Background SARS-CoV-2 lineage B.1.1.7 has been associated with an increased rate of transmission and disease severity among subjects testing positive in the community. Its impact on hospitalised patients is less well documented. Methods We collected viral sequences and clinical data of patients admitted with SARS-CoV-2 and hospital-onset COVID-19 infections (HOCIs), sampled 16 November 2020 to 10 January 2021, from eight hospitals participating in the COG-UK-HOCI study. Associations between the variant and the outcomes of all-cause mortality and intensive therapy unit (ITU) admission were evaluated using mixed effects Cox models adjusted by age, sex, comorbidities, care home residence, pregnancy and ethnicity. Findings Sequences were obtained from 2341 inpatients (HOCI cases=786) and analysis of clinical outcomes was carried out in 2147 inpatients with all data available. The HR for mortality of B.1.1.7 compared with other lineages was 1.01 (95% CI 0.79 to 1.28, p=0.94) and for ITU admission was 1.01 (95% CI 0.75 to 1.37, p=0.96). Analysis of sex-specific effects of B.1.1.7 identified increased risk of mortality (HR 1.30, 95% CI 0.95 to 1.78, p=0.096) and ITU admission (HR 1.82, 95% CI 1.15 to 2.90, p=0.011) in females infected with the variant but not males (mortality HR 0.82, 95% CI 0.61 to 1.10, p=0.177; ITU HR 0.74, 95% CI 0.52 to 1.04, p=0.086). Interpretation In common with smaller studies of patients hospitalised with SARS-CoV-2, we did not find an overall increase in mortality or ITU admission associated with B.1.1.7 compared with other lineages. However, women with B.1.1.7 may be at an increased risk of admission to intensive care and at modestly increased risk of mortality. The sequence data analysed are included within publicly available datasets (). However, due to data governance restrictions it is not possible to share the associated patient characteristics and clinical outcome data for the analysis described, as these are considered sensitive and full anonymisation is not possible. The corresponding author (OTS) affirms that the manuscript is an honest, accurate and transparent account of the study being reported; that no important aspects of the study have been omitted and that any discrepancies from the study as planned have been explained.

中文翻译：

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SARS-CoV-2 谱系 B.1.1.7 与住院女性而非男性的疾病严重程度相关：多中心队列研究

背景 SARS-CoV-2 谱系 B.1.1.7 与社区检测呈阳性的受试者中传播率和疾病严重程度的增加有关。它对住院患者的影响尚不清楚。方法 我们收集了 2020 年 11 月 16 日至 2021 年 1 月 10 日期间从参与 COG-UK-HOCI 研究的八家医院采集的 SARS-CoV-2 和院内发病的 COVID-19 感染 (HOCI) 患者的病毒序列和临床数据。 。使用根据年龄、性别、合并症、疗养院居住、怀孕和种族调整的混合效应 Cox 模型评估变异与全因死亡率和重症治疗室 (ITU) 入院结果之间的关联。结果 从 2341 名住院患者（HOCI 病例 = 786）中获得序列，并利用所有可用数据对 2147 名住院患者的临床结果进行了分析。与其他谱系相比，B.1.1.7 的死亡率 HR 为 1.01（95% CI 0.79 至 1.28，p=0.94），ITU 准入的 HR 为 1.01（95% CI 0.75 至 1.37，p=0.96）。对 B.1.1.7 的性别特异性影响的分析发现，死亡风险（HR 1.30，95% CI 0.95 至 1.78，p=0.096）和 ITU 准入风险增加（HR 1.82，95% CI 1.15 至 2.90，p=0.011）感染该变体的女性而非男性（死亡率 HR 0.82，95% CI 0.61 至 1.10，p=0.177；ITU HR 0.74，95% CI 0.52 至 1.04，p=0.086）。解释 与针对 SARS-CoV-2 住院患者的小型研究一样，与其他谱系相比，我们没有发现与 B.1.1.7 相关的死亡率或 ITU 入院率总体增加。然而，患有 B.1.1.7 的女性进入重症监护室的风险可能会增加，死亡风险也会略有增加。分析的序列数据包含在公开可用的数据集中（）。然而，由于数据治理限制，无法共享相关的患者特征和临床结果数据以进行所述分析，因为这些数据被认为是敏感的，并且不可能完全匿名。通讯作者 (OTS) 确认该手稿是对所报告研究的诚实、准确和透明的描述；研究没有遗漏任何重要方面，并且与计划研究的任何差异都已得到解释。