Risk of severe outcomes among Omicron sub-lineages BA.4.6, BA.2.75, and BQ.1 compared to BA.5 in England

Risk of severe outcomes among Omicron sub-lineages BA.4.6, BA.2.75, and BQ.1 compared to BA.5 in England

Since the emergence of Omicron variant of SARS-CoV-2 in late 2021, a number of sub-lineages have arisen and circulated internationally. Little is known about the relative severity of Omicron sub-lineages BA.2.75, BA.4.6, and BQ.1. We undertook a case–control analysis to determine the clinical severi...

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Bibliographic Details
Published in:Epidemiology and infection Vol. 151; p. e189
Main Authors: Seghezzo, Giulia, Nash, Sophie G., Aziz, Nurin A., Hope, Russell, Bernal, Jamie L., Gallagher, Eileen, Dabrera, Gavin, Thelwall, Simon
Format: Journal Article
Language:English
Published: Cambridge, UK Cambridge University Press 31-10-2023
Subjects:
Age
COVID-19
COVID-19 vaccines
Emergency medical care
Emergency medical services
Ethnicity
Genomes
Hospitals
Infections
Laboratories
Medical personnel
Mutation
Original Paper
Population
Public health
Regression analysis
Severe acute respiratory syndrome coronavirus 2
Statistical analysis
United Kingdom > UK
England
COVID-19
severity
epidemiology
genomics
case-control
SARS-COV-2
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Summary:Since the emergence of Omicron variant of SARS-CoV-2 in late 2021, a number of sub-lineages have arisen and circulated internationally. Little is known about the relative severity of Omicron sub-lineages BA.2.75, BA.4.6, and BQ.1. We undertook a case–control analysis to determine the clinical severity of these lineages relative to BA.5, using whole genome sequenced, PCR-confirmed infections, between 1 August 2022 and 27 November 2022, among those who presented to emergency care in England 14 days after and up to one day prior to the positive specimen. A total of 10,375 episodes were included in the analysis; of which, 5,207 (50.2%) were admitted to the hospital or died. Multivariable conditional regression analyses found no evidence of greater odds of hospital admission or death among those with BA.2.75 (odds ratio (OR) = 0.96, 95% confidence interval (CI): 0.84–1.09) and BA.4.6 (OR = 1.02, 95% CI: 0.88– 1.17) or BQ.1 (OR = 1.03, 95% CI: 0.94–1.13) compared to BA.5. Future lineages may not follow the same trend and there remains a need for continued surveillance of COVID-19 variants and their clinical outcomes to inform the public health response.
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ISSN:0950-2688
1469-4409
DOI:10.1017/S0950268823001760