Associations between SARS-CoV-2 variants and risk of COVID-19 hospitalization among confirmed cases in Washington State: a retrospective cohort study
Miguel I. Paredes,
Lauren A. Frisbie,
Shah A Mohamed Bakhash,
Patrick C Mathias,
Lea M Starita,
Chris D. Frazar,
Deborah A. Nickerson,
Daniel L. Bates,
Matthew E. Hartman,
Truong N Nguyen,
Joshua D. Richards,
Jacob L Rodriguez,
Philip E. Dykema,
Drew C. MacKellar,
Hannah K. Gray,
JohnAric MoonDance Peterson,
Laura Marcela Torres,
Krisandra J. Allen,
Hanna N. Oltean
Posted 30 Sep 2021
medRxiv DOI: 10.1101/2021.09.29.21264272
Posted 30 Sep 2021
Background: The COVID-19 pandemic is now dominated by variant lineages; the resulting impact on disease severity remains unclear. Using a retrospective cohort study, we assessed the risk of hospitalization following infection with nine variants of concern or interest (VOC/VOI). Methods: Our study includes individuals with positive SARS-CoV-2 RT PCR in the Washington Disease Reporting System and with available viral genome data, from December 1, 2020 to July 30, 2021. The main 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 the risk of hospitalization following infection with a VOC/VOI, adjusting for age, sex, and vaccination status. Findings: Of the 23,563 cases, 22,068 (93.7%) were sequenced through sentinel surveillance, of which 582 (2.6%) were hospitalized due to COVID-19. Higher hospitalization risk was found for infections with Gamma (HR 3.23, 95% CI 2.19-4.76), Beta (HR 3.03, 95% CI 1.68-5.47), Delta (HR 2.35, 95% CI 1.7-3.22), and Alpha (HR 1.61, 95% CI 1.28-2.03) compared to infections with an ancestral lineage. Following VOC infection, unvaccinated patients show a similar higher hospitalization risk, while vaccinated patients show no significant difference in risk, both when compared to unvaccinated, ancestral lineage cases. Interpretation: Infection with a VOC results in a higher hospitalization risk, with an active vaccination attenuating that risk. Our findings support promoting hospital preparedness, vaccination, and robust genomic surveillance.
- Downloaded 1,910 times
- Download rankings, all-time:
- Site-wide: 11,208
- In infectious diseases: 1,621
- Year to date:
- Site-wide: 1,795
- Since beginning of last month:
- Site-wide: 1,435
Downloads over time
Distribution of downloads per paper, site-wide
- 27 Nov 2020: The website and API now include results pulled from medRxiv as well as bioRxiv.
- 18 Dec 2019: We're pleased to announce PanLingua, a new tool that enables you to search for machine-translated bioRxiv preprints using more than 100 different languages.
- 21 May 2019: PLOS Biology has published a community page about Rxivist.org and its design.
- 10 May 2019: The paper analyzing the Rxivist dataset has been published at eLife.
- 1 Mar 2019: We now have summary statistics about bioRxiv downloads and submissions.
- 8 Feb 2019: Data from Altmetric is now available on the Rxivist details page for every preprint. Look for the "donut" under the download metrics.
- 30 Jan 2019: preLights has featured the Rxivist preprint and written about our findings.
- 22 Jan 2019: Nature just published an article about Rxivist and our data.
- 13 Jan 2019: The Rxivist preprint is live!