Objective To evaluate the relation between diagnosis of covid-19 with SARS-CoV-2 variant B.1.1.7 (also known as variant of concern 202012/01) and the risk of hospital admission compared with diagnosis with wild-type SARS-CoV-2 variants. Design Retrospective cohort analysis. Setting Community based SARS-CoV-2 testing in England, individually linked with hospital admission data. Participants 839 278 patients with laboratory confirmed covid-19, of whom 36 233 had been admitted to hospital within 14 days, tested between 23 November 2020 and 31 January 2021 and analysed at a laboratory with an available TaqPath assay that enables assessment of S-gene target failure (SGTF), a proxy test for the B.1.1.7 variant. Patient data were stratified by age, sex, ethnicity, deprivation, region of residence, and date of positive test. Main outcome measures Hospital admission between one and 14 days after the first positive SARS-CoV-2 test. Results 27 710 (4.7%) of 592 409 patients with SGTF variants and 8523 (3.5%) of 246 869 patients without SGTF variants had been admitted to hospital within one to 14 days. The stratum adjusted hazard ratio of hospital admission was 1.52 (95% confidence interval 1.47 to 1.57) for patients with covid-19 infected with SGTF variants, compared with those infected with non-SGTF variants. The effect was modified by age (P<0.001), with hazard ratios of 0.93-1.21 in patients younger than 20 years with versus without SGTF variants, 1.29 in those aged 20-29, and 1.45-1.65 in those aged ≥30 years. The adjusted absolute risk of hospital admission within 14 days was 4.7% (95% confidence interval 4.6% to 4.7%) for patients with SGTF variants and 3.5% (3.4% to 3.5%) for those with non-SGTF variants. Conclusions The results suggest that the risk of hospital admission is higher for people infected with the B.1.1.7 variant compared with wild-type SARS-CoV-2, likely reflecting a more severe disease. The higher severity may be specific to adults older than 30 years.

中文翻译：

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SARS-CoV-2 变种 B.1.1.7 患者的入院风险：队列分析


目的 与野生型 SARS-CoV 诊断相比，评估 SARS-CoV-2 变体 B.1.1.7（也称为关注变体 202012/01）诊断出的 covid-19 与入院风险之间的关系-2个变体。设计回顾性队列分析。在英格兰设置基于社区的 SARS-CoV-2 检测，并与入院数据单独关联。参与者 839 278 名实验室确诊的 covid-19 患者，其中 36 233 人在 14 天内入院，在 2020 年 11 月 23 日至 2021 年 1 月 31 日期间进行了检测，并在实验室使用可评估 S 基因的 TaqPath 检测进行了分析目标失败（SGTF），B.1.1.7 变体的代理测试。患者数据按年龄、性别、种族、贫困、居住地区和阳性检测日期进行分层。主要结果衡量首次 SARS-CoV-2 检测呈阳性后 1 至 14 天内的入院情况。结果 592 409 例 SGTF 变异患者中的 27 710 例 (4.7%) 和 246 869 例无 SGTF 变异患者中的 8523 例 (3.5%) 在 1 至 14 天内入院。与感染非 SGTF 变体的患者相比，感染 SGTF 变体的 covid-19 患者入院的分层调整风险比为 1.52（95% 置信区间为 1.47 至 1.57）。效果因年龄而改变（P<0.001），20岁以下的有SGTF变异的患者与无SGTF变异的患者相比，其风险比为0.93-1.21，20-29岁的患者为1.29，年龄≥30岁的患者为1.45-1.65。 SGTF 变异患者 14 天内入院的调整后绝对风险为 4.7%（95% 置信区间 4.6% 至 4.7%），非 SGTF 变异患者为 3.5%（3.4% 至 3.5%）。 结论 结果表明，与野生型 SARS-CoV-2 相比，感染 B.1.1.7 变种的人入院的风险更高，可能反映了更严重的疾病。较高的严重程度可能是 30 岁以上成年人特有的。