

Aalborg University - Department of Chemistry and Bioscience ( email )

Denmark

Thomas Yssing Michaelsen

Aalborg University - Department of Chemistry and Bioscience ( email )

Denmark

Camilla Holten Møller

Statens Serum Institut

Denmark

Steen Ethelberg

Statens Serums Institut - Department of Infectious Disease Epidemiology ( email )

Copenhagen
Denmark

Rebecca Legarth

Statens Serum Institut

Denmark

Mia Sara Fischer Button

Statens Serum Institut

Denmark

Sophie Madeleine Gubbels

Statens Serum Institut - Division of Infectious Disease Preparedness

Denmark

Marianne Voldstedlund

Statens Serums Institut

Copenhagen
Denmark

Kåre Mølbak

Statens Serums Institut - Department of Infectious Disease Epidemiology

Ørestads Boulevard 5
Copenhagen, 2300S
Denmark

Robert Leo Skov

Statens Serum Institut

Denmark

Anders Fomsgaard

Statens Serum Institut

Denmark

Tyra Grove Krause

Statens Serum Institut

Denmark

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