OBJECTIVE : To evaluate the association between coronavirus disease 2019 (COVID-19) diagnosis with SARS-CoV-2 variant B.1.1.7 (also known as Variant of Concern 202012/01) and the risk of hospitalisation compared to diagnosis with wildtype SARS-CoV-2 variants. DESIGN : Retrospective cohort, analysed using a matched nested case-control study design. SETTING : Community-based SARS-CoV-2 testing in England, individually linked with hospitalisation data from the Secondary Uses Service and the Emergency Care Data Set. PARTICIPANTS: 493,053 laboratory-confirmed COVID-19 patients, of whom 19,482 had been hospitalised  , tested between 23 November 2020 and 4 January 2021 and analysed at a laboratory with an available TaqPath assay that enables assessment of S-gene target failure (SGTF). SGTF is a proxy test for the B.1.1.7 variant. Nested case-control analysis of 18,814 pairs of hospitalised/non-hospitalised patients, one-to-one matched on age, sex, ethnicity, deprivation, region of residence, and date of positive test (matches found for 96.6\%). MAIN OUTCOME MEASURES : Hospitalisation between 1 and 14 days after the first positive SARS-CoV-2 test. RESULTS: The matching-adjusted conditional odds ratio of  hospitalisation was 1.58 (95\% confidence interval 1.50 to 1.67  ) for COVID-19 patients infected with a SGTF-associated variant , compared to those infected with non-SGTF-associated variants. Secondary cohort analyses yielded similar estimates. The effect was modified by age (p<0.001), with ORs of 0.96-1.13 below age 20 years and 1.57-1.67 in age groups 40 years or older. CONCLUSIONS : The results suggest that the risk of hospitalisation is higher for individuals infected with the B.1.1.7 variant compared to wildtype SARS-CoV-2, likely reflecting a more severe disease. The higher severity may be specific to older age groups.
Objective : To evaluate the relationship between coronavirus disease 2019 (COVID-19) diagnosis with SARS-CoV-2 variant B.1.1.7 (also known as Variant of Concern 202012/01) and the risk of hospitalisation compared to diagnosis with wildtype SARS-CoV-2 variants. Design : Retrospective cohort, analysed using stratified Cox regression. Setting : Community-based SARS-CoV-2 testing in England, individually linked with hospitalisation data from the Secondary Uses Service and the Emergency Care Data Set. Participants: 839,278 laboratory-confirmed COVID-19 patients, of whom 36,233 had been hospitalised within 14 days , tested between 23rd November 2020 and 31st January 2021 and analysed at a laboratory with an available TaqPath assay that enables assessment of S-gene target failure (SGTF). SGTF is a proxy test for the B.1.1.7 variant. Patient data were stratified by age, sex, ethnicity, deprivation, region of residence, and date of positive test . Main Outcome Measures : Hospitalisation between 1 and 14 days after the first positive SARS-CoV-2 test. Results: In total, 27,710 of 592,409 SGTF patients (4.7\%) and 8,523 of 246,869 non-SGTF patients (3.5\%) had been hospitalised within 1-14 days. The stratum-adjusted hazard ratio (HR) of hospitalisation was 1.52 (95\% confidence interval CI 1.47 to 1.57 ) for COVID-19 patients infected with SGTF variants , compared to those infected with non-SGTF variants. The effect was modified by age (p<0.001), with HRs of 0.93-1.21 for SGTF compared to non-SGTF patients below age 20 years , 1.29 in those aged 20-29, and 1.45-1.65 in age groups 30 years or older. Conclusions : The results suggest that the risk of hospitalisation is higher for individuals infected with the B.1.1.7 variant compared to wildtype SARS-CoV-2, likely reflecting a more severe disease. The higher severity may be specific to adults above the age of 30.
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OBJECTIVE
Objective
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association
relationship
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DESIGN
Design
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a matched nested case-control study design. SETTING
stratified Cox regression. Setting
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PARTICIPANTS: 493,053
Participants: 839,278
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19,482
36,233
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within 14 days
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23
23rd
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4
31st
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Nested case-control analysis of 18,814 pairs of hospitalised/non-hospitalised patients, one-to-one matched on
Patient data were stratified by
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(matches found for 96.6\%). MAIN OUTCOME MEASURES
. Main Outcome Measures
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RESULTS: The matching-adjusted conditional odds ratio
Results: In total, 27,710
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592,409 SGTF patients (4.7\%) and 8,523 of 246,869 non-SGTF patients (3.5\%) had been hospitalised within 1-14 days. The stratum-adjusted hazard ratio (HR) of
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1.58
1.52
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1.50 to 1.67
CI
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1.47 to 1.57
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a SGTF-associated variant
SGTF variants
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non-SGTF-associated variants. Secondary cohort analyses yielded similar estimates.
non-SGTF variants.
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ORs of 0.96-1.13
HRs of 0.93-1.21 for SGTF compared to non-SGTF patients
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and 1.57-1.67
, 1.29 in those aged 20-29, and 1.45-1.65
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40
30
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CONCLUSIONS
Conclusions
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older age groups.
adults above the age of 30.