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Objective: To evaluate the relationship between coronavirus disease 2019(COVID-19) diagnosis with SARS-CoV-2 variant B.1.1.7 (also known as Variant ofConcern 202012/01) and the risk of hospitalisation compared to diagnosis withwildtype SARS-CoV-2 variants.  Design: Retrospective cohort, analysed using stratified Cox regression.  Setting: Community-based SARS-CoV-2 testing in England, individually linkedwith hospitalisation data.  Participants: 839,278 laboratory-confirmed COVID-19 patients, of whom 36,233had been hospitalised within 14 days, tested between 23rd November 2020 and31st January 2021 and analysed at a laboratory with an available TaqPath assaythat enables assessment of S-gene target failure (SGTF). SGTF is a proxy testfor the B.1.1.7 variant. Patient data were stratified by age, sex, ethnicity,deprivation, region of residence, and date of positive test.  Main outcome measures: Hospitalisation between 1 and 14 days after the firstpositive SARS-CoV-2 test.  Results: 27,710 of 592,409 SGTF patients (4.7%) and 8,523 of 246,869 non-SGTFpatients (3.5%) had been hospitalised within 1-14 days. The stratum-adjustedhazard ratio (HR) of hospitalisation was 1.52 (95% confidence interval [CI]1.47 to 1.57) for COVID-19 patients infected with SGTF variants, compared tothose infected with non-SGTF variants. The effect was modified by age(P<0.001), with HRs of 0.93-1.21 for SGTF compared to non-SGTF patients belowage 20 years, 1.29 in those aged 20-29, and 1.45-1.65 in age groups 30 years orolder.  Conclusions: The results suggest that the risk of hospitalisation is higherfor individuals infected with the B.1.1.7 variant compared to wildtypeSARS-CoV-2, likely reflecting a more severe disease. The higher severity may bespecific to adults above the age of 30.

Hospitalisation risk for COVID-19 patients infected with SARS-CoV-2 variant B.1.1.7: cohort analysis