SARS-CoV-2 variant of concern P.1 (Gamma) infection in young and middle-aged patients admitted to the intensive care units of a single hospital in Salvador, Northeast Brazil, February 2021

•A second COVID-19 wave accelerated after the emergence of the P.1 lineage (Gamma).•An increased percentage of younger patients needed intensive care during the second wave.•More COVID-19 patients without comorbidities entered the ICU in February 2021.•A high prevalence of Gamma was found in younger...

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Published in:	International journal of infectious diseases Vol. 111; pp. 47 - 54
Main Authors:	Nonaka, Carolina Kymie Vasques, Gräf, Tiago, Barcia, Camila Araújo de Lorenzo, Costa, Vanessa Ferreira, de Oliveira, Janderson Lopes, Passos, Rogério da Hora, Bastos, Iasmin Nogueira, de Santana, Maria Clara Brito, Santos, Ian Marinho, de Sousa, Karoline Almeida Felix, Weber, Thamires Gomes Lopes, Siqueira, Isadora Cristina de, Rocha, Clarissa Araújo Gurgel, Mendes, Ana Verena Almeida, Souza, Bruno Solano de Freitas
Format:	Journal Article
Language:	English
Published:	Canada Elsevier Ltd 01-10-2021 The Author(s). Published by Elsevier Ltd on behalf of International Society for Infectious Diseases Elsevier
Subjects:	Adult Brazil - epidemiology COVID-19 COVID-19 - epidemiology COVID-19 - virology Gamma Hospitals Humans Intensive Care Units Middle Aged P.1 SARS-CoV-2 Variants of concern Brazil COVID-19 Gamma Variants of concern SARS-CoV-2 P.1
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Summary:	•A second COVID-19 wave accelerated after the emergence of the P.1 lineage (Gamma).•An increased percentage of younger patients needed intensive care during the second wave.•More COVID-19 patients without comorbidities entered the ICU in February 2021.•A high prevalence of Gamma was found in younger ICU patients in February 2021. To evaluate changes in the characteristics of patients with coronavirus disease 2019 (COVID-19) after the emergence of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variant of concern (VOC) P.1 (Gamma), by comparing the clinical, demographic, and laboratory profiles of patients hospitalized during the first (May to July 2020) and second (December 2020 to February 2021) pandemic waves. Data were collected from the records of COVID-19 patients (n = 4164) admitted to a single hospital in Salvador, Northeast Brazil. SARS-CoV-2 genome sequencing was performed on nasopharyngeal swab samples from 12 patients aged <60 years admitted to the intensive care unit (ICU) in February 2021. Between June 2020 and February 2021, the median age of patients admitted to the ICU decreased from 66 to 58 years (P < 0.05). This was accompanied by an increased proportion of patients without comorbidities (15.32% vs 32.20%, P < 0.0001). A significant reduction in the cycle threshold values of SARS-CoV-2 RT-PCR tests was observed in the second wave (P < 0.0001). Sequencing analysis detected lineage Gamma in all 12 ICU patients sampled in February 2021. The results of this study demonstrated an increased proportion of younger adults without comorbidities with severe disease during the second COVID-19 wave, shortly after the confirmation of local Gamma circulation.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	1201-9712 1878-3511 1878-3511
DOI:	10.1016/j.ijid.2021.08.003