@article{Stirrup_O-2021_100951,
title = {SARS-CoV-2 lineage B.1.1.7 is associated with greater disease severity among hospitalised women but not men: multicentre cohort study},
author = {Stirrup, O. and Boshier, F. and Venturini, C. and Guerra-Assunção, J. and Alcolea-Medina, A. and Beckett, A. and Charalampous, T. and da Silva Filipe, A. and Glaysher, S. and Khan, T. and Kulasegaran Shylini, R. and Kele, B. and Monahan, I. and Mollett, G. and Parker, M. and Pelosi, E. and Randell, P. and Roy, S. and Taylor, J. and Weller, S. and Wilson-Davies, E. and Wade, P. and Williams, R. and Copas, A. and Cutino-Moguel, M. and Freemantle, N. and Hayward, A. and Holmes, A. and Hughes, J. and Mahungu, T. and Nebbia, G. and Partridge, D. and Pope, C. and Price, J. and Robson, S. and Saeed, K. and de Silva, T. and Snell, L. and Thomson, E. and Witney, A. and Breuer, J. and COG-UK-HOCI Variant Substudy Consortium and COVID-19 Genomics UK (COG-UK) consortium},
month = {sep},
year = {2021},
abstract = {Background: SARS-CoV-2 lineage B.1.1.7 has been associated with an increased rate of transmission and disease severity among subjects testing positive in the community. Its impact on hospitalised patients is less well documented. Methods: We collected viral sequences and clinical data of patients admitted with SARS-CoV-2 and hospital-onset COVID-19 infections (HOCIs), sampled 16 November 2020 to 10 January 2021, from eight hospitals participating in the COG-UK-HOCI study. Associations between the variant and the outcomes of all-cause mortality and intensive therapy unit (ITU) admission were evaluated using mixed effects Cox models adjusted by age, sex, comorbidities, care home residence, pregnancy and ethnicity. Findings: Sequences were obtained from 2341 inpatients (HOCI cases=786) and analysis of clinical outcomes was carried out in 2147 inpatients with all data available. The HR for mortality of B.1.1.7 compared with other lineages was 1.01 (95% CI 0.79 to 1.28, p=0.94) and for ITU admission was 1.01 (95% CI 0.75 to 1.37, p=0.96). Analysis of sex-specific effects of B.1.1.7 identified increased risk of mortality (HR 1.30, 95% CI 0.95 to 1.78, p=0.096) and ITU admission (HR 1.82, 95% CI 1.15 to 2.90, p=0.011) in females infected with the variant but not males (mortality HR 0.82, 95% CI 0.61 to 1.10, p=0.177; ITU HR 0.74, 95% CI 0.52 to 1.04, p=0.086). Interpretation: In common with smaller studies of patients hospitalised with SARS-CoV-2, we did not find an overall increase in mortality or ITU admission associated with B.1.1.7 compared with other lineages. However, women with B.1.1.7 may be at an increased risk of admission to intensive care and at modestly increased risk of mortality.},
volume = {8},
journal = {BMJ Open Respiratory Research},
publisher = {BMJ Publishing Group},
url = {http://dx.doi.org/10.1136/bmjresp-2021-001029},
}
