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Article ; Online: Multivariate profile and acute-phase correlates of cognitive deficits in a COVID-19 hospitalised cohort

EClinicalMedicine, Vol 47, Iss , Pp 101417- (2022)

2022

Abstract: Summary: Background: Preliminary evidence has highlighted a possible association between severe COVID-19 and persistent cognitive deficits. Further research is required to confirm this association, determine whether cognitive deficits relate to clinical ... ...

Abstract	Summary: Background: Preliminary evidence has highlighted a possible association between severe COVID-19 and persistent cognitive deficits. Further research is required to confirm this association, determine whether cognitive deficits relate to clinical features from the acute phase or to mental health status at the point of assessment, and quantify rate of recovery. Methods: 46 individuals who received critical care for COVID-19 at Addenbrooke's hospital between 10th March 2020 and 31st July 2020 (16 mechanically ventilated) underwent detailed computerised cognitive assessment alongside scales measuring anxiety, depression and post-traumatic stress disorder under supervised conditions at a mean follow up of 6.0 (± 2.1) months following acute illness. Patient and matched control (N = 460) performances were transformed into standard deviation from expected scores, accounting for age and demographic factors using N = 66,008 normative datasets. Global accuracy and response time composites were calculated (G_SScore & G_RT). Linear modelling predicted composite score deficits from acute severity, mental-health status at assessment, and time from hospital admission. The pattern of deficits across tasks was qualitatively compared with normal age-related decline, and early-stage dementia. Findings: COVID-19 survivors were less accurate (G_SScore=-0.53SDs) and slower (G_RT=+0.89SDs) in their responses than expected compared to their matched controls. Acute illness, but not chronic mental health, significantly predicted cognitive deviation from expected scores (G_SScore (p=0.0037) and G_RT (p = 0.0366)). The most prominent task associations with COVID-19 were for higher cognition and processing speed, which was qualitatively distinct from the profiles of normal ageing and dementia and similar in magnitude to the effects of ageing between 50 and 70 years of age. A trend towards reduced deficits with time from illness (r∼=0.15) did not reach statistical significance. Interpretation: Cognitive deficits after severe ...
Keywords	COVID-19 ; Cognition ; Cognitive assessment ; Attention ; Memory ; Reasoning ; Medicine (General) ; R5-920
Subject code	150
Language	English
Publishing date	2022-05-01T00:00:00Z
Publisher	Elsevier
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Risk factors for herpes simplex virus type-1 infection and reactivation

Harriet Forbes / Ben Warne / Lars Doelken / Nicole Brenner / Tim Waterboer / Robert Luben / Nicholas J Wareham / Charlotte Warren-Gash / Effrossyni Gkrania-Klotsas

PLoS ONE, Vol 14, Iss 5, p e

Cross-sectional studies among EPIC-Norfolk participants.

2019 Volume 0215553

Abstract: Background The prevalence of, and risk factors for, herpes simplex virus type-1 (HSV-1) infection and reactivation in older individuals are poorly understood. Methods This is a prospective population-based study among community-dwelling individuals aged ... ...

Abstract	Background The prevalence of, and risk factors for, herpes simplex virus type-1 (HSV-1) infection and reactivation in older individuals are poorly understood. Methods This is a prospective population-based study among community-dwelling individuals aged 40-79 years, followed from 1993, formed as a random subsample of the UK-based EPIC-Norfolk cohort. HSV-1 seropositivity was derived from immunoglobulin G measurements and frequent oro-labial HSV reactivation was self-reported. We carried out two cross-sectional studies using logistic regression to investigate childhood social and environmental conditions as risk factors for HSV-1 seropositivity and comorbidities as risk factors for apparent HSV oro-labial reactivation. Results Of 9,929 participants, 6310 (63.6%) were HSV-1 IgG positive, and 870 (of 4,934 seropositive participants with reactivation data) experienced frequent oro-labial reactivation. Being born outside the UK/Ireland, contemporaneous urban living and having ≥4 siblings were risk factors for HSV-1 seropositivity. Ever diagnosed with kidney disease, but no other comorbidities, was associated with an increased risk of frequent HSV reactivation (adjOR 1.87, 95%CI: 1.02-3.40). Discussion Apparent HSV-1 seropositivity and clinical reactivation are common within an ageing UK population. HSV-1 seropositivity is socially patterned while risk factors for oro-labial HSV reactivation are less clear. Further large studies of risk factors are needed to inform HSV-1 control strategies.
Keywords	Medicine ; R ; Science ; Q
Subject code	610
Language	English
Publishing date	2019-01-01T00:00:00Z
Publisher	Public Library of Science (PLoS)
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Single-dose BNT162b2 vaccine protects against asymptomatic SARS-CoV-2 infection

Nick K Jones / Lucy Rivett / Shaun Seaman / Richard J Samworth / Ben Warne / Chris Workman / Mark Ferris / Jo Wright / Natalie Quinnell / Ashley Shaw / Cambridge COVID-19 Collaboration / Ian G Goodfellow / Paul J Lehner / Rob Howes / Giles Wright / Nicholas J Matheson / Michael P Weekes

eLife, Vol

2021 Volume 10

Abstract: The BNT162b2 mRNA COVID-19 vaccine (Pfizer-BioNTech) is being utilised internationally for mass COVID-19 vaccination. Evidence of single-dose protection against symptomatic disease has encouraged some countries to opt for delayed booster doses of ... ...

Abstract	The BNT162b2 mRNA COVID-19 vaccine (Pfizer-BioNTech) is being utilised internationally for mass COVID-19 vaccination. Evidence of single-dose protection against symptomatic disease has encouraged some countries to opt for delayed booster doses of BNT162b2, but the effect of this strategy on rates of asymptomatic SARS-CoV-2 infection remains unknown. We previously demonstrated frequent pauci- and asymptomatic SARS-CoV-2 infection amongst healthcare workers (HCWs) during the UK’s first wave of the COVID-19 pandemic, using a comprehensive PCR-based HCW screening programme (Rivett et al., 2020; Jones et al., 2020). Here, we evaluate the effect of first-dose BNT162b2 vaccination on test positivity rates and find a fourfold reduction in asymptomatic infection amongst HCWs ≥12 days post-vaccination. These data provide real-world evidence of short-term protection against asymptomatic SARS-CoV-2 infection following a single dose of BNT162b2 vaccine, suggesting that mass first-dose vaccination will reduce SARS-CoV-2 transmission, as well as the burden of COVID-19 disease.
Keywords	SARS-CoV-2 ; COVID-19 ; BNT162b2 ; vaccination ; asymptomatic ; Pfizer-BioNTech ; Medicine ; R ; Science ; Q ; Biology (General) ; QH301-705.5
Language	English
Publishing date	2021-04-01T00:00:00Z
Publisher	eLife Sciences Publications Ltd
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: How achievable are COVID-19 clinical trial recruitment targets? A UK observational cohort study and trials registry analysis

BMJ Open, Vol 10, Iss

2020 Volume 10

Abstract: Objectives To analyse enrolment to interventional trials during the first wave of the COVID-19 pandemic in England and describe the barriers to successful recruitment in the circumstance of a further wave or future pandemics.Design We analysed registered ...

Abstract	Objectives To analyse enrolment to interventional trials during the first wave of the COVID-19 pandemic in England and describe the barriers to successful recruitment in the circumstance of a further wave or future pandemics.Design We analysed registered interventional COVID-19 trial data and concurrently did a prospective observational study of hospitalised patients with COVID-19 who were being assessed for eligibility to one of the RECOVERY, C19-ACS or SIMPLE trials.Setting Interventional COVID-19 trial data were analysed from the clinicaltrials.gov and International Standard Randomized Controlled Trial Number databases on 12 July 2020. The patient cohort was taken from five centres in a respiratory National Institute for Health Research network. Population and modelling data were taken from published reports from the UK government and Medical Research Council Biostatistics Unit.Participants 2082 consecutive admitted patients with laboratory-confirmed SARS-CoV-2 infection from 27 March 2020 were included.Main outcome measures Proportions enrolled, and reasons for exclusion from the aforementioned trials. Comparisons of trial recruitment targets with estimated feasible recruitment numbers.Results Analysis of trial registration data for COVID-19 treatment studies enrolling in England showed that by 12 July 2020, 29 142 participants were needed. In the observational study, 430 (20.7%) proceeded to randomisation. 82 (3.9%) declined participation, 699 (33.6%) were excluded on clinical grounds, 363 (17.4%) were medically fit for discharge and 153 (7.3%) were receiving palliative care. With 111 037 people hospitalised with COVID-19 in England by 12 July 2020, we determine that 22 985 people were potentially suitable for trial enrolment. We estimate a UK hospitalisation rate of 2.38%, and that another 1.25 million infections would be required to meet recruitment targets of ongoing trials.Conclusions Feasible recruitment rates, study design and proliferation of trials can limit the number, and size, that will ...
Keywords	Medicine ; R ; covid19
Subject code	610
Language	English
Publishing date	2020-10-01T00:00:00Z
Publisher	BMJ Publishing Group
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Genomic epidemiology of SARS-CoV-2 in a UK university identifies dynamics of transmission

Dinesh Aggarwal / Ben Warne / Aminu S. Jahun / William L. Hamilton / Thomas Fieldman / Louis du Plessis / Verity Hill / Beth Blane / Emmeline Watkins / Elizabeth Wright / Grant Hall / Catherine Ludden / Richard Myers / Myra Hosmillo / Yasmin Chaudhry / Malte L. Pinckert / Iliana Georgana / Rhys Izuagbe / Danielle Leek /

Olisaeloka Nsonwu / Gareth J. Hughes / Simon Packer / Andrew J. Page / Marina Metaxaki / Stewart Fuller / Gillian Weale / Jon Holgate / Christopher A. Brown / The Cambridge Covid-19 testing Centre / University of Cambridge Asymptomatic COVID-19 Screening Programme Consortium / The COVID-19 Genomics UK (COG-UK) Consortium / Rob Howes / Duncan McFarlane / Gordon Dougan / Oliver G. Pybus / Daniela De Angelis / Patrick H. Maxwell / Sharon J. Peacock / Michael P. Weekes / Chris Illingworth / Ewan M. Harrison / Nicholas J. Matheson / Ian G. Goodfellow

Nature Communications, Vol 13, Iss 1, Pp 1-

2022 Volume 16

Abstract: In this study, Aggarwal and colleagues perform prospective sequencing of SARS-CoV-2 isolates derived from asymptomatic student screening and symptomatic testing of students and staff at the University of Cambridge. They identify important factors that ... ...

Abstract	In this study, Aggarwal and colleagues perform prospective sequencing of SARS-CoV-2 isolates derived from asymptomatic student screening and symptomatic testing of students and staff at the University of Cambridge. They identify important factors that contributed to within university transmission and onward spread into the wider community.
Keywords	Science ; Q
Language	English
Publishing date	2022-02-01T00:00:00Z
Publisher	Nature Portfolio
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Genomic epidemiology of COVID-19 in care homes in the east of England

William L Hamilton / Gerry Tonkin-Hill / Emily R Smith / Dinesh Aggarwal / Charlotte J Houldcroft / Ben Warne / Luke W Meredith / Myra Hosmillo / Aminu S Jahun / Martin D Curran / Surendra Parmar / Laura G Caller / Sarah L Caddy / Fahad A Khokhar / Anna Yakovleva / Grant Hall / Theresa Feltwell / Malte L Pinckert / Iliana Georgana /

Yasmin Chaudhry / Colin S Brown / Sonia Gonçalves / Roberto Amato / Ewan M Harrison / Nicholas M Brown / Mathew A Beale / Michael Spencer Chapman / David K Jackson / Ian Johnston / Alex Alderton / John Sillitoe / Cordelia Langford / Gordon Dougan / Sharon J Peacock / Dominic P Kwiatowski / Ian G Goodfellow / M Estee Torok / COVID-19 Genomics Consortium UK

eLife, Vol

2021 Volume 10

Abstract: COVID-19 poses a major challenge to care homes, as SARS-CoV-2 is readily transmitted and causes disproportionately severe disease in older people. Here, 1167 residents from 337 care homes were identified from a dataset of 6600 COVID-19 cases from the ... ...

Abstract	COVID-19 poses a major challenge to care homes, as SARS-CoV-2 is readily transmitted and causes disproportionately severe disease in older people. Here, 1167 residents from 337 care homes were identified from a dataset of 6600 COVID-19 cases from the East of England. Older age and being a care home resident were associated with increased mortality. SARS-CoV-2 genomes were available for 700 residents from 292 care homes. By integrating genomic and temporal data, 409 viral clusters within the 292 homes were identified, indicating two different patterns – outbreaks among care home residents and independent introductions with limited onward transmission. Approximately 70% of residents in the genomic analysis were admitted to hospital during the study, providing extensive opportunities for transmission between care homes and hospitals. Limiting viral transmission within care homes should be a key target for infection control to reduce COVID-19 mortality in this population.
Keywords	COVID-19 ; SARS-CoV-2 ; genomics ; epidemiology ; Medicine ; R ; Science ; Q ; Biology (General) ; QH301-705.5
Subject code	360
Language	English
Publishing date	2021-03-01T00:00:00Z
Publisher	eLife Sciences Publications Ltd
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Superspreaders drive the largest outbreaks of hospital onset COVID-19 infections

Christopher JR Illingworth / William L Hamilton / Ben Warne / Matthew Routledge / Ashley Popay / Chris Jackson / Tom Fieldman / Luke W Meredith / Charlotte J Houldcroft / Myra Hosmillo / Aminu S Jahun / Laura G Caller / Sarah L Caddy / Anna Yakovleva / Grant Hall / Fahad A Khokhar / Theresa Feltwell / Malte L Pinckert / Iliana Georgana /

eLife, Vol

2021 Volume 10

Abstract: SARS-CoV-2 is notable both for its rapid spread, and for the heterogeneity of its patterns of transmission, with multiple published incidences of superspreading behaviour. Here, we applied a novel network reconstruction algorithm to infer patterns of ... ...

Abstract	SARS-CoV-2 is notable both for its rapid spread, and for the heterogeneity of its patterns of transmission, with multiple published incidences of superspreading behaviour. Here, we applied a novel network reconstruction algorithm to infer patterns of viral transmission occurring between patients and health care workers (HCWs) in the largest clusters of COVID-19 infection identified during the first wave of the epidemic at Cambridge University Hospitals NHS Foundation Trust, UK. Based upon dates of individuals reporting symptoms, recorded individual locations, and viral genome sequence data, we show an uneven pattern of transmission between individuals, with patients being much more likely to be infected by other patients than by HCWs. Further, the data were consistent with a pattern of superspreading, whereby 21% of individuals caused 80% of transmission events. Our study provides a detailed retrospective analysis of nosocomial SARS-CoV-2 transmission, and sheds light on the need for intensive and pervasive infection control procedures.
Keywords	SARS-CoV-2 ; nosocomial transmission ; superspreader ; hospital ; Medicine ; R ; Science ; Q ; Biology (General) ; QH301-705.5
Subject code	360
Language	English
Publishing date	2021-08-01T00:00:00Z
Publisher	eLife Sciences Publications Ltd
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Effective control of SARS-CoV-2 transmission between healthcare workers during a period of diminished community prevalence of COVID-19

Nick K Jones / Lucy Rivett / Dominic Sparkes / Sally Forrest / Sushmita Sridhar / Jamie Young / Joana Pereira-Dias / Claire Cormie / Harmeet Gill / Nicola Reynolds / Michelle Wantoch / Matthew Routledge / Ben Warne / Jack Levy / William David Córdova Jiménez / Fathima Nisha Begum Samad / Chris McNicholas / Mark Ferris / Jane Gray /

Michael Gill / The CITIID-NIHR COVID-19 BioResource Collaboration / Martin D Curran / Stewart Fuller / Afzal Chaudhry / Ashley Shaw / John R Bradley / Gregory J Hannon / Ian G Goodfellow / Gordon Dougan / Kenneth GC Smith / Paul J Lehner / Giles Wright / Nicholas J Matheson / Stephen Baker / Michael P Weekes

eLife, Vol

2020 Volume 9

Abstract: Previously, we showed that 3% (31/1032)of asymptomatic healthcare workers (HCWs) from a large teaching hospital in Cambridge, UK, tested positive for SARS-CoV-2 in April 2020. About 15% (26/169) HCWs with symptoms of coronavirus disease 2019 (COVID-19) ... ...

Abstract	Previously, we showed that 3% (31/1032)of asymptomatic healthcare workers (HCWs) from a large teaching hospital in Cambridge, UK, tested positive for SARS-CoV-2 in April 2020. About 15% (26/169) HCWs with symptoms of coronavirus disease 2019 (COVID-19) also tested positive for SARS-CoV-2 (Rivett et al., 2020). Here, we show that the proportion of both asymptomatic and symptomatic HCWs testing positive for SARS-CoV-2 rapidly declined to near-zero between 25th April and 24th May 2020, corresponding to a decline in patient admissions with COVID-19 during the ongoing UK ‘lockdown’. These data demonstrate how infection prevention and control measures including staff testing may help prevent hospitals from becoming independent ‘hubs’ of SARS-CoV-2 transmission, and illustrate how, with appropriate precautions, organizations in other sectors may be able to resume on-site work safely.
Keywords	COVID-19 ; SARS-CoV-2 ; infectious disease ; virology ; occupational health ; emerging pathogens ; Medicine ; R ; Science ; Q ; Biology (General) ; QH301-705.5
Subject code	360
Language	English
Publishing date	2020-06-01T00:00:00Z
Publisher	eLife Sciences Publications Ltd
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Point of Care Nucleic Acid Testing for SARS-CoV-2 in Hospitalized Patients

Dami A. Collier / Sonny M. Assennato / Ben Warne / Nyarie Sithole / Katherine Sharrocks / Allyson Ritchie / Pooja Ravji / Matthew Routledge / Dominic Sparkes / Jordan Skittrall / Anna Smielewska / Isobel Ramsey / Neha Goel / Martin Curran / David Enoch / Rhys Tassell / Michelle Lineham / Devan Vaghela / Clare Leong /

Cell Reports Medicine, Vol 1, Iss 5, Pp 100062- (2020)

A Clinical Validation Trial and Implementation Study

2020

Abstract: Summary: There is an urgent need for rapid SARS-CoV-2 testing in hospitals to limit nosocomial spread. We report an evaluation of point of care (POC) nucleic acid amplification testing (NAAT) in 149 participants with parallel combined nasal and throat ... ...

Abstract	Summary: There is an urgent need for rapid SARS-CoV-2 testing in hospitals to limit nosocomial spread. We report an evaluation of point of care (POC) nucleic acid amplification testing (NAAT) in 149 participants with parallel combined nasal and throat swabbing for POC versus standard lab RT-PCR testing. Median time to result is 2.6 (IQR 2.3–4.8) versus 26.4 h (IQR 21.4–31.4, p < 0.001), with 32 (21.5%) positive and 117 (78.5%) negative. Cohen’s κ correlation between tests is 0.96 (95% CI 0.91–1.00). When comparing nearly 1,000 tests pre- and post-implementation, the median time to definitive bed placement from admission is 23.4 (8.6-41.9) versus 17.1 h (9.0–28.8), p = 0.02. Mean length of stay on COVID-19 “holding” wards is 58.5 versus 29.9 h (p < 0.001). POC testing increases isolation room availability, avoids bed closures, allows discharge to care homes, and expedites access to hospital procedures. POC testing could mitigate the impact of COVID-19 on hospital systems.
Keywords	COVID-19 ; SARS-CoV-2 ; POC ; point of care ; diagnostic test ; nosocomial ; Medicine (General) ; R5-920
Language	English
Publishing date	2020-08-01T00:00:00Z
Publisher	Elsevier
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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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. 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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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