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The 28-day risk of death for the B117 COVID-19 variant was 64% higher than for previously circulating strains in people over the age of 30, according to a British study.
The study, led by researchers at the University of Exeter and published today in BMJ, involved community testing and death data from 54,906 matched pairs of participants who tested positive for COVID-19 from October 1, 2020 to January 29, 2021.
Of the 109,812 total participants, 367 (0.3%) died. Of the 54,906 participants infected with B117, 227 (0.4%) died, compared with 141 (0.3%) infected with other strains.
The relative risk (HR) of death 28 days after diagnosis was 1.64 (95% confidence interval [CI], 1.32 to 2.04) for patients infected with the B117 variant, compared to previously circulating strains of SARS-CoV-2.
While the HR for death was not significantly higher in people infected with B117 until 14 days after diagnosis, it rose to 2.40 (95% CI, 1.66 to 3.47) during days 15-28. The deceased participants were older (mean age, 66.9 vs. 46.3 years) than their peers, and more were males.
“In this comparatively low risk group, this represents an increase in deaths from 2.5 to 4.1 per 1,000 cases,” the authors wrote. “The increase in the risk ratio between 1.32 and 2.04, higher than for the other variants, results in an increase in the risk of death from 32% to 104%, with the estimated risk ratio on more likely of 1.64, or an increase in the risk of death of 64%. The risk of death in this group of participants identified in the community, however, remains relatively low. “
B117 was first identified in the UK in October 2020 and quickly became dominant, triggering a nationwide lockdown and raising concerns about a possible increase in transmission and severity of the disease.
The absolute risk remains low
People diagnosed with B117 infections had a higher viral load at diagnosis than those infected with other variants, which the authors said could be attributed to a variant trait or the tendency of these participants to seek care when it was most contagious.
The researchers warned that their results may not apply to other settings and age groups, as their study only included around 8% of COVID-19 deaths in England during the period study. Only 26% of COVID deaths occurred in the community during this time, and data on B117 status was only available for 30% of those deaths. “It remains to be seen whether the increase in mortality from community testing is also observed in elderly patients or in patients admitted to hospital,” they said.
Leon Danon, MSci, MSc, PhD, lead author of the University of Bristol study, said in a press release from the University of Exeter: “We focused our analysis on cases that occurred between November 2020 and January 2021, when the old variants and a new variant was present in the UK. This allowed us to maximize the number of “matches” and reduce the impact of other biases. Subsequent analyzes confirmed our results . “
B117 is believed to be highly transmissible due to mutations in parts of the virus genome that encode the spike protein responsible for binding to human cells, but the effects of these mutations on disease severity, outcome and death rates remain uncertain. Future research, the authors said, could help better allocate vaccine resources and distribution and identify optimal times to ease public health restrictions.
“Health capacity planning and national and international control policies are all affected by this finding, with mortality increasing the weight of the argument that more coordinated and stringent measures are warranted to reduce SARS deaths- CoV-2 ”, the researchers concluded.
Danon added in the press release: “SARS-CoV-2 appears to be able to mutate rapidly, and there is real concern that other variants will emerge with rapidly deploying vaccine resistance. Watch for new variants as they arise. as they appear, measuring their characteristics and acting appropriately must be a key part of the public health response in the future. “
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