Assessment of Mortality and Hospital Admissions Associated with Confirmed Infection with SARS-CoV-2 Variant of Concern VOC-202012/01 (B.1.1.7) a Matched Cohort and Time-to-Event Analysis

28 Pages Posted: 22 Mar 2021

See all articles by Gavin Dabrera

Gavin Dabrera

Public Health England - National Infection Service

Hester Allen

Public Health England

Asad Zaidi

Public Health England

Katherine Twohig

Government of the United Kingdom - Public Health England

Simon Thelwall

Government of the United Kingdom - Public Health England

Elizabeth Marchant

Public Health England; Government of the United Kingdom - National Health Service (NHS)

Nurin Abdul Aziz

Public Health England - National Infection Service

Theresa Lamagni

Government of the United Kingdom, Department of Health and Social Care, National Infection Service, Healthcare-Associated Infection and Antimicrobial Resistance (HCAI & AMR) Division

Richard Myers

Government of the United Kingdom - Public Health England

Andre Charlett

Public Health England Colindale

Fernando Capelastegui

Public Health England - National Infection Service

Dimple Yasvin Chudasama

Public Health England - National Infection Service

Joe Flannagan

Public Health England - National Infection Service

Tom Clare

Public Health England - National Infection Service

Flavien Coukan

Imperial College London; Public Health England

Mary Sinnathamby

Government of the United Kingdom - Public Health England

Neil M. Ferguson

Imperial College London - MRC Centre for Global Infectious Disease Analysis

Susan Hopkins

University of Oxford - NIHR Health Protection Research Unit in Healthcare Associated Infection and Antimicrobial Resistance; Public Health England Colindale

Meera A. Chand

Public Health England Colindale

Russell Hope

Public Health England

Meaghan Kall

Public Health England Colindale

Date Written: March 11, 2021

Abstract

Background: The emergence of VOC202012/01 in England, known as B.1.1.7 or informally as the ‘UK variant’, has coincided with rapid increases in the number of PCR-confirmed positive cases in areas where the variant has been concentrated.

Methods: To assess whether infection with SARS-CoV-2 variant VOC202012/01 is associated with more severe clinical outcomes compared to wild-type infection, genomically sequenced and confirmed variant and wild-type cases were linked to routine healthcare and surveillance datasets. Two statistical analyses were conducted to compare the risk of hospital admission and death within 28 days of test between variant and wild-type cases: a case-control study and an adjusted Cox proportional hazards model. Differences in severity of disease were assessed by comparing hospital admission and mortality, including length of hospitalisation and time to death.

Results: Of 63,609 genomically sequenced COVID-19 cases tested in England between October and December 2020 6,038 were variant cases. In the matched cohort analysis 2,821 variant cases were matched to 2,821 to wild-type cases. In the time to event analysis we observed a 34% increased risk in hospitalisation associated with the variant compared to wild-type cases, however, no significant difference in the risk of mortality was observed.

Conclusion: We found evidence of increased risk of hospitalisation after adjusting for key confounders, suggesting increase infection severity associated with this variant. Follow-up studies are needed to assess potential longer-term differences in the clinical outcomes of people infected with the VOC-202012/01 variant.

Note: Funding Statement: UKRI (project grant MR/V038109/1), Centre funding (MR/R015600/1) from the Medical Research Council and DfID, NIHR (Health Protection Research Unit for Modelling and Health Economics and project.

Declaration of Interests: There is no competing interest declaration for all authors but Prof Neil Furguson would like to acknowledge the following funders: “UKRI (project grant MR/V038109/1), Centre funding (MR/R015600/1) from the Medical Research Council and DfID, NIHR (Health Protection Research Unit for Modelling and Health Economics and project grant PR-OD-1017-20002).”

Ethics Approval Statement: The PHE Research Support and Governance Office exempted this study from full ethical review. The research was classified as surveillance undertaken as part of PHE’s legal responsibility to monitor COVID-19 and was found to be fully compliant with all current regulatory requirements.

Keywords: COVID-19, Epidemiology, VOC202012/01

Suggested Citation

Dabrera, Gavin and Allen, Hester and Zaidi, Asad and Twohig, Katherine and Thelwall, Simon and Marchant, Elizabeth and Abdul Aziz, Nurin and Lamagni, Theresa and Myers, Richard and Charlett, Andre and Capelastegui, Fernando and Chudasama, Dimple Yasvin and Flannagan, Joe and Clare, Tom and Coukan, Flavien and Sinnathamby, Mary and Ferguson, Neil M. and Hopkins, Susan and Chand, Meera A. and Hope, Russell and Kall, Meaghan, Assessment of Mortality and Hospital Admissions Associated with Confirmed Infection with SARS-CoV-2 Variant of Concern VOC-202012/01 (B.1.1.7) a Matched Cohort and Time-to-Event Analysis (March 11, 2021). Available at SSRN: https://ssrn.com/abstract=3802578 or http://dx.doi.org/10.2139/ssrn.3802578

Gavin Dabrera (Contact Author)

Public Health England - National Infection Service ( email )

Wellington House
133-155 Waterloo Road
London, SE1 8UG
United Kingdom

Hester Allen

Public Health England ( email )

Wellington House,
133-155 Waterloo Rd,
London, SE1 8UG

Asad Zaidi

Public Health England ( email )

Wellington House,
133-155 Waterloo Rd,
London, SE1 8UG

Katherine Twohig

Government of the United Kingdom - Public Health England ( email )

Wellington House
133-155 Waterloo Road
London, SE1 8UG
United Kingdom

Simon Thelwall

Government of the United Kingdom - Public Health England ( email )

Wellington House
133-155 Waterloo Road
London, SE1 8UG
United Kingdom

Elizabeth Marchant

Public Health England

61 Colindale Avenue
London, NW9 5EQ
United Kingdom

Government of the United Kingdom - National Health Service (NHS) ( email )

London, SW1A 2NS
United Kingdom

Nurin Abdul Aziz

Public Health England - National Infection Service ( email )

United Kingdom

Theresa Lamagni

Government of the United Kingdom, Department of Health and Social Care, National Infection Service, Healthcare-Associated Infection and Antimicrobial Resistance (HCAI & AMR) Division

United Kingdom

Richard Myers

Government of the United Kingdom - Public Health England

Wellington House
133-155 Waterloo Road
London, SE1 8UG
United Kingdom

Andre Charlett

Public Health England Colindale ( email )

61 Colindale Avenue
London, NW9 5EQ
United Kingdom

Fernando Capelastegui

Public Health England - National Infection Service ( email )

United Kingdom

Dimple Yasvin Chudasama

Public Health England - National Infection Service

61 Colindale Avenue
London, NW9 5EQ
United Kingdom

Joe Flannagan

Public Health England - National Infection Service

61 Colindale Avenue
London, NW9 5EQ
United Kingdom

Tom Clare

Public Health England - National Infection Service ( email )

United Kingdom

Flavien Coukan

Imperial College London ( email )

London
United Kingdom

Public Health England ( email )

United Kingdom

Mary Sinnathamby

Government of the United Kingdom - Public Health England ( email )

Wellington House
133-155 Waterloo Road
London, SE1 8UG
United Kingdom

Neil M. Ferguson

Imperial College London - MRC Centre for Global Infectious Disease Analysis ( email )

South Kensington Campus
Exhibition Road
London, Greater London SW7 2AZ
United Kingdom

Susan Hopkins

University of Oxford - NIHR Health Protection Research Unit in Healthcare Associated Infection and Antimicrobial Resistance ( email )

Oxford
United Kingdom

Public Health England Colindale ( email )

61 Colindale Avenue
London, NW9 5EQ
United Kingdom

Meera A. Chand

Public Health England Colindale ( email )

61 Colindale Avenue
London, NW9 5EQ
United Kingdom

Russell Hope

Public Health England ( email )

61 Colindale Avenue
London, NW9 5EQ
United Kingdom

Meaghan Kall

Public Health England Colindale ( email )

61 Colindale Avenue
London, NW9 5EQ
United Kingdom

Do you have a job opening that you would like to promote on SSRN?

Paper statistics

Downloads
239
Abstract Views
2,415
rank
154,094
PlumX Metrics