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  1. Article ; Online: Ethnic variation in outcome of people hospitalised during the first COVID-19 epidemic wave in Wales (UK)

    Christopher Williams / Daniel Rh Thomas / Ananda Giri Shankar / Meirion R Evans / Paul Longley / Oghogho Orife / Amy Plimmer / George Karani / Janusz Janiec / Roiyah Saltus

    BMJ Open, Vol 11, Iss

    an analysis of national surveillance data using Onomap, a name-based ethnicity classification tool

    2021  Volume 8

    Abstract: Objective To identify ethnic differences in proportion positive for SARS-CoV-2, and proportion hospitalised, proportion admitted to intensive care and proportion died in hospital with COVID-19 during the first epidemic wave in Wales.Design Descriptive ... ...

    Abstract Objective To identify ethnic differences in proportion positive for SARS-CoV-2, and proportion hospitalised, proportion admitted to intensive care and proportion died in hospital with COVID-19 during the first epidemic wave in Wales.Design Descriptive analysis of 76 503 SARS-CoV-2 tests carried out in Wales to 31 May 2020. Cohort study of 4046 individuals hospitalised with confirmed COVID-19 between 1 March and 31 May. In both analyses, ethnicity was assigned using a name-based classifier.Setting Wales (UK).Primary and secondary outcomes Admission to an intensive care unit following hospitalisation with a positive SARS-CoV-2 PCR test. Death within 28 days of a positive SARS-CoV-2 PCR test.Results Using a name-based ethnicity classifier, we found a higher proportion of black, Asian and ethnic minority people tested for SARS-CoV-2 by PCR tested positive, compared with those classified as white. Hospitalised black, Asian and minority ethnic cases were younger (median age 53 compared with 76 years; p<0.01) and more likely to be admitted to intensive care. Bangladeshi (adjusted OR (aOR): 9.80, 95% CI 1.21 to 79.40) and ‘white – other than British or Irish’ (aOR: 1.99, 95% CI 1.15 to 3.44) ethnic groups were most likely to be admitted to intensive care unit. In Wales, older age (aOR for over 70 years: 10.29, 95% CI 6.78 to 15.64) and male gender (aOR: 1.38, 95% CI 1.19 to 1.59), but not ethnicity, were associated with death in hospitalised patients.Conclusions This study adds to the growing evidence that ethnic minorities are disproportionately affected by COVID-19. During the first COVID-19 epidemic wave in Wales, although ethnic minority populations were less likely to be tested and less likely to be hospitalised, those that did attend hospital were younger and more likely to be admitted to intensive care. Primary, secondary and tertiary COVID-19 prevention should target ethnic minority communities in Wales.
    Keywords Medicine ; R
    Subject code 390 ; 360
    Language English
    Publishing date 2021-08-01T00:00:00Z
    Publisher BMJ Publishing Group
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  2. Article ; Online: Changes in symptomatology, reinfection, and transmissibility associated with the SARS-CoV-2 variant B.1.1.7

    Mark S Graham, PhD / Carole H Sudre, PhD / Anna May, MA / Michela Antonelli, PhD / Benjamin Murray, MSc / Thomas Varsavsky, MSc / Kerstin Kläser, MSc / Liane S Canas, PhD / Erika Molteni, PhD / Marc Modat, PhD / David A Drew, PhD / Long H Nguyen, MD / Lorenzo Polidori, MSc / Somesh Selvachandran, MSc / Christina Hu, MA / Joan Capdevila, PhD / Alexander Hammers, ProfPhD / Andrew T Chan, ProfMD / Jonathan Wolf, MA /
    Tim D Spector, ProfPhD / Claire J Steves, PhD / Sebastien Ourselin, ProfPhD / Cherian Koshy / Amy Ash / Emma Wise / Nathan Moore / Matilde Mori / Nick Cortes / Jessica Lynch / Stephen Kidd / Derek J Fairley / Tanya Curran / James P McKenna / Helen Adams / Christophe Fraser / Tanya Golubchik / David Bonsall / Mohammed O Hassan-Ibrahim / Cassandra S Malone / Benjamin J Cogger / Michelle Wantoch / Nicola Reynolds / Ben Warne / Joshua Maksimovic / Karla Spellman / Kathryn McCluggage / Michaela John / Robert Beer / Safiah Afifi / Sian Morgan / Angela Marchbank / Anna Price / Christine Kitchen / Huw Gulliver / Ian Merrick / Joel Southgate / Martyn Guest / Robert Munn / Trudy Workman / Thomas R Connor / William Fuller / Catherine Bresner / Luke B Snell / Amita Patel / Themoula Charalampous / Gaia Nebbia / Rahul Batra / Jonathan Edgeworth / Samuel C Robson / Angela H Beckett / David M Aanensen / Anthony P Underwood / Corin A Yeats / Khalil Abudahab / Ben EW Taylor / Mirko Menegazzo / Gemma Clark / Wendy Smith / Manjinder Khakh / Vicki M Fleming / Michelle M Lister / Hannah C Howson-Wells / Louise Berry / Tim Boswell / Amelia Joseph / Iona Willingham / Carl Jones / Christopher Holmes / Paul Bird / Thomas Helmer / Karlie Fallon / Julian Tang / Veena Raviprakash / Sharon Campbell / Nicola Sheriff / Victoria Blakey / Lesley-Anne Williams / Matthew W Loose / Nadine Holmes / Christopher Moore / Matthew Carlile / Victoria Wright / Fei Sang / Johnny Debebe / Francesc Coll / Adrian W Signell / Gilberto Betancor / Harry D Wilson / Sahar Eldirdiri / Anita Kenyon / Thomas Davis / Oliver G Pybus / Louis du Plessis / Alex E Zarebski / Jayna Raghwani / Moritz UG Kraemer / Sarah Francois / Stephen W Attwood / Tetyana I Vasylyeva / Marina Escalera Zamudio / Bernardo Gutierrez / M. Estee Torok / William L Hamilton / Ian G Goodfellow / Grant Hall / Aminu S Jahun / Yasmin Chaudhry / Myra Hosmillo / Malte L Pinckert / Iliana Georgana / Samuel Moses / Hannah Lowe / Luke Bedford / Jonathan Moore / Susanne Stonehouse / Chloe L Fisher / Ali R Awan / John BoYes / Judith Breuer / Kathryn Ann Harris / Julianne Rose Brown / Divya Shah / Laura Atkinson / Jack CD Lee / Nathaniel Storey / Flavia Flaviani / Adela Alcolea-Medina / Rebecca Williams / Gabrielle Vernet / Michael R Chapman / Lisa J Levett / Judith Heaney / Wendy Chatterton / Monika Pusok / Li Xu-McCrae / Darren L Smith / Matthew Bashton / Gregory R Young / Alison Holmes / Paul Anthony Randell / Alison Cox / Pinglawathee Madona / Frances Bolt / James Price / Siddharth Mookerjee / Manon Ragonnet-Cronin / Fabricia F. Nascimento / David Jorgensen / Igor Siveroni / Rob Johnson / Olivia Boyd / Lily Geidelberg / Erik M Volz / Aileen Rowan / Graham P Taylor / Katherine L Smollett / Nicholas J Loman / Joshua Quick / Claire McMurray / Joanne Stockton / Sam Nicholls / Will Rowe / Radoslaw Poplawski / Alan McNally / Rocio T Martinez Nunez / Jenifer Mason / Trevor I Robinson / Elaine O'Toole / Joanne Watts / Cassie Breen / Angela Cowell / Graciela Sluga / Nicholas W Machin / Shazaad S Y Ahmad / Ryan P George / Fenella Halstead / Venkat Sivaprakasam / Wendy Hogsden / Chris J Illingworth / Chris Jackson / Emma C Thomson / James G Shepherd / Patawee Asamaphan / Marc O Niebel / Kathy K Li / Rajiv N Shah / Natasha G Jesudason / Lily Tong / Alice Broos / Daniel Mair / Jenna Nichols / Stephen N Carmichael / Kyriaki Nomikou / Elihu Aranday-Cortes / Natasha Johnson / Igor Starinskij / Ana da Silva Filipe / David L Robertson / Richard J Orton / Joseph Hughes / Sreenu Vattipally / Joshua B Singer / Seema Nickbakhsh / Antony D Hale / Louissa R Macfarlane-Smith / Katherine L Harper / Holli Carden / Yusri Taha / Brendan AI Payne / Shirelle Burton-Fanning / Sheila Waugh / Jennifer Collins / Gary Eltringham / Steven Rushton / Sarah O'Brien / Amanda Bradley / Alasdair Maclean / Guy Mollett / Rachel Blacow / Kate E Templeton / Martin P McHugh / Rebecca Dewar / Elizabeth Wastenge / Samir Dervisevic / Rachael Stanley / Emma J Meader / Lindsay Coupland / Louise Smith / Clive Graham / Edward Barton / Debra Padgett / Garren Scott / Emma Swindells / Jane Greenaway / Andrew Nelson / Clare M McCann / Wen C Yew / Monique Andersson / Timothy Peto / Anita Justice / David Eyre / Derrick Crook / Tim J Sloan / Nichola Duckworth / Sarah Walsh / Anoop J Chauhan / Sharon Glaysher / Kelly Bicknell / Sarah Wyllie / Scott Elliott / Allyson Lloyd / Robert Impey / Nick Levene / Lynn Monaghan / Declan T Bradley / Tim Wyatt / Elias Allara / Clare Pearson / Husam Osman / Andrew Bosworth / Esther Robinson / Peter Muir / Ian B Vipond / Richard Hopes / Hannah M Pymont / Stephanie Hutchings / Martin D Curran / Surendra Parmar / Angie Lackenby / Tamyo Mbisa / Steven Platt / Shahjahan Miah / David Bibby / Carmen Manso / Jonathan Hubb / Meera Chand / Gavin Dabrera / Mary Ramsay / Daniel Bradshaw / Alicia Thornton / Richard Myers / Ulf Schaefer / Natalie Groves / Eileen Gallagher / David Lee / David Williams / Nicholas Ellaby / Ian Harrison / Hassan Hartman / Nikos Manesis / Vineet Patel / Chloe Bishop / Vicki Chalker / Juan Ledesma / Katherine A Twohig / Matthew T.G. Holden / Sharif Shaaban / Alec Birchley / Alexander Adams / Alisha Davies / Amy Gaskin / Amy Plimmer / Bree Gatica-Wilcox / Caoimhe McKerr / Catherine Moore / Chris Williams / David Heyburn / Elen De Lacy / Ember Hilvers / Fatima Downing / Giri Shankar / Hannah Jones / Hibo Asad / Jason Coombes / Joanne Watkins / Johnathan M Evans / Laia Fina / Laura Gifford / Lauren Gilbert / Lee Graham / Malorie Perry / Mari Morgan / Matthew Bull / Michelle Cronin / Nicole Pacchiarini / Noel Craine / Rachel Jones / Robin Howe / Sally Corden / Sara Rey / Sara Kumziene-SummerhaYes / Sarah Taylor / Simon Cottrell / Sophie Jones / Sue Edwards / Justin O'Grady / Andrew J Page / Alison E Mather / David J Baker / Steven Rudder / Alp Aydin / Gemma L Kay / Alexander J Trotter / Nabil-Fareed Alikhan / Leonardo de Oliveira Martins / Thanh Le-Viet / Lizzie Meadows / Anna Casey / Liz Ratcliffe / David A Simpson / Zoltan Molnar / Thomas Thompson / Erwan Acheson / Jane AH Masoli / Bridget A Knight / Sian Ellard / Cressida Auckland / Christopher R Jones / Tabitha W Mahungu / Dianne Irish-Tavares / Tanzina Haque / Jennifer Hart / Eric Witele / Melisa Louise Fenton / Ashok Dadrah / Amanda Symmonds / Tranprit Saluja / Yann Bourgeois / Garry P Scarlett / Katie F Loveson / Salman Goudarzi / Christopher Fearn / Kate Cook / Hannah Dent / Hannah Paul / David G Partridge / Mohammad Raza / Cariad Evans / Kate Johnson / Steven Liggett / Paul Baker / Stephen Bonner / Sarah Essex / Ronan A Lyons / Kordo Saeed / Adhyana I.K Mahanama / Buddhini Samaraweera / Siona Silveira / Emanuela Pelosi / Eleri Wilson-Davies / Rachel J Williams / Mark Kristiansen / Sunando Roy / Charlotte A Williams / Marius Cotic / Nadua Bayzid / Adam P Westhorpe / John A Hartley / Riaz Jannoo / Helen L Lowe / Angeliki Karamani / Leah Ensell / Jacqui A Prieto / Sarah Jeremiah / Dimitris Grammatopoulos / Sarojini Pandey / Lisa Berry / Katie Jones / Alex Richter / Andrew Beggs / Angus Best / Benita Percival / Jeremy Mirza / Oliver Megram / Megan Mayhew / Liam Crawford / Fiona Ashcroft / Emma Moles-Garcia / Nicola Cumley / Colin P Smith / Giselda Bucca / Andrew R Hesketh / Beth Blane / Sophia T Girgis / Danielle Leek / Sushmita Sridhar / Sally Forrest / Claire Cormie / Harmeet K Gill / Joana Dias / Ellen E Higginson / Mailis Maes / Jamie Young / Leanne M Kermack / Ravi Kumar Gupta / Catherine Ludden / Sharon J Peacock / Sophie Palmer / Carol M Churcher / Nazreen F Hadjirin / Alessandro M Carabelli / Ellena Brooks / Kim S Smith / Katerina Galai / Georgina M McManus / Chris Ruis / Rose K Davidson / Andrew Rambaut / Thomas Williams / Carlos E Balcazar / Michael D Gallagher / Áine O'Toole / Stefan Rooke / Verity Hill / Kathleen A Williamson / Thomas D Stanton / Stephen L Michell / Claire M Bewshea / Ben Temperton / Michelle L Michelsen / Joanna Warwick-Dugdale / Robin Manley / Audrey Farbos / James W Harrison / Christine M Sambles / David J Studholme / Aaron R Jeffries / Alistair C Darby / Julian A Hiscox / Steve Paterson / Miren Iturriza-Gomara / Kathryn A Jackson / Anita O Lucaci / Edith E Vamos / Margaret Hughes / Lucille Rainbow / Richard Eccles / Charlotte Nelson / Mark Whitehead / Lance Turtle / Sam T Haldenby / Richard Gregory / Matthew Gemmell / Claudia Wierzbicki / Hermione J Webster / Thushan I de Silva / Nikki Smith / Adrienn Angyal / Benjamin B Lindsey / Danielle C Groves / Luke R Green / Dennis Wang / Timothy M Freeman / Matthew D Parker / Alexander J Keeley / Paul J Parsons / Rachel M Tucker / Rebecca Brown / Matthew Wyles / Max Whiteley / Peijun Zhang / Marta Gallis / Stavroula F Louka / Chrystala Constantinidou / Meera Unnikrishnan / Sascha Ott / Jeffrey K.J. Cheng / Hannah E. Bridgewater / Lucy R. Frost / Grace Taylor-Joyce / Richard Stark / Laura Baxter / Mohammad T. Alam / Paul E Brown / Dinesh Aggarwal / Alberto C Cerda / Tammy V Merrill / Rebekah E Wilson / Patrick C McClure / Joseph G Chappell / Theocharis Tsoleridis / Jonathan Ball / David Buck / John A Todd / Angie Green / Amy Trebes / George MacIntyre-Cockett / Mariateresa de Cesare / Alex Alderton / Roberto Amato / Cristina V Ariani / Mathew A Beale / Charlotte Beaver / Katherine L Bellis / Emma Betteridge / James Bonfield / John Danesh / Matthew J Dorman / Eleanor Drury / Ben W Farr / Luke Foulser / Sonia Goncalves / Scott Goodwin / Marina Gourtovaia / Ewan M Harrison / David K Jackson / Dorota Jamrozy / Ian Johnston / Leanne Kane / Sally Kay / Jon-Paul Keatley / Dominic Kwiatkowski / Cordelia F Langford / Mara Lawniczak / Laura Letchford / Rich Livett / Stephanie Lo / Inigo Martincorena / Samantha McGuigan / Rachel Nelson / Steve Palmer / Naomi R Park / Minal Patel / Liam Prestwood / Christoph Puethe / Michael A Quail / Shavanthi Rajatileka / Carol Scott / Lesley Shirley / John Sillitoe / Michael H Spencer Chapman / Scott AJ Thurston / Gerry Tonkin-Hill / Danni Weldon / Diana Rajan / Iraad F Bronner / Louise Aigrain / Nicholas M Redshaw / Stefanie V Lensing / Robert Davies / Andrew Whitwham / Jennifier Liddle / Kevin Lewis / Jaime M Tovar-Corona / Steven Leonard / Jillian Durham / Andrew R Bassett / Shane McCarthy / Robin J Moll / Keith James / Karen Oliver / Alex Makunin / Jeff Barrett / Rory N Gunson

    The Lancet Public Health, Vol 6, Iss 5, Pp e335-e

    an ecological study

    2021  Volume 345

    Abstract: Summary: Background: The SARS-CoV-2 variant B.1.1.7 was first identified in December, 2020, in England. We aimed to investigate whether increases in the proportion of infections with this variant are associated with differences in symptoms or disease ... ...

    Abstract Summary: Background: The SARS-CoV-2 variant B.1.1.7 was first identified in December, 2020, in England. We aimed to investigate whether increases in the proportion of infections with this variant are associated with differences in symptoms or disease course, reinfection rates, or transmissibility. Methods: We did an ecological study to examine the association between the regional proportion of infections with the SARS-CoV-2 B.1.1.7 variant and reported symptoms, disease course, rates of reinfection, and transmissibility. Data on types and duration of symptoms were obtained from longitudinal reports from users of the COVID Symptom Study app who reported a positive test for COVID-19 between Sept 28 and Dec 27, 2020 (during which the prevalence of B.1.1.7 increased most notably in parts of the UK). From this dataset, we also estimated the frequency of possible reinfection, defined as the presence of two reported positive tests separated by more than 90 days with a period of reporting no symptoms for more than 7 days before the second positive test. The proportion of SARS-CoV-2 infections with the B.1.1.7 variant across the UK was estimated with use of genomic data from the COVID-19 Genomics UK Consortium and data from Public Health England on spike-gene target failure (a non-specific indicator of the B.1.1.7 variant) in community cases in England. We used linear regression to examine the association between reported symptoms and proportion of B.1.1.7. We assessed the Spearman correlation between the proportion of B.1.1.7 cases and number of reinfections over time, and between the number of positive tests and reinfections. We estimated incidence for B.1.1.7 and previous variants, and compared the effective reproduction number, Rt, for the two incidence estimates. Findings: From Sept 28 to Dec 27, 2020, positive COVID-19 tests were reported by 36 920 COVID Symptom Study app users whose region was known and who reported as healthy on app sign-up. We found no changes in reported symptoms or disease duration associated with B.1.1.7. For the same period, possible reinfections were identified in 249 (0·7% [95% CI 0·6–0·8]) of 36 509 app users who reported a positive swab test before Oct 1, 2020, but there was no evidence that the frequency of reinfections was higher for the B.1.1.7 variant than for pre-existing variants. Reinfection occurrences were more positively correlated with the overall regional rise in cases (Spearman correlation 0·56–0·69 for South East, London, and East of England) than with the regional increase in the proportion of infections with the B.1.1.7 variant (Spearman correlation 0·38–0·56 in the same regions), suggesting B.1.1.7 does not substantially alter the risk of reinfection. We found a multiplicative increase in the Rt of B.1.1.7 by a factor of 1·35 (95% CI 1·02–1·69) relative to pre-existing variants. However, Rt fell below 1 during regional and national lockdowns, even in regions with high proportions of infections with the B.1.1.7 variant. Interpretation: The lack of change in symptoms identified in this study indicates that existing testing and surveillance infrastructure do not need to change specifically for the B.1.1.7 variant. In addition, given that there was no apparent increase in the reinfection rate, vaccines are likely to remain effective against the B.1.1.7 variant. Funding: Zoe Global, Department of Health (UK), Wellcome Trust, Engineering and Physical Sciences Research Council (UK), National Institute for Health Research (UK), Medical Research Council (UK), Alzheimer's Society.
    Keywords Public aspects of medicine ; RA1-1270
    Subject code 150
    Language English
    Publishing date 2021-05-01T00:00:00Z
    Publisher Elsevier
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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