Research finds variant more lethal as well as more contagious; it’s the predominant strain in Israel
New research announced on Wednesday showed that the UK coronavirus variant now predominant in Israel may be twice as deadly as other variants circulating in the UK, underscoring concerns about how mutations may change the characteristics of the disease.
The study, published in the British Medical Journal and carried out by epidemiologists at the British universities of Bristol and Exeter, found that the strain first found in Kent is between 32 percent and 104% more deadly.
The research showed that this UK variant led to 227 deaths in a sample group of 54,906 patients, which was compared with a closely matched cohort of patients who had other strains. The second group saw 141 deaths.
Participants were all aged 30 or over, and were matched on the basis of age, sex, ethnicity, index of multiple deprivation, local authority region and the date they were diagnosed, differing only in the strain of the virus they had contracted.
A patient is wheeled on a trolley after arriving in an ambulance outside the Royal London Hospital in east London, Feb. 4, 2021 (AP Photo/Matt Dunham)
The study also found that the viral load appeared to be higher for the variant, which could increase disease severity as well as making it easier to contract.
“In the community, death from COVID-19 is still a rare event, but the B117 variant raises the risk,” said the study’s lead author, Robert Challen from the University of Exeter.
The variant is already known to be more contagious than other strains, and its spread in Israel has coincided with an uptick in serious cases among younger people, including pregnant women.
Last month UK government research found the variant could be up to 70% more deadly than previously known strains.
The findings from the New and Emerging Respiratory Virus Threats Advisory Group, published on the government’s website, build on preliminary research released January 21. The group includes experts from universities and public agencies across the UK.
That report was based on analysis of a dozen studies that found the so-called Kent variant is likely 30% to 70% more deadly than other variants. The studies compared hospitalization and death rates among people infected with the variant and those infected with other variants.
The study was released as the UK continued its successful vaccine rollout. Britain has now given about 35% of its adult population at least one vaccine shot.
SOURCE: timesofisrael.com/uk-study-...
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Conclusions
The variant of concern, in addition to being more transmissible, seems to be more lethal. We expect this to be associated with changes in its phenotypic properties because of multiple genetic mutations,27 and we see no reason why this finding would be specific to the UK. This development, borne out in epidemiological analyses, implies that the rate of patients with serious infection requiring hospital attention will increase. At the time of writing (15 February 2021) the national lockdown appears to be effective at reducing the transmission rate of SARS-CoV-2 in the UK, but proliferation of the new variant has made it more difficult to control the covid-19 outbreak. The resulting number of deaths will scale linearly with the proportion of people infected with the new variant. Other analyses have indicated that the new variant is also associated with increased transmissibility, which would lead to a potentially exponential increase in the resulting number of deaths.12 Clinicians at the front line should be aware that a higher mortality rate is likely even if quality of practice remains unchanged. This has broader implications for any vaccination allocation policy designed to reduce mortality in the late middle age groups, typical of the community identified patients in this dataset.
The question remains whether excess mortality due to VOC-202012/1 will be observed in other population groups, particularly elderly people, care home residents, and those with other comorbidities who generally present directly to hospital as an emergency. Hospital based studies require a mechanism to distinguish emerging variants from previously circulating variants, currently only done through genotyping. Owing to the effort involved, the proportion of genotyped samples representing patients admitted to hospital remains low, and we recommend that PCR tests that specifically target VOC-202012/1 mutations should be more widely used.
Moreover, the emergence of VOC-202012/1 and its mutations (including E484K), combined with other variants of concern, including those identified in Brazil and South Africa,28 highlights the capacity of SARS-CoV-2 to rapidly evolve new phenotypic variants, with mutants that evade vaccines being a real possibility.29 Our study has helped to characterise the clinical presentation and outcome of one new variant, but given sufficient amounts of informative data our findings can be generalisable to other variants. Assessment of the clinical outcomes of multiple circulating phenotypic variants, however, requires scalable technology that is capable of identifying substantial numbers of patients infected with emerging variants (eg, broad PCR assay panels targeting variant foci30) and robust collection of outcome data.
In this study we controlled for the effect of time, geographical location, age, sex, ethnicity, and deprivation, but these are important factors to understand if future outcomes are to improve. Future work on the relative impact of these might allow for better targeting of resource allocation,31 vaccine distribution strategies, and relaxation of restrictions.
What is already known on this topic
The SARS-CoV-2 variant of concern 202012/1, first detected in the south east of England in autumn 2020, is more transmissible than previously circulating variants
The emergence of this variant coincided with high hospital occupancy, which is known to increase mortality
Before this study, unbiased estimates of the mortality of the variant of concern were not available
Individuals infected with the variant of concern, identified at UK community test centres, were between 32% and 104% (central estimate 64%) more likely to die than equivalent individuals infected with previously circulating variants
The absolute risk of death in this largely unvaccinated population remains low, but clinicians and public health officials should be aware that a higher mortality rate is likely even if practice remains unchanged.
See also: independent.co.uk/news/heal...
Research suggests the Pfizer jab is just as effective against the Kent variant of coronavirus, while other data indicates the Oxford/AstraZeneca jab has a similar efficacy against it.
