Trends in Cases, Hospitalizations, and Mortality Related to the Omicron BA.4/BA.5 Subvariants in South Africa
© The Author(s) 2022. Published by Oxford University Press on behalf of Infectious Diseases Society of America..
BACKGROUND: In this study, we compared admission incidence risk and the risk of mortality in the Omicron BA.4/BA.5 wave to previous waves.
METHODS: Data from South Africa's SARS-CoV-2 case linelist, national COVID-19 hospital surveillance system, and Electronic Vaccine Data System were linked and analyzed. Wave periods were defined when the country passed a weekly incidence of 30 cases/100 000 population. In-hospital case fatality ratios (CFRs) during the Delta, Omicron BA.1/BA.2, and Omicron BA.4/BA.5 waves were compared using post-imputation random effect multivariable logistic regression models.
RESULTS: The CFR was 25.9% (N = 37 538 of 144 778), 10.9% (N = 6123 of 56 384), and 8.2% (N = 1212 of 14 879) in the Delta, Omicron BA.1/BA.2, and Omicron BA.4/BA.5 waves, respectively. After adjusting for age, sex, race, comorbidities, health sector, and province, compared with the Omicron BA.4/BA.5 wave, patients had higher risk of mortality in the Omicron BA.1/BA.2 wave (adjusted odds ratio [aOR], 1.3; 95% confidence interval [CI]: 1.2-1.4) and Delta wave (aOR, 3.0; 95% CI: 2.8-3.2). Being partially vaccinated (aOR, 0.9; 95% CI: .9-.9), fully vaccinated (aOR, 0.6; 95% CI: .6-.7), and boosted (aOR, 0.4; 95% CI: .4-.5) and having prior laboratory-confirmed infection (aOR, 0.4; 95% CI: .3-.4) were associated with reduced risks of mortality.
CONCLUSIONS: Overall, admission incidence risk and in-hospital mortality, which had increased progressively in South Africa's first 3 waves, decreased in the fourth Omicron BA.1/BA.2 wave and declined even further in the fifth Omicron BA.4/BA.5 wave. Mortality risk was lower in those with natural infection and vaccination, declining further as the number of vaccine doses increased.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:76 |
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| Enthalten in: |
Clinical infectious diseases : an official publication of the Infectious Diseases Society of America - 76(2023), 8 vom: 17. Apr., Seite 1468-1475 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Jassat, Waasila [VerfasserIn] |
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| Links: |
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| Themen: |
COVID-19 |
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| Anmerkungen: |
Date Completed 19.04.2023 Date Revised 06.11.2023 published: Print Citation Status MEDLINE |
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| doi: |
10.1093/cid/ciac921 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM349657602 |
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| 100 | 1 | |a Jassat, Waasila |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Trends in Cases, Hospitalizations, and Mortality Related to the Omicron BA.4/BA.5 Subvariants in South Africa |
| 264 | 1 | |c 2023 | |
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| 500 | |a Date Completed 19.04.2023 | ||
| 500 | |a Date Revised 06.11.2023 | ||
| 500 | |a published: Print | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © The Author(s) 2022. Published by Oxford University Press on behalf of Infectious Diseases Society of America. | ||
| 520 | |a BACKGROUND: In this study, we compared admission incidence risk and the risk of mortality in the Omicron BA.4/BA.5 wave to previous waves | ||
| 520 | |a METHODS: Data from South Africa's SARS-CoV-2 case linelist, national COVID-19 hospital surveillance system, and Electronic Vaccine Data System were linked and analyzed. Wave periods were defined when the country passed a weekly incidence of 30 cases/100 000 population. In-hospital case fatality ratios (CFRs) during the Delta, Omicron BA.1/BA.2, and Omicron BA.4/BA.5 waves were compared using post-imputation random effect multivariable logistic regression models | ||
| 520 | |a RESULTS: The CFR was 25.9% (N = 37 538 of 144 778), 10.9% (N = 6123 of 56 384), and 8.2% (N = 1212 of 14 879) in the Delta, Omicron BA.1/BA.2, and Omicron BA.4/BA.5 waves, respectively. After adjusting for age, sex, race, comorbidities, health sector, and province, compared with the Omicron BA.4/BA.5 wave, patients had higher risk of mortality in the Omicron BA.1/BA.2 wave (adjusted odds ratio [aOR], 1.3; 95% confidence interval [CI]: 1.2-1.4) and Delta wave (aOR, 3.0; 95% CI: 2.8-3.2). Being partially vaccinated (aOR, 0.9; 95% CI: .9-.9), fully vaccinated (aOR, 0.6; 95% CI: .6-.7), and boosted (aOR, 0.4; 95% CI: .4-.5) and having prior laboratory-confirmed infection (aOR, 0.4; 95% CI: .3-.4) were associated with reduced risks of mortality | ||
| 520 | |a CONCLUSIONS: Overall, admission incidence risk and in-hospital mortality, which had increased progressively in South Africa's first 3 waves, decreased in the fourth Omicron BA.1/BA.2 wave and declined even further in the fifth Omicron BA.4/BA.5 wave. Mortality risk was lower in those with natural infection and vaccination, declining further as the number of vaccine doses increased | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 650 | 4 | |a COVID-19 | |
| 650 | 4 | |a Omicron BA.4 | |
| 650 | 4 | |a Omicron BA.5 | |
| 650 | 4 | |a hospital admissions | |
| 650 | 4 | |a mortality | |
| 700 | 1 | |a Abdool Karim, Salim S |e verfasserin |4 aut | |
| 700 | 1 | |a Ozougwu, Lovelyn |e verfasserin |4 aut | |
| 700 | 1 | |a Welch, Richard |e verfasserin |4 aut | |
| 700 | 1 | |a Mudara, Caroline |e verfasserin |4 aut | |
| 700 | 1 | |a Masha, Maureen |e verfasserin |4 aut | |
| 700 | 1 | |a Rousseau, Petro |e verfasserin |4 aut | |
| 700 | 1 | |a Wolmarans, Milani |e verfasserin |4 aut | |
| 700 | 1 | |a Selikow, Anthony |e verfasserin |4 aut | |
| 700 | 1 | |a Govender, Nevashan |e verfasserin |4 aut | |
| 700 | 1 | |a Walaza, Sibongile |e verfasserin |4 aut | |
| 700 | 1 | |a von Gottberg, Anne |e verfasserin |4 aut | |
| 700 | 1 | |a Wolter, Nicole |e verfasserin |4 aut | |
| 700 | 1 | |a Terrence Pisa, Pedro |e verfasserin |4 aut | |
| 700 | 1 | |a Sanne, Ian |e verfasserin |4 aut | |
| 700 | 1 | |a Govender, Sharlene |e verfasserin |4 aut | |
| 700 | 1 | |a Blumberg, Lucille |e verfasserin |4 aut | |
| 700 | 1 | |a Cohen, Cheryl |e verfasserin |4 aut | |
| 700 | 1 | |a Groome, Michelle J |e verfasserin |4 aut | |
| 700 | 0 | |a DATCOV Author Group |e verfasserin |4 aut | |
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