دورية أكاديمية
Changing character and waning impact of COVID-19 at a tertiary centre in Cape Town, South Africa.
| العنوان: | Changing character and waning impact of COVID-19 at a tertiary centre in Cape Town, South Africa. |
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| المؤلفون: | Hermans LE; Department of Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa., Booysen P; Centre for Infectious Diseases Research in Africa, Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town, South Africa., Boloko L; Centre for Infectious Diseases Research in Africa, Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town, South Africa., Adriaanse M; Division of Infectious Diseases and HIV Medicine, Department of Medicine, University of Cape Town, Cape Town, South Africa., de Wet TJ; Department of Medical Microbiology, Faculty of Health Sciences, University of Cape town, Cape Town, South Africa., Lifson AR; Department of Medicine, Faculty of Internal Medicine, Groote Schuur Hospital, Cape Town, South Africa., Wadee N; Centre for Infectious Diseases Research in Africa, Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town, South Africa., Papavarnavas N; Institute of Infectious Disease and HIV Medicine, Department of Medicine, University of Cape Town, Cape Town, South Africa., Marais G; Division of Medical Virology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa.; Division of Medical Microbiology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa., Hsiao NY; Division of Medical Virology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa., Rosslee MJ; Department of Medicine, Victoria Hospital, Wynberg, Cape Town, South Africa., Symons G; Department of Medicine, Division of Pulmonology, Groote Schuur Hospital, Cape Town, South Africa., Calligaro GL; Department of Medicine, Division of Pulmonology, Groote Schuur Hospital, Cape Town, South Africa., Iranzadeh A; Department of Integrative Biomedical Sciences, Computational Biology Division, University of Cape Town, Cape Town, South Africa., Wilkinson RJ; Centre for Infectious Diseases Research in Africa, Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town, South Africa.; The Francis Crick Institute, London, United Kingdom.; Department of Infectious Disease, Imperial College, London, United Kingdom., Ntusi NAB; Department of Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa.; South African Medical Research Council, University of Cape Town Extramural Research Unit on the Intersection of Noncommunicable Diseases and Infectious Diseases, Cape Town, South Africa., Williamson C; Department of Pathology, IDM and CIDRI-Africa, Division of Medical Virology, University of Cape Town, Cape Town, South Africa., Davies MA; Department of Health and Wellness, Western Cape Government, Cape Town, South Africa.; Centre for Infectious Disease Epidemiology and Research, School of Public Health, University of Cape Town, Cape Town, South Africa., Meintjes G; Department of Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa.; Centre for Infectious Diseases Research in Africa, Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town, South Africa., Wasserman S; Centre for Infectious Diseases Research in Africa, Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town, South Africa.; Institute for Infection and Immunity, St George's, University of London, London, United Kingdom. |
| المصدر: | Southern African journal of infectious diseases [S Afr J Infect Dis] 2023 Dec 18; Vol. 38 (1), pp. 550. Date of Electronic Publication: 2023 Dec 18 (Print Publication: 2023). |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: AOSIS Publishing Country of Publication: South Africa NLM ID: 101646666 Publication Model: eCollection Cited Medium: Internet ISSN: 2313-1810 (Electronic) Linking ISSN: 23120053 NLM ISO Abbreviation: S Afr J Infect Dis Subsets: PubMed not MEDLINE |
| أسماء مطبوعة: | Publication: 2019- : Durbanville, Cape Town, South Africa : AOSIS Publishing Original Publication: [Centurion] : Medpharm Publications (Pty) Ltd., 2014- |
| مستخلص: | Background: The emergence of genetic variants of SARS-CoV-2 was associated with changing epidemiological characteristics throughout coronavirus disease 2019 (COVID-19) pandemic in population-based studies. Individual-level data on the clinical characteristics of infection with different SARS-CoV-2 variants in African countries is less well documented. Objectives: To describe the evolving clinical differences observed with the various SARS-CoV-2 variants of concern and compare the Omicron-driven wave in infections to the previous Delta-driven wave. Method: We performed a retrospective observational cohort study among patients admitted to a South African referral hospital with COVID-19 pneumonia. Patients were stratified by epidemiological wave period, and in a subset, the variants associated with each wave were confirmed by genomic sequencing. Outcomes were analysed by Cox proportional hazard models. Results: We included 1689 patients were included, representing infection waves driven predominantly by ancestral, Beta, Delta and Omicron BA1/BA2 & BA4/BA5 variants. Crude 28-day mortality was 25.8% (34/133) in the Omicron wave period versus 37.1% (138/374) in the Delta wave period (hazard ratio [HR] 0.68 [95% CI 0.47-1.00] p = 0.049); this effect persisted after adjustment for age, gender, HIV status and presence of cardiovascular disease (adjusted HR [aHR] 0.43 [95% CI 0.28-0.67] p < 0.001). Hospital-wide SARS-CoV-2 admissions and deaths were highest during the Delta wave period, with a decoupling of SARS-CoV-2 deaths and overall deaths thereafter. Conclusion: There was lower in-hospital mortality during Omicron-driven waves compared with the prior Delta wave, despite patients admitted during the Omicron wave being at higher risk. Contribution: This study summarises clinical characteristics associated with SARS-CoV-2 variants during the COVID-19 pandemic at a South African tertiary hospital, demonstrating a waning impact of COVID-19 on healthcare services over time despite epidemic waves driven by new variants. Findings suggest the absence of increasing virulence from later variants and protection from population and individual-level immunity. Competing Interests: The authors have declared that no competing interest exists. (© 2023. The Authors.) |
| References: | Lancet Glob Health. 2022 Jul;10(7):e961-e969. (PMID: 35597249) Lancet Infect Dis. 2021 Sep;21(9):1195-1197. (PMID: 33857407) Ann Intern Med. 2022 Jun;175(6):831-837. (PMID: 35286147) Lancet. 2022 Jan 29;399(10323):437-446. (PMID: 35065011) Nature. 2022 Mar;603(7902):687-692. (PMID: 35062015) Nature. 2022 Mar;603(7902):715-720. (PMID: 35104836) BMJ. 2022 Aug 2;378:e070695. (PMID: 35918098) South Afr J Crit Care. 2021 Aug 06;37(2):. (PMID: 35493978) Clin Pract (Lond). 2014;11(5):525-535. (PMID: 25589951) Lancet HIV. 2021 Sep;8(9):e554-e567. (PMID: 34363789) S Afr Med J. 2020 Aug 26;110(10):973-981. (PMID: 33205723) |
| معلومات مُعتمدة: | CC2112 United Kingdom ARC_ Arthritis Research UK; U01 AI170426 United States AI NIAID NIH HHS; United Kingdom WT_ Wellcome Trust; K43 TW011421 United States TW FIC NIH HHS; U01 AI069924 United States AI NIAID NIH HHS |
| فهرسة مساهمة: | Keywords: COVID-19; Delta; Omicron; SARS-CoV-2; clinical characteristics; observational study |
| تواريخ الأحداث: | Date Created: 20240115 Latest Revision: 20240210 |
| رمز التحديث: | 20240210 |
| مُعرف محوري في PubMed: | PMC10784273 |
| DOI: | 10.4102/sajid.v38i1.550 |
| PMID: | 38223432 |
| قاعدة البيانات: | MEDLINE |
Full Text Finder | تدمد: | 2313-1810 |
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| DOI: | 10.4102/sajid.v38i1.550 |