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Erschienen in: Wiener klinische Wochenschrift 23-24/2022

07.09.2022 | original article

Comparison of clinical characteristics among patients infected with alpha vs. delta SARS-CoV-2 variants

verfasst von: Benedikt Rumpf, Benno Lickefett, Clemens Baumgartner, Victoria Kauer, Mario Karolyi, Erich Pawelka, Tamara Seitz, Marianna Traugott, Petr Triska, Andreas Bergthaler, Hermann Laferl, Christoph Wenisch, Alexander Zoufaly

Erschienen in: Wiener klinische Wochenschrift | Ausgabe 23-24/2022

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Summary

Background

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has undergone different molecular changes, sprouting genetic variants of the original wildtype. Clinical comparisons between patients infected with alpha versus delta are scarce.

Methods

In this retrospective observational study, adult patients hospitalized with coronavirus disease 2019 (COVID-19) due to confirmed SARS-CoV‑2 alpha or delta infection were included. Patient characteristics, virologic and laboratory parameters, as well as the clinical course were compared in patients infected with alpha vs. delta variants.

Results

A total of 106 patients infected with alpha and 215 patients infected with delta were included. Patients infected with the delta variant were admitted to hospital earlier after symptom onset (6 vs. 7 days, p < 0.001). Blood levels of C‑reactive protein (43.3 vs. 62.9 mg/l, p = 0.02) and neutrophil count (3.81 vs. 4.53 G/l, p = 0.06) were lower in delta patients. Furthermore, at hospital admission cycle threshold (CT) values were significantly lower in patients infected with the delta variant (22.3 vs. 24.9, p < 0.001). Patients infected with the delta variant needed supplemental oxygen less often during disease course (50% vs. 64%, p = 0.02). Furthermore, there was a statistically non-significant trend towards a lower ICU admission rate among delta patients (16% vs. 24%, p = 0.08)

Conclusion

Patients diagnosed with the delta variant were admitted to the hospital earlier, had a less severe course of disease and a higher viral replication on admission. This may provide a window of opportunity for antivirals in the hospital setting.
Literatur
1.
Zurück zum Zitat Karlinsky A, Kobak D. Tracking excess mortality across countries during the COVID-19 pandemic with the World Mortality Dataset. Elife. 2021;10:e69336.CrossRef Karlinsky A, Kobak D. Tracking excess mortality across countries during the COVID-19 pandemic with the World Mortality Dataset. Elife. 2021;10:e69336.CrossRef
2.
Zurück zum Zitat Wu F, Zhao S, Yu B, Chen YM, Wang W, Song ZG, et al. A new coronavirus associated with human respiratory disease in China. Nature. 2020;579(7798):265–9.CrossRef Wu F, Zhao S, Yu B, Chen YM, Wang W, Song ZG, et al. A new coronavirus associated with human respiratory disease in China. Nature. 2020;579(7798):265–9.CrossRef
3.
Zurück zum Zitat Volz E, Mishra S, Chand M, Barrett JC, Johnson R, Geidelberg L, et al. Transmission of SARS-CoV‑2 Lineage B.1.1.7 in England: insights from linking epidemiological and genetic data. medRxiv, 2020.12.30.20249034. 2021. Volz E, Mishra S, Chand M, Barrett JC, Johnson R, Geidelberg L, et al. Transmission of SARS-CoV‑2 Lineage B.1.1.7 in England: insights from linking epidemiological and genetic data. medRxiv, 2020.12.30.20249034. 2021.
4.
Zurück zum Zitat Galloway SE, Paul P, MacCannell DR, Johansson MA, Brooks JT, MacNeil A, et al. Emergence of SARS-coV‑2 B.1.1.7 lineage—United States, december 29, 2020-january 12, 2021. Mmwr Morb Mortal Wkly Rep. 2021;70(3):95–9.CrossRef Galloway SE, Paul P, MacCannell DR, Johansson MA, Brooks JT, MacNeil A, et al. Emergence of SARS-coV‑2 B.1.1.7 lineage—United States, december 29, 2020-january 12, 2021. Mmwr Morb Mortal Wkly Rep. 2021;70(3):95–9.CrossRef
5.
Zurück zum Zitat Worobey M, Pekar J, Larsen BB, Nelson MI, Hill V, Joy JB, et al. The emergence of SARS-CoV‑2 in Europe and North America. Science. 2020;370(6516):564–70.CrossRef Worobey M, Pekar J, Larsen BB, Nelson MI, Hill V, Joy JB, et al. The emergence of SARS-CoV‑2 in Europe and North America. Science. 2020;370(6516):564–70.CrossRef
6.
Zurück zum Zitat Starr TN, Greaney AJ, Hilton SK, Ellis D, Crawford KHD, Dingens AS, et al. Deep mutational scanning of SARS-CoV‑2 receptor binding domain reveals constraints on folding and ACE2 binding. Cell. 2020;182(5):1295–310.e20.CrossRef Starr TN, Greaney AJ, Hilton SK, Ellis D, Crawford KHD, Dingens AS, et al. Deep mutational scanning of SARS-CoV‑2 receptor binding domain reveals constraints on folding and ACE2 binding. Cell. 2020;182(5):1295–310.e20.CrossRef
7.
Zurück zum Zitat Harvey WT, Carabelli AM, Jackson B, Gupta RK, Thomson EC, Harrison EM, et al. SARS-CoV‑2 variants, spike mutations and immune escape. Nat Rev Microbiol. 2021;19(7):409–24.CrossRef Harvey WT, Carabelli AM, Jackson B, Gupta RK, Thomson EC, Harrison EM, et al. SARS-CoV‑2 variants, spike mutations and immune escape. Nat Rev Microbiol. 2021;19(7):409–24.CrossRef
9.
Zurück zum Zitat Earnest R, Uddin R, Matluk N, Renzette N, Siddle KJ, Loreth C, et al. Comparative transmissibility of SARS-CoV‑2 variants Delta and Alpha in New England, USA. medRxiv, 2021.10.06.21264641. 2021.CrossRef Earnest R, Uddin R, Matluk N, Renzette N, Siddle KJ, Loreth C, et al. Comparative transmissibility of SARS-CoV‑2 variants Delta and Alpha in New England, USA. medRxiv, 2021.10.06.21264641. 2021.CrossRef
10.
Zurück zum Zitat Planas D, Veyer D, Baidaliuk A, Staropoli I, Guivel-Benhassine F, Rajah MM, et al. Reduced sensitivity of SARS-CoV‑2 variant Delta to antibody neutralization. Nature. 2021;596(7871):276–80.CrossRef Planas D, Veyer D, Baidaliuk A, Staropoli I, Guivel-Benhassine F, Rajah MM, et al. Reduced sensitivity of SARS-CoV‑2 variant Delta to antibody neutralization. Nature. 2021;596(7871):276–80.CrossRef
11.
Zurück zum Zitat Salleh MZ, Derrick JP, Deris ZZ. Structural evaluation of the spike glycoprotein variants on SARS-coV‑2 transmission and immune evasion. Int J Mol Sci. 2021;22(14):7425.CrossRef Salleh MZ, Derrick JP, Deris ZZ. Structural evaluation of the spike glycoprotein variants on SARS-coV‑2 transmission and immune evasion. Int J Mol Sci. 2021;22(14):7425.CrossRef
12.
Zurück zum Zitat Teyssou E, Delagrèverie H, Visseaux B, Lambert-Niclot S, Brichler S, Ferre V, et al. The Delta SARS-CoV‑2 variant has a higher viral load than the Beta and the historical variants in nasopharyngeal samples from newly diagnosed COVID-19 patients. J Infect. 2021;83(4):e1–e3.CrossRef Teyssou E, Delagrèverie H, Visseaux B, Lambert-Niclot S, Brichler S, Ferre V, et al. The Delta SARS-CoV‑2 variant has a higher viral load than the Beta and the historical variants in nasopharyngeal samples from newly diagnosed COVID-19 patients. J Infect. 2021;83(4):e1–e3.CrossRef
13.
Zurück zum Zitat Twohig KA, Nyberg T, Zaidi A, Thelwall S, Sinnathamby MA, Aliabadi S, et al. Hospital admission and emergency care attendance risk for SARS-CoV‑2 delta (B.1.617.2) compared with alpha (B.1.1.7) variants of concern: a cohort study. Lancet Infect Dis. 2022. https://doi.org/10.1016/S1473-3099(21)00475-8.CrossRef Twohig KA, Nyberg T, Zaidi A, Thelwall S, Sinnathamby MA, Aliabadi S, et al. Hospital admission and emergency care attendance risk for SARS-CoV‑2 delta (B.1.617.2) compared with alpha (B.1.1.7) variants of concern: a cohort study. Lancet Infect Dis. 2022. https://​doi.​org/​10.​1016/​S1473-3099(21)00475-8.CrossRef
14.
Zurück zum Zitat Rao SN, Manissero D, Steele VR, Pareja J. A narrative systematic review of the clinical utility of cycle threshold values in the context of COVID-19. Infect Dis Ther. 2020;9(3):573–86.CrossRef Rao SN, Manissero D, Steele VR, Pareja J. A narrative systematic review of the clinical utility of cycle threshold values in the context of COVID-19. Infect Dis Ther. 2020;9(3):573–86.CrossRef
15.
Zurück zum Zitat Herold T, Jurinovic V, Arnreich C, Lipworth BJ, Hellmuth JC, von Bergwelt-Baildon M, et al. Elevated levels of IL‑6 and CRP predict the need for mechanical ventilation in COVID-19. J Allergy Clin Immunol. 2020;146(1):128–136.e4.CrossRef Herold T, Jurinovic V, Arnreich C, Lipworth BJ, Hellmuth JC, von Bergwelt-Baildon M, et al. Elevated levels of IL‑6 and CRP predict the need for mechanical ventilation in COVID-19. J Allergy Clin Immunol. 2020;146(1):128–136.e4.CrossRef
16.
Zurück zum Zitat Cavalcante-Silva LHA, Carvalho DCM, Lima ÉA, Galvão JGFM, da Silva JSF, Sales-Neto JM, et al. Neutrophils and COVID-19: the road so far. Int Immunopharmacol. 2021;90:107233.CrossRef Cavalcante-Silva LHA, Carvalho DCM, Lima ÉA, Galvão JGFM, da Silva JSF, Sales-Neto JM, et al. Neutrophils and COVID-19: the road so far. Int Immunopharmacol. 2021;90:107233.CrossRef
17.
Zurück zum Zitat Tomar B, Anders H‑J, Desai J, Mulay SR. Neutrophils and neutrophil extracellular traps drive necroinflammation in COVID-19. Cells. 2020;9(6):1383.CrossRef Tomar B, Anders H‑J, Desai J, Mulay SR. Neutrophils and neutrophil extracellular traps drive necroinflammation in COVID-19. Cells. 2020;9(6):1383.CrossRef
18.
Zurück zum Zitat Lee S, Kim T, Lee E, Lee C, Kim H, Rhee H, et al. Clinical course and molecular viral shedding among asymptomatic and symptomatic patients with SARS-CoV‑2 infection in a community treatment center in the republic of korea. JAMA Intern Med. 2020;180(11):1447–52.CrossRef Lee S, Kim T, Lee E, Lee C, Kim H, Rhee H, et al. Clinical course and molecular viral shedding among asymptomatic and symptomatic patients with SARS-CoV‑2 infection in a community treatment center in the republic of korea. JAMA Intern Med. 2020;180(11):1447–52.CrossRef
19.
Zurück zum Zitat Kripalani S, Theobald CN, Anctil B, Vasilevskis EE. Reducing hospital readmission rates: current strategies and future directions. Annu Rev Med. 2014;65:471–85.CrossRef Kripalani S, Theobald CN, Anctil B, Vasilevskis EE. Reducing hospital readmission rates: current strategies and future directions. Annu Rev Med. 2014;65:471–85.CrossRef
22.
Zurück zum Zitat Gupta A, Gonzalez-Rojas Y, Juarez E, Crespo Casal M, Moya J, Falci DR, et al. Early treatment for Covid-19 with SARS-coV‑2 neutralizing antibody sotrovimab. N Engl J Med. 2021;385(21):1941–50.CrossRef Gupta A, Gonzalez-Rojas Y, Juarez E, Crespo Casal M, Moya J, Falci DR, et al. Early treatment for Covid-19 with SARS-coV‑2 neutralizing antibody sotrovimab. N Engl J Med. 2021;385(21):1941–50.CrossRef
23.
Zurück zum Zitat A Neutralizing Monoclonal Antibody for Hospitalized Patients with Covid-19. New England Journal of Medicine. 2020;384(10):905–14. A Neutralizing Monoclonal Antibody for Hospitalized Patients with Covid-19. New England Journal of Medicine. 2020;384(10):905–14.
24.
Zurück zum Zitat Cao B, Hayden FG. Antiviral monotherapy for hospitalised patients with COVID-19 is not enough. Lancet. 2020;396(10259):1310–1.CrossRef Cao B, Hayden FG. Antiviral monotherapy for hospitalised patients with COVID-19 is not enough. Lancet. 2020;396(10259):1310–1.CrossRef
25.
Zurück zum Zitat Group RC, Horby PW, Mafham M, Peto L, Campbell M, Pessoa-Amorim G, et al. Casirivimab and imdevimab in patients admitted to hospital with COVID-19 (RECOVERY): a randomised, controlled, open-label, platform trial. medRxiv, 2021.06.15.21258542. 2021. Group RC, Horby PW, Mafham M, Peto L, Campbell M, Pessoa-Amorim G, et al. Casirivimab and imdevimab in patients admitted to hospital with COVID-19 (RECOVERY): a randomised, controlled, open-label, platform trial. medRxiv, 2021.06.15.21258542. 2021.
27.
Zurück zum Zitat Ader F, Bouscambert-Duchamp M, Hites M, Peiffer-Smadja N, Poissy J, Belhadi D, et al. Remdesivir plus standard of care versus standard of care alone for the treatment of patients admitted to hospital with COVID-19 (DisCoVeRy): a phase 3, randomised, controlled, open-label trial. Lancet Infect Dis. 2021. https://doi.org/10.1016/S1473-3099(21)00485-0.CrossRef Ader F, Bouscambert-Duchamp M, Hites M, Peiffer-Smadja N, Poissy J, Belhadi D, et al. Remdesivir plus standard of care versus standard of care alone for the treatment of patients admitted to hospital with COVID-19 (DisCoVeRy): a phase 3, randomised, controlled, open-label trial. Lancet Infect Dis. 2021. https://​doi.​org/​10.​1016/​S1473-3099(21)00485-0.CrossRef
28.
Zurück zum Zitat Sundararaj Stanleyraj J, Sethuraman N, Gupta R, Thiruvoth S, Gupta M, Ryo A. Treating COVID-19: are we missing out the window of opportunity? J Antimicrob Chemother. 2020;76(2):283–5.CrossRef Sundararaj Stanleyraj J, Sethuraman N, Gupta R, Thiruvoth S, Gupta M, Ryo A. Treating COVID-19: are we missing out the window of opportunity? J Antimicrob Chemother. 2020;76(2):283–5.CrossRef
Metadaten
Titel
Comparison of clinical characteristics among patients infected with alpha vs. delta SARS-CoV-2 variants
verfasst von
Benedikt Rumpf
Benno Lickefett
Clemens Baumgartner
Victoria Kauer
Mario Karolyi
Erich Pawelka
Tamara Seitz
Marianna Traugott
Petr Triska
Andreas Bergthaler
Hermann Laferl
Christoph Wenisch
Alexander Zoufaly
Publikationsdatum
07.09.2022
Verlag
Springer Vienna
Erschienen in
Wiener klinische Wochenschrift / Ausgabe 23-24/2022
Print ISSN: 0043-5325
Elektronische ISSN: 1613-7671
DOI
https://doi.org/10.1007/s00508-022-02084-1

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