The SARS-CoV-2 Alpha variant was associated with increased clinical severity of COVID-19 in Scotland: A genomics-based retrospective cohort analysis

Pascall, David J., Vink, Elen, Blacow, Rachel, Bulteel, Naomi, Campbell, Alasdair, Campbell, Robyn, Clifford, Sarah, Davis, Chris, Filipe, Ana da Silva, Sakka, Noha El, Fjodorova, Ludmila, Forrest, Ruth, Goldstein, Emily, Gunson, Rory, Haughney, John, Holden, Matthew T. G., Honour, Patrick, Hughes, Joseph, James, Edward, Lewis, Tim, Lycett, Samantha, MacLean, Oscar, McHugh, Martin, Mollett, Guy, Onishi, Yusuke, Parcell, Ben, Ray, Surajit, Robertson, David L., Shabaan, Sharif, Shepherd, James G., Smollett, Katherine, Templeton, Kate, Wastnedge, Elizabeth, Wilkie, Craig, Williams, Thomas and Thomson, Emma C. and The COVID-19 Genomics UK (COG-UK) Consortium (2023) The SARS-CoV-2 Alpha variant was associated with increased clinical severity of COVID-19 in Scotland: A genomics-based retrospective cohort analysis. PLoS One, 18 (4). ISSN 1932-6203

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Abstract

Objectives: 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. Methods: 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. Results: 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). Conclusions: The Alpha variant was associated with more severe clinical disease in the Scottish population than co-circulating lineages.

Item Type: Article
Additional Information: Data Availability: Data cannot be shared publicly due to ethical constraints on data sharing because it contains sensitive patient data. As such, full data cannot be removed from the NHS GG&C SafeHaven, a trusted research environment without appropriate permissions. Aggregated data are available in the supplementary materials. The Safe Haven can be contacted for data access requests safehaven@ggc.scot.nhs.uk. Funding: COG-UK is supported by funding from the Medical Research Council (MRC) part of UK Research & Innovation (UKRI), the National Institute of Health Research (NIHR) and Genome Research Limited, operating as the Wellcome Sanger Institute. Funding was also provided by UKRI through the JUNIPER consortium (MR/V038613/1). Sequencing, bioinformatics and statistical support was funded by the Medical Research Council (MRC) core awards for the MRC-University of Glasgow Centre for Virus Research (MC UU 1201412) and MRC Biostatistics Unit (MC UU 00002/11). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Faculty \ School: Faculty of Medicine and Health Sciences > Norwich Medical School
UEA Research Groups: Faculty of Medicine and Health Sciences > Research Centres > Metabolic Health
Faculty of Medicine and Health Sciences > Research Centres > Norwich Institute for Healthy Aging
Faculty of Medicine and Health Sciences > Research Groups > Musculoskeletal Medicine
Faculty of Medicine and Health Sciences > Research Groups > Nutrition and Preventive Medicine
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Depositing User: LivePure Connector
Date Deposited: 01 Nov 2024 11:30
Last Modified: 16 Dec 2024 01:43
URI: https://ueaeprints.uea.ac.uk/id/eprint/97412
DOI: 10.1371/journal.pone.0284187

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