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Several SARS-CoV-2 variants that evolved during the COVID-19 pandemic haveappeared to differ in severity, based on analyses of single-country datasets.With decreased SARS-CoV-2 testing and sequencing, international collaborativestudies will become increasingly important for timely assessment of theseverity of newly emerged variants. The Joint WHO Regional Office for Europeand ECDC Infection Severity Working Group was formed to produce and pilot astandardised study protocol to estimate relative variant case-severity insettings with individual-level SARS-CoV-2 testing and COVID-19 outcome dataduring periods when two variants were co-circulating. To assess feasibility,the study protocol and its associated statistical analysis code was applied bylocal investigators in Denmark, England, Luxembourg, Norway, Portugal andScotland to assess the case-severity of Omicron BA.1 relative to Delta cases.After pooling estimates using meta-analysis methods (random effects estimates),the risk of hospital admission (adjusted hazard ratio [aHR]=0.41, 95% CI0.31-0.54), ICU admission (aHR=0.12, 95% CI 0.05-0.27), and death (aHR=0.31,95% CI 0.28-0.35) was lower for Omicron BA.1 compared to Delta cases. The aHRsvaried by age group and vaccination status. In conclusion, this study hasdemonstrated the feasibility of conducting variant severity analyses in amultinational collaborative framework. The results add further evidence for thereduced severity of the Omicron BA.1 variant.

euro surveillance/eurosurveillance

A standardised protocol for assessment of relative SARS-CoV-2 variant  severity, with application to severity risk for COVID-19 cases infected with  Omicron BA.1 compared to Delta variants in six European countries