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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
Author(s) -
Miguel I. Paredes,
Stephanie M. Lunn,
Michael Famulare,
Lauren Frisbie,
Ian Painter,
Roy Burstein,
Pavitra Roychoudhury,
Hong Xie,
Shah A. Mohamed Bakhash,
Ricardo Perez,
Maria E Lukes,
Sean Ellis,
Saraswathi Sathees,
Patrick C. Mathias,
Alexander L. Greninger,
Lea M. Starita,
Chris Frazar,
Erica Ryke,
Weizhi Zhong,
Luis Fernando Gamboa,
Machiko Threlkeld,
Jover Lee,
Evan McDermot,
Melissa Truong,
Deborah A. Nickerson,
Daniel Bates,
Matthew E. Hartman,
Eric Haugen,
Truong N. Nguyen,
Joshua D. Richards,
Jacob L. Rodriguez,
J Stamatoyannopoulos,
Eric Thorland,
Geoff Melly,
Philip Dykema,
Drew MacKellar,
Hannah K. Gray,
Avi Singh,
JohnAric M. Peterson,
Denny Russell,
Laura Marcela Torres,
Scott Lindquist,
Trevor Bedford,
Krisandra Allen,
Han. Oltean
Publication year - 2022
Publication title -
clinical infectious diseases
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.44
H-Index - 336
eISSN - 1537-6591
pISSN - 1058-4838
DOI - 10.1093/cid/ciac279
Subject(s) - medicine , hazard ratio , retrospective cohort study , coronavirus , confidence interval , cohort , pandemic , proportional hazards model , cohort study , disease , covid-19 , infectious disease (medical specialty)
Background The 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 seven SARS-CoV-2 variants. Methods Our study includes individuals with positive SARS-CoV-2 RT-PCR in the Washington Disease Reporting System with available viral genome data, from December 1, 2020 to January 14, 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. Findings 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%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 0.56-1.52) 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. Conclusion 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.

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