Increased risk of severe COVID-19 in hospitalized patients with SARS-CoV-2 Alpha variant infection: a multicentre matched cohort study
Authors: Martin-Blondel Guillaume , Lescure François-Xavier , Assoumou Lambert , Charpentier Charlotte , Chapplain Jean-Marc , Perpoint Thomas , Grouteau Gaspard , Cordel Hugues , Pialoux Gilles , Pacanowski Jérome , Thy Michael , Bauvois Adeline , Laureillard Didier , Hamrouni Fadia , Algarte-Genin Michèle , Poissy Julien , Descamps Diane , Costagliola Dominique ,   for the CoCliCo Study Group, Martin-Blondel Guillaume , Delobel Pierre , Grouteau Gaspard , Le Henaff Jean Roch , Mear Vincent , Lagarrigues Sandra , Frelat Alais , De Nadai Thomas , Steinmeyer Zara , Del Bello Arnaud , Ruiz Stéphanie , Sarton Benjamine , Noel-Savina Elise , Izopet Jacques , Peiffer-Smadja Nathan , Thy Michael , Gare Mathilde , Le Pluart Diane , Lescure François-Xavier , Rioux Christophe , Deconinck Laurène , Yazdanpanah Yazdan , BenoitVisseaux  , Descamps Diane , Charpentier Charlotte , Chapplain Jean-Marc , Tattevin Pierre , Perpoint Thomas , Bouscambert-Duchamp Maude , Yonis Hodane , Chabert Paul , Cordel Hugues , Mohamed-Kassim Youssouf , Hassold Nolan , Brichler Segolène , Caliez Julien , Rambaud Thomas , Lopez-Sublet Marilucy , Adnet Frédéric , Pialoux Gilles , Palacios Christia , bachir Marwa , Nadal Marine , turpin Mathieu , Parrot Antoine , Fofana Djeneba , Pacanowski Jérome , Lacombe Karine , Gras Emmanuelle , Levi Laura , Surgers Laure , Devred Ines , Valin Nadia , Chiarabini Thibault , Meynard Jean Luc , Bauvois Adeline , Duran Clara , Gault Elyanne , Kahn Jean-Emmanuel , Rouveix Elisabeth , Geri Guillaume , laureillard Didier , Sotto Albert , Loubet Paul , Roger Claire , Poissy Julien , Lambert Marc , Assaf Ady , Bocket Laurence , Bani-Sadr Firouzé , N’Guyen Yohan , Romaru Juliette , Hentzien Maxime , Gabas Thomas , Chabrol Amélie , Billiou Cecilia , Menager Philippe , Billy Christophe , Laurichesse Jean-Jacques , Simba Fabrice Ketty N. , Paz Pauline Caraux , Tinang Liliane , Bounhiol Agathe , Burnat Catherine , Soriot-Thomas Sandrine , Basille Damien , Lanoix Jean Philippe , Zerbib Yoan , Zerbib Yoann , Pouvaret Anne , Lanternier Fanny , Mascitti Helene , Dinh Aurélien , Davido Benjamin , Lesprit Philippe , Suresnes  , France  , de Biologie Clinique : Philippe Les Service , Farfour Eric , Neuville Mathilde , Allaoua Linda Nait , Lejaille Michèle , De Castro Nathalie , Molina Jean-Michel , Ponscarme Diane , Tateo Mariagrazia , Liegeon Geoffroy , Boussen Ines , Huriez Pauline , Cabié André , Campana Valentine , Calmont Isabelle , Turmel Jean-Marie , Karine Guitteaud , Sandrine Pierre-François , Marquise Athéna , Cabras Ornella , Lehoux Mélanie , Chabartier Cyrille , Dubee Vincent , Ndiaye Diama , Lefeuvre Caroline , Kouatchet Achille , Nguyen Duc , Tumiotto Camille , Sioniac Pierre , Boyer Alexandre , Faucher Jean-François , Desvaux Edouard , Rogez Sylvie , Le Turnier Paul , Raffi François , Canet Emmanuel , Roquilly Antoine , Castain Louise , Secher Solène , Mondain Véronique , Piroth Lionel , Auvray Christelle , Chavanet Pascal , Buisson Marielle , Mahy Sophie , Catherine François-Xavier , Esteve Clementine , Duong Michel , Charles Carole , Gohier Sandrine , Schaffer Céline , Robineau Olivier , Bortolotti Perrine , Pradier Maxime , Goehringer Francois , Corbel Alice , Kotzyba Jeanne , Alexandre Kévin , Beduneau Gaetan , Alessandri-Gradt Elodie , Martinot Martin , Gravier Simon , Ion Ciprian , de Lastours Victoire , Rahli Roza , Garrait Valérie , Richier Laurent , Smati-lafarge Mounira , Frémont Guillemette , Nivose Pierre Louis , André Marie Hélène , Gerin Magdalena , Hamdi Aicha , Sayre Naomi , Cossec Stephanie , Alviset Sophie , Billy Pierre Alain , Gousseff Marie , Forestier Emmanuel , Destrem Anne-Laure , Rogeaux Olivier , Bosch Alexie , Bryant Sabrina , Bourgeois Gaëlle , Dos Santos Schaller Ophélie , Carret Marie-Christine , Ettahar Nicolas , Moudjahed Haciba , Leone Nathalie , Djennaoui Mehdi , Lefebvre Nicolas , Ursenbach Axel , Danion François , Ruch Yvon , Solis Morgane , Merdji Hamid , Kassègne Loïc , Pommeret Fanny , Blameble Emeline Colomba , Manssouria Merad , Stoclin Annabelle , Griscelli Franck , Deriaz Sophie , Oziol Eric , Favier Laurent , Obiols Julien , Gicquel Pascal , Rapp Christophe , Louvet Laurence , Ihout Paul , Zabbé Jean-Benoit , Bellec Laurent , Chroboczek Tomasz , Mégessier Sandrine , Lacoste Marie , Viala Benjamin , Challan-Belval Thibaut , Wackenheim Chloé , Letertre-Gibert Paule , Grossi Olivier 
Published: June 2022

Abstract
Background
The impact of the variant of concern (VOC) Alpha on the severity of COVID-19 has been debated. We report our analysis in France.

Methods
We conducted an exposed/unexposed cohort study with retrospective data collection, comparing patients infected by VOC Alpha to contemporaneous patients infected by historical lineages. Participants were matched on age (± 2.5 years), sex and region of hospitalization. The primary endpoint was the proportion of hospitalized participants with severe COVID-19, defined as a WHO-scale > 5 or by the need of a non-rebreather mask, occurring up to day 29 after admission. We used a logistic regression model stratified on each matched pair and accounting for factors known to be associated with the severity of the disease.

Results
We included 650 pairs of patients hospitalized between Jan 1, 2021, and Feb 28, 2021, in 47 hospitals. Median age was 70 years and 61.3% of participants were male. The proportion of participants with comorbidities was high in both groups (85.0% vs 90%, p = 0.004). Infection by VOC Alpha was associated with a higher odds of severe COVID-19 (41.7% vs 38.5%—aOR = 1.33 95% CI [1.03–1.72]).

Conclusion
Infection by the VOC Alpha was associated with a higher odds of severe COVID-19.