@article{e8dd402a720b450f8b7bd7056fa23a40,
title = "The SARS-CoV-2 Alpha variant was associated with increased clinical severity of COVID-19 in Scotland: A genomics-based retrospective cohort analysis",
abstract = "OBJECTIVES: The SARS-CoV-2 Alpha variant was associated with increased transmission relative to other variants present at the time of its emergence and several studies have shown an association between Alpha variant infection and increased hospitalisation and 28-day mortality. However, none have addressed the impact on maximum severity of illness in the general population classified by the level of respiratory support required, or death. We aimed to do this.METHODS: In this retrospective multi-centre clinical cohort sub-study of the COG-UK consortium, 1475 samples from Scottish hospitalised and community cases collected between 1st November 2020 and 30th January 2021 were sequenced. We matched sequence data to clinical outcomes as the Alpha variant became dominant in Scotland and modelled the association between Alpha variant infection and severe disease using a 4-point scale of maximum severity by 28 days: 1. no respiratory support, 2. supplemental oxygen, 3. ventilation and 4. death.RESULTS: Our cumulative generalised linear mixed model analyses found evidence (cumulative odds ratio: 1.40, 95% CI: 1.02, 1.93) of a positive association between increased clinical severity and lineage (Alpha variant versus pre-Alpha variants).CONCLUSIONS: The Alpha variant was associated with more severe clinical disease in the Scottish population than co-circulating lineages.",
keywords = "Humans, SARS-CoV-2/genetics, COVID-19, Retrospective Studies, Scotland/epidemiology, Genomics",
author = "{The COVID-19 Genomics UK (COG-UK) Consortium} and Pascall, {David J} and Elen Vink and Rachel Blacow and Naomi Bulteel and Alasdair Campbell and Robyn Campbell and Sarah Clifford and Chris Davis and {da Silva Filipe}, Ana and {El Sakka}, Noha and Ludmila Fjodorova and Ruth Forrest and Emily Goldstein and Rory Gunson and John Haughney and Holden, {Matthew T G} and Patrick Honour and Joseph Hughes and Edward James and Tim Lewis and Samantha Lycett and Oscar MacLean and Martin McHugh and Guy Mollett and Yusuke Onishi and Ben Parcell and Surajit Ray and Robertson, {David L} and Sharif Shabaan and Shepherd, {James G} and Katherine Smollett and Kate Templeton and Elizabeth Wastnedge and Craig Wilkie and Thomas Williams and Thomson, {Emma C} and Matthew Bashton and Darren Smith and Andrew Nelson and Young, {Gregory R.}",
note = "Matthew Bashton, Andrew Nelson, Clare McCann, Greg Young and Darren Smith are members of the COVID-19 Genomics UK consortium. COG-UK is supported by funding from the Medical Research Council (MRC) part of UK Research & Innovation (UKRI), the National Institute of Health Research (NIHR) and Genome Research Limited, operating as the Wellcome Sanger Institute. Funding was also provided by UKRI through the JUNIPER consortium (MR/V038613/1). Sequencing, bioinformatics and statistical support was funded by the Medical Research Council (MRC) core awards for the MRC-University of Glasgow Centre for Virus Research (MC UU 1201412) and MRC Biostatistics Unit (MC UU 00002/11).",
year = "2023",
month = apr,
day = "13",
doi = "10.1371/journal.pone.0284187",
language = "English",
volume = "18",
journal = "PLoS One",
issn = "1932-6203",
publisher = "Public Library of Science",
number = "4",
}