Hospitalisation and mortality risk of SARS-COV-2 variant omicron sub-lineage BA.2 compared to BA.1 in England

H. H. Webster; T. Nyberg; M. A. Sinnathamby; N. Abdul Aziz; N. Ferguson; G. Seghezzo; P. B. Blomquist; J. Bridgen; M. Chand; N. Groves; R. Myers; R. Hope; E. Ashano; J. Lopez-Bernal; D. De Angelis; G. Dabrera; A. M. Presanis; S. Thelwall

doi:10.1038/s41467-022-33740-9

Hospitalisation and mortality risk of SARS-COV-2 variant omicron sub-lineage BA.2 compared to BA.1 in England

H. H. Webster, T. Nyberg, M. A. Sinnathamby, N. Abdul Aziz, N. Ferguson, G. Seghezzo, P. B. Blomquist, J. Bridgen, M. Chand, N. Groves, R. Myers, R. Hope, E. Ashano, J. Lopez-Bernal, D. De Angelis, G. Dabrera, A. M. Presanis, S. Thelwall^*

^*Corresponding author for this work

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Abstract

The Omicron variant of SARS-CoV-2 became the globally dominant variant in early 2022. A sub-lineage of the Omicron variant (BA.2) was identified in England in January 2022. Here, we investigated hospitalisation and mortality risks of COVID-19 cases with the Omicron sub-lineage BA.2 (n = 258,875) compared to BA.1 (n = 984,337) in a large cohort study in England. We estimated the risk of hospital attendance, hospital admission or death using multivariable stratified proportional hazards regression models. After adjustment for confounders, BA.2 cases had lower or similar risks of death (HR = 0.80, 95% CI 0.71–0.90), hospital admission (HR = 0.88, 95% CI 0.83–0.94) and any hospital attendance (HR = 0.98, 95% CI 0.95–1.01). These findings that the risk of severe outcomes following infection with BA.2 SARS-CoV-2 was slightly lower or equivalent to the BA.1 sub-lineage can inform public health strategies in countries where BA.2 is spreading.

Original language	English
Article number	6053
Journal	Nature Communications
Volume	13
Issue number	1
DOIs	https://doi.org/10.1038/s41467-022-33740-9
Publication status	Published - 13 Oct 2022

Bibliographical note

Funding Information: We would like to acknowledge the efforts of multiple teams in enabling the severity assessment of this SARS-CoV-2 variant. We would like to thank the UKHSA Second Generation Surveillance System, DataLake and Datastore teams for maintaining the databases in which the data are stored. We thank NHS Digital and Hospital-onset COVID team at UKHSA for enabling surveillance of hospitalisation. We also thank colleagues for maintaining COVID-19 vaccination surveillance at the National Immunisation Management service, Julia Stowe and Freya Kirsebom (UKHSA, Immunisation and Vaccine Preventable Diseases Division) and colleagues for helpful discussions surrounding hospitalisation surveillance, and Andre Charlett (UKHSA Statistics, Modelling and Economics division) for his ongoing work overseeing the UKHSA COVID-19 data streams. This work was supported by UK Research and Innovation (UKRI) Medical Research Council (MRC) (NMF: Centre for Global Infectious Disease Analysis [MR/R015600/1]; DDA, AMP: [Unit Programme number MC/UU/00002/11]); UKRI MRC/Department of Health and Social Care (DHSC) National Institute for Health and Care Research (NIHR) COVID-19 rapid response call (TN, DDA, AMP: [MC/PC/19074]; NMF: [MR/V038109/1]); NIHR Health Protection Units in: Modelling and Health Economics (NMF), and Behavioural Science and Evaluation (DDA); philanthropic funding from Community Jameel (NMF); and the WHO Regional Office for Europe (TN, DDA, AMP). The funders played no direct role in the study. The views expressed are those of the authors and not necessarily those of the NIHR or the DHSC.
N.M.F. sits on a number of UK government and World Health Organization groups providing scientific advice relating to SARS-CoV-2. G.D. declares that his employer UK Health Security Agency (previously operating as Public Health England) received funding from GlaxoSmithKline for a research project related to influenza antiviral treatment. This preceded and had no relation to COVID-19, and G.D. had no role in and received no funding from the project. D.D.A. sits on two UK government groups providing scientific advice relating to SARS-CoV-2 (Scientific Pandemic Influenza Group on Modelling [SPI-M] and UKHSA’s Variant Technical Group [VTG]). The remaining authors declare no competing interests.

Open Access: This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.

Publisher Copyright: © Crown 2022

Citation: Webster, H.H., Nyberg, T., Sinnathamby, M.A. et al. Hospitalisation and mortality risk of SARS-COV-2 variant omicron sub-lineage BA.2 compared to BA.1 in England. Nat Commun 13, 6053 (2022). https://doi.org/10.1038/s41467-022-33740-9

DOI: https://doi.org/10.1038/s41467-022-33740-9

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Cite this

Webster, H. H., Nyberg, T., Sinnathamby, M. A., Aziz, N. A., Ferguson, N., Seghezzo, G., Blomquist, P. B., Bridgen, J., Chand, M., Groves, N., Myers, R., Hope, R., Ashano, E., Lopez-Bernal, J., De Angelis, D., Dabrera, G., Presanis, A. M., & Thelwall, S. (2022). Hospitalisation and mortality risk of SARS-COV-2 variant omicron sub-lineage BA.2 compared to BA.1 in England. Nature Communications, 13(1), Article 6053. https://doi.org/10.1038/s41467-022-33740-9

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abstract = "The Omicron variant of SARS-CoV-2 became the globally dominant variant in early 2022. A sub-lineage of the Omicron variant (BA.2) was identified in England in January 2022. Here, we investigated hospitalisation and mortality risks of COVID-19 cases with the Omicron sub-lineage BA.2 (n = 258,875) compared to BA.1 (n = 984,337) in a large cohort study in England. We estimated the risk of hospital attendance, hospital admission or death using multivariable stratified proportional hazards regression models. After adjustment for confounders, BA.2 cases had lower or similar risks of death (HR = 0.80, 95\% CI 0.71–0.90), hospital admission (HR = 0.88, 95\% CI 0.83–0.94) and any hospital attendance (HR = 0.98, 95\% CI 0.95–1.01). These findings that the risk of severe outcomes following infection with BA.2 SARS-CoV-2 was slightly lower or equivalent to the BA.1 sub-lineage can inform public health strategies in countries where BA.2 is spreading.",

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note = "Funding Information: We would like to acknowledge the efforts of multiple teams in enabling the severity assessment of this SARS-CoV-2 variant. We would like to thank the UKHSA Second Generation Surveillance System, DataLake and Datastore teams for maintaining the databases in which the data are stored. We thank NHS Digital and Hospital-onset COVID team at UKHSA for enabling surveillance of hospitalisation. We also thank colleagues for maintaining COVID-19 vaccination surveillance at the National Immunisation Management service, Julia Stowe and Freya Kirsebom (UKHSA, Immunisation and Vaccine Preventable Diseases Division) and colleagues for helpful discussions surrounding hospitalisation surveillance, and Andre Charlett (UKHSA Statistics, Modelling and Economics division) for his ongoing work overseeing the UKHSA COVID-19 data streams. This work was supported by UK Research and Innovation (UKRI) Medical Research Council (MRC) (NMF: Centre for Global Infectious Disease Analysis [MR/R015600/1]; DDA, AMP: [Unit Programme number MC/UU/00002/11]); UKRI MRC/Department of Health and Social Care (DHSC) National Institute for Health and Care Research (NIHR) COVID-19 rapid response call (TN, DDA, AMP: [MC/PC/19074]; NMF: [MR/V038109/1]); NIHR Health Protection Units in: Modelling and Health Economics (NMF), and Behavioural Science and Evaluation (DDA); philanthropic funding from Community Jameel (NMF); and the WHO Regional Office for Europe (TN, DDA, AMP). The funders played no direct role in the study. The views expressed are those of the authors and not necessarily those of the NIHR or the DHSC. N.M.F. sits on a number of UK government and World Health Organization groups providing scientific advice relating to SARS-CoV-2. G.D. declares that his employer UK Health Security Agency (previously operating as Public Health England) received funding from GlaxoSmithKline for a research project related to influenza antiviral treatment. This preceded and had no relation to COVID-19, and G.D. had no role in and received no funding from the project. D.D.A. sits on two UK government groups providing scientific advice relating to SARS-CoV-2 (Scientific Pandemic Influenza Group on Modelling [SPI-M] and UKHSA{\textquoteright}s Variant Technical Group [VTG]). The remaining authors declare no competing interests. Open Access: This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article{\textquoteright}s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article{\textquoteright}s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/. Publisher Copyright: {\textcopyright} Crown 2022 Citation: Webster, H.H., Nyberg, T., Sinnathamby, M.A. et al. Hospitalisation and mortality risk of SARS-COV-2 variant omicron sub-lineage BA.2 compared to BA.1 in England. Nat Commun 13, 6053 (2022). https://doi.org/10.1038/s41467-022-33740-9 DOI: https://doi.org/10.1038/s41467-022-33740-9",

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Webster, HH, Nyberg, T, Sinnathamby, MA, Aziz, NA, Ferguson, N, Seghezzo, G, Blomquist, PB, Bridgen, J, Chand, M , Groves, N , Myers, R , Hope, R, Ashano, E, Lopez-Bernal, J , De Angelis, D , Dabrera, G , Presanis, AM & Thelwall, S 2022, 'Hospitalisation and mortality risk of SARS-COV-2 variant omicron sub-lineage BA.2 compared to BA.1 in England', Nature Communications, vol. 13, no. 1, 6053. https://doi.org/10.1038/s41467-022-33740-9

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T1 - Hospitalisation and mortality risk of SARS-COV-2 variant omicron sub-lineage BA.2 compared to BA.1 in England

AU - Webster, H. H.

AU - Nyberg, T.

AU - Sinnathamby, M. A.

AU - Aziz, N. Abdul

AU - Ferguson, N.

AU - Seghezzo, G.

AU - Blomquist, P. B.

AU - Bridgen, J.

AU - Chand, M.

AU - Groves, N.

AU - Myers, R.

AU - Hope, R.

AU - Ashano, E.

AU - Lopez-Bernal, J.

AU - De Angelis, D.

AU - Dabrera, G.

AU - Presanis, A. M.

AU - Thelwall, S.

N1 - Funding Information: We would like to acknowledge the efforts of multiple teams in enabling the severity assessment of this SARS-CoV-2 variant. We would like to thank the UKHSA Second Generation Surveillance System, DataLake and Datastore teams for maintaining the databases in which the data are stored. We thank NHS Digital and Hospital-onset COVID team at UKHSA for enabling surveillance of hospitalisation. We also thank colleagues for maintaining COVID-19 vaccination surveillance at the National Immunisation Management service, Julia Stowe and Freya Kirsebom (UKHSA, Immunisation and Vaccine Preventable Diseases Division) and colleagues for helpful discussions surrounding hospitalisation surveillance, and Andre Charlett (UKHSA Statistics, Modelling and Economics division) for his ongoing work overseeing the UKHSA COVID-19 data streams. This work was supported by UK Research and Innovation (UKRI) Medical Research Council (MRC) (NMF: Centre for Global Infectious Disease Analysis [MR/R015600/1]; DDA, AMP: [Unit Programme number MC/UU/00002/11]); UKRI MRC/Department of Health and Social Care (DHSC) National Institute for Health and Care Research (NIHR) COVID-19 rapid response call (TN, DDA, AMP: [MC/PC/19074]; NMF: [MR/V038109/1]); NIHR Health Protection Units in: Modelling and Health Economics (NMF), and Behavioural Science and Evaluation (DDA); philanthropic funding from Community Jameel (NMF); and the WHO Regional Office for Europe (TN, DDA, AMP). The funders played no direct role in the study. The views expressed are those of the authors and not necessarily those of the NIHR or the DHSC. N.M.F. sits on a number of UK government and World Health Organization groups providing scientific advice relating to SARS-CoV-2. G.D. declares that his employer UK Health Security Agency (previously operating as Public Health England) received funding from GlaxoSmithKline for a research project related to influenza antiviral treatment. This preceded and had no relation to COVID-19, and G.D. had no role in and received no funding from the project. D.D.A. sits on two UK government groups providing scientific advice relating to SARS-CoV-2 (Scientific Pandemic Influenza Group on Modelling [SPI-M] and UKHSA’s Variant Technical Group [VTG]). The remaining authors declare no competing interests. Open Access: This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/. Publisher Copyright: © Crown 2022 Citation: Webster, H.H., Nyberg, T., Sinnathamby, M.A. et al. Hospitalisation and mortality risk of SARS-COV-2 variant omicron sub-lineage BA.2 compared to BA.1 in England. Nat Commun 13, 6053 (2022). https://doi.org/10.1038/s41467-022-33740-9 DOI: https://doi.org/10.1038/s41467-022-33740-9

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N2 - The Omicron variant of SARS-CoV-2 became the globally dominant variant in early 2022. A sub-lineage of the Omicron variant (BA.2) was identified in England in January 2022. Here, we investigated hospitalisation and mortality risks of COVID-19 cases with the Omicron sub-lineage BA.2 (n = 258,875) compared to BA.1 (n = 984,337) in a large cohort study in England. We estimated the risk of hospital attendance, hospital admission or death using multivariable stratified proportional hazards regression models. After adjustment for confounders, BA.2 cases had lower or similar risks of death (HR = 0.80, 95% CI 0.71–0.90), hospital admission (HR = 0.88, 95% CI 0.83–0.94) and any hospital attendance (HR = 0.98, 95% CI 0.95–1.01). These findings that the risk of severe outcomes following infection with BA.2 SARS-CoV-2 was slightly lower or equivalent to the BA.1 sub-lineage can inform public health strategies in countries where BA.2 is spreading.

AB - The Omicron variant of SARS-CoV-2 became the globally dominant variant in early 2022. A sub-lineage of the Omicron variant (BA.2) was identified in England in January 2022. Here, we investigated hospitalisation and mortality risks of COVID-19 cases with the Omicron sub-lineage BA.2 (n = 258,875) compared to BA.1 (n = 984,337) in a large cohort study in England. We estimated the risk of hospital attendance, hospital admission or death using multivariable stratified proportional hazards regression models. After adjustment for confounders, BA.2 cases had lower or similar risks of death (HR = 0.80, 95% CI 0.71–0.90), hospital admission (HR = 0.88, 95% CI 0.83–0.94) and any hospital attendance (HR = 0.98, 95% CI 0.95–1.01). These findings that the risk of severe outcomes following infection with BA.2 SARS-CoV-2 was slightly lower or equivalent to the BA.1 sub-lineage can inform public health strategies in countries where BA.2 is spreading.

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Hospitalisation and mortality risk of SARS-COV-2 variant omicron sub-lineage BA.2 compared to BA.1 in England

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