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Evaluation of clinical course of gamma (P.1) variant of concern versus lineages in hospitalized patients with covid-19 in a reference center in Brazil

Title: Evaluation of clinical course of gamma (P.1) variant of concern versus lineages in hospitalized patients with covid-19 in a reference center in Brazil
Authors: Zavascki, Alexandre Prehn; Vieceli, Tarsila; Wink, Priscila Lamb; Volpato, Fabiana Caroline Zempulski; Monteiro, Francielle Liz; Willig, Julia Biz; Ferreira, Charles Francisco; Arns, Beatriz; Costa, Guilherme Oliveira Magalhães; Niches, Matheus de Souza; Martins, Andreza Francisco; Barth, Afonso Luis
Publication Year: 2022
Collection: Universidade Federal do Rio Grande do Sul (UFRGS): Lume
Subject Terms: COVID-19; Hospitalização; SARS-CoV-2; Genoma; Estudos de coortes; Brasil
Description: The SARS-CoV-2 variant of concern (VOC) gamma (P.1) has increased transmissibility and resulted in elevated hospitalization and mortality rates in Brazil. We investigated the clinical course of COVID-19 caused by gamma and non-VOCs at a reference hospital in Brazil in a retrospective cohort study with nonelderly hospitalized patients from two periods, before and after the emergence of gamma. Cohort 1 included patients from both periods whose samples would be eligible for whole-genome sequencing (WGS). Cohort 2 was composed of randomly selected patients from Cohort 1 whose samples were submitted to WGS. A total of 433 patients composed Cohort 1: 259 from the first and 174 from the second period. Baseline characteristics were similar, except for a higher incidence of severe distress respiratory syndrome at admission in patients from the second period. Patients from the second period had significantly higher incidence rates of advanced respiratory support (adjusted hazard ratio [aHR]: 2.04; 95% confidence interval [CI], 1.60–2.59), invasive ventilatory support (aHR: 2.72; 95% CI: 2.05–3.62), and 28-day mortality from the onset of symptoms (aHR: 2.62; 95% CI: 1.46–4.72). A total of 86 (43 gamma and 43 non-gamma) patients composed Cohort 2. Patients with confirmed gamma VOC infections had higher advanced ventilatory support and mortality rates than non–gamma-infected patients. Our study suggests that non-elderly patients hospitalized for COVID-19 in the second period (used as a proxy of gamma infection) had a more severe clinical course. This might have contributed to higher hospitalization and death rates observed in the second wave in Brazil.
Document Type: article in journal/newspaper
File Description: application/pdf
Language: English
Relation: The American journal of tropical medicine and hygiene. Cleveland, Ohio. Vol. 107, no. 2 (2022), p. 245-251; https://hdl.handle.net/10183/262865; 001171584
Availability: https://hdl.handle.net/10183/262865
Rights: Open Access
Accession Number: edsbas.482D0E6E
Database: BASE