Associations Between Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Variants and Risk of Coronavirus Disease 2019 (COVID-19) Hospitalization Among Confirmed Cases in Washington State: A Retrospective Cohort Study

被引：31

作者：

Paredes, Miguel, I ^{[1
,2
]}

Lunn, Stephanie M. ^{[3
]}

Famulare, Michael ^{[4
]}

Frisbie, Lauren A. ^{[3
]}

Painter, Ian ^{[3
]}

Burstein, Roy ^{[4
]}

Roychoudhury, Pavitra ^{[2
,5
]}

Xie, Hong ^{[5
]}

Bakhash, Shah A. Mohamed ^{[5
]}

Perez, Ricardo ^{[5
]}

Lukes, Maria ^{[5
]}

Ellis, Sean ^{[5
]}

Sathees, Saraswathi ^{[5
]}

Mathias, Patrick C. ^{[5
]}

Greninger, Alexander ^{[2
,5
]}

Starita, Lea M. ^{[6
,7
]}

Frazar, Chris D. ^{[6
]}

Ryke, Erica ^{[6
]}

Zhong, Weizhi ^{[7
]}

Gamboa, Luis ^{[7
]}

Threlkeld, Machiko ^{[6
]}

Lee, Jover ^{[2
]}

McDermot, Evan ^{[7
]}

Truong, Melissa ^{[7
]}

Nickerson, Deborah A. ^{[6
,7
]}

Bates, Daniel L. ^{[8
]}

Hartman, Matthew E. ^{[8
,9
]}

Haugen, Eric ^{[8
]}

Nguyen, Truong N. ^{[8
]}

Richards, Joshua D. ^{[8
]}

Rodriguez, Jacob L. ^{[8
]}

Stamatoyannopoulos, John A. ^{[8
]}

Thorland, Eric ^{[8
]}

Melly, Geoff ^{[3
]}

Dykema, Philip E. ^{[3
]}

MacKellar, Drew C. ^{[3
]}

Gray, Hannah K. ^{[3
]}

Singh, Avi ^{[3
]}

Peterson, JohnAric M. ^{[3
]}

Russell, Denny ^{[3
]}

Torres, Laura Marcela ^{[3
]}

Lindquist, Scott ^{[3
]}

Bedford, Trevor ^{[1
,2
,6
,10
]}

Allen, Krisandra J. ^{[3
]}

Oltean, Hanna N. ^{[3
]}

机构：

[1] Univ Washington, Dept Epidemiol, Seattle, WA 98195 USA

[2] Fred Hutchinson Canc Res Ctr, Vaccine & Infect Dis Div, 1124 Columbia St, Seattle, WA 98104 USA

[3] Washington State Dept Hlth, Shoreline, WA, Australia

[4] Bill & Melinda Gates Fdn, Inst Dis Modeling, Seattle, WA USA

[5] Univ Washington, Dept Lab Med & Pathol, Seattle, WA 98195 USA

[6] Univ Washington, Dept Genome Sci, Seattle, WA 98195 USA

[7] Brotman Baty Inst Precis Med, Seattle, WA USA

[8] Altius Inst Biomed Sci, Seattle, WA USA

[9] Swedish Med Ctr, Dept Cardiovasc Serv, Seattle, WA USA

[10] Howard Hughes Med Inst, Seattle, WA USA

来源：

CLINICAL INFECTIOUS DISEASES | 2022年 / 75卷 / 01期

基金：

美国国家卫生研究院;

关键词：

COVID-19; SARS-CoV-2; variants; hospitalization; vaccination;

D O I：

10.1093/cid/ciac279

中图分类号：

R392 [医学免疫学]; Q939.91 [免疫学];

学科分类号：

100102 ;

摘要：

Background The coronavirus disease 2019 (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 7 severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants. Methods Our study includes individuals with positive SARS-CoV-2 reverse transcription polymerase chain reaction (RT-PCR) in the Washington Disease Reporting System with available viral genome data, from 1 December 2020 to 14 January 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. Results In total, 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% confidence interval [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 .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. Conclusions 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 severe acute respiratory syndrome coronavirus 2 (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.

引用

页码：E536 / E544

页数：9

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