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Different clinical features in Malawian outpatients presenting with COVID-19 prior to and during Omicron variant dominance: A prospective observational study

The SARS-CoV-2 Omicron variant has resulted in a high number of cases, but a relatively low incidence of severe disease and deaths, compared to the pre-Omicron variants. Therefore, we assessed the differences in symptom prevalence between Omicron and pre-Omicron infections in a sub-Saharan African p...

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Autores principales: Chibwana, Marah G., Thole, Herbert W., Anscombe, Cat, Ashton, Philip M., Green, Edward, Barnes, Kayla G., Cornick, Jen, Turner, Ann, Witte, Desiree, Nthala, Sharon, Thom, Chikondi, Kanyandula, Felistas, Ainani, Anna, Mtike, Natasha, Tambala, Hope, N’goma, Veronica, Mwafulirwa, Dorah, Asima, Erick, Morton, Ben, Gmeiner, Markus, Gundah, Zaziwe, Kawalazira, Gift, French, Neil, Feasey, Nicholas, Heyderman, Robert S., Swarthout, Todd D., Jambo, Kondwani C.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10022204/
https://www.ncbi.nlm.nih.gov/pubmed/36963090
http://dx.doi.org/10.1371/journal.pgph.0001575
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author Chibwana, Marah G.
Thole, Herbert W.
Anscombe, Cat
Ashton, Philip M.
Green, Edward
Barnes, Kayla G.
Cornick, Jen
Turner, Ann
Witte, Desiree
Nthala, Sharon
Thom, Chikondi
Kanyandula, Felistas
Ainani, Anna
Mtike, Natasha
Tambala, Hope
N’goma, Veronica
Mwafulirwa, Dorah
Asima, Erick
Morton, Ben
Gmeiner, Markus
Gundah, Zaziwe
Kawalazira, Gift
French, Neil
Feasey, Nicholas
Heyderman, Robert S.
Swarthout, Todd D.
Jambo, Kondwani C.
author_facet Chibwana, Marah G.
Thole, Herbert W.
Anscombe, Cat
Ashton, Philip M.
Green, Edward
Barnes, Kayla G.
Cornick, Jen
Turner, Ann
Witte, Desiree
Nthala, Sharon
Thom, Chikondi
Kanyandula, Felistas
Ainani, Anna
Mtike, Natasha
Tambala, Hope
N’goma, Veronica
Mwafulirwa, Dorah
Asima, Erick
Morton, Ben
Gmeiner, Markus
Gundah, Zaziwe
Kawalazira, Gift
French, Neil
Feasey, Nicholas
Heyderman, Robert S.
Swarthout, Todd D.
Jambo, Kondwani C.
author_sort Chibwana, Marah G.
collection PubMed
description The SARS-CoV-2 Omicron variant has resulted in a high number of cases, but a relatively low incidence of severe disease and deaths, compared to the pre-Omicron variants. Therefore, we assessed the differences in symptom prevalence between Omicron and pre-Omicron infections in a sub-Saharan African population. We collected data from outpatients presenting at two primary healthcare facilities in Blantyre, Malawi, from November 2020 to March 2022. Eligible participants were aged >1month old, with signs suggestive of COVID-19, and those not suspected of COVID-19, from whom we collected nasopharyngeal swabs for SARS-CoV-2 PCR testing, and sequenced positive samples to identify infecting-variants. In addition, we calculated the risk of presenting with a given symptom in individuals testing SARS-CoV-2 PCR positive before and during the Omicron variant-dominated period. Among 5176 participants, 6.4% were under 5, and 77% were aged 18 to 50 years. SARS-CoV-2 infection prevalence peaked in January 2021 (Beta), July 2021 (Delta), and December 2021 (Omicron). We found that cough (risk ratio (RR), 1.50; 95% confidence interval (CI), 1.00 to 2.30), fatigue (RR 2.27; 95% CI, 1.29 to 3.86) and headache (RR 1.64; 95% CI, 1.15 to 2.34) were associated with a high risk of SARS-CoV-2 infection during the pre-Omicron period. In comparison, only headache (RR 1.41; 95% CI, 1.07 to 1.86) did associate with a high risk of SARS-CoV-2 infection during the Omicron-dominated period. In conclusion, clinical symptoms associated with Omicron infection differed from prior variants and were harder to identify clinically with current symptom guidelines. Our findings encourage regular review of case definitions and testing policies to ensure case ascertainment.
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spelling pubmed-100222042023-03-17 Different clinical features in Malawian outpatients presenting with COVID-19 prior to and during Omicron variant dominance: A prospective observational study Chibwana, Marah G. Thole, Herbert W. Anscombe, Cat Ashton, Philip M. Green, Edward Barnes, Kayla G. Cornick, Jen Turner, Ann Witte, Desiree Nthala, Sharon Thom, Chikondi Kanyandula, Felistas Ainani, Anna Mtike, Natasha Tambala, Hope N’goma, Veronica Mwafulirwa, Dorah Asima, Erick Morton, Ben Gmeiner, Markus Gundah, Zaziwe Kawalazira, Gift French, Neil Feasey, Nicholas Heyderman, Robert S. Swarthout, Todd D. Jambo, Kondwani C. PLOS Glob Public Health Research Article The SARS-CoV-2 Omicron variant has resulted in a high number of cases, but a relatively low incidence of severe disease and deaths, compared to the pre-Omicron variants. Therefore, we assessed the differences in symptom prevalence between Omicron and pre-Omicron infections in a sub-Saharan African population. We collected data from outpatients presenting at two primary healthcare facilities in Blantyre, Malawi, from November 2020 to March 2022. Eligible participants were aged >1month old, with signs suggestive of COVID-19, and those not suspected of COVID-19, from whom we collected nasopharyngeal swabs for SARS-CoV-2 PCR testing, and sequenced positive samples to identify infecting-variants. In addition, we calculated the risk of presenting with a given symptom in individuals testing SARS-CoV-2 PCR positive before and during the Omicron variant-dominated period. Among 5176 participants, 6.4% were under 5, and 77% were aged 18 to 50 years. SARS-CoV-2 infection prevalence peaked in January 2021 (Beta), July 2021 (Delta), and December 2021 (Omicron). We found that cough (risk ratio (RR), 1.50; 95% confidence interval (CI), 1.00 to 2.30), fatigue (RR 2.27; 95% CI, 1.29 to 3.86) and headache (RR 1.64; 95% CI, 1.15 to 2.34) were associated with a high risk of SARS-CoV-2 infection during the pre-Omicron period. In comparison, only headache (RR 1.41; 95% CI, 1.07 to 1.86) did associate with a high risk of SARS-CoV-2 infection during the Omicron-dominated period. In conclusion, clinical symptoms associated with Omicron infection differed from prior variants and were harder to identify clinically with current symptom guidelines. Our findings encourage regular review of case definitions and testing policies to ensure case ascertainment. Public Library of Science 2023-03-08 /pmc/articles/PMC10022204/ /pubmed/36963090 http://dx.doi.org/10.1371/journal.pgph.0001575 Text en © 2023 Chibwana et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Chibwana, Marah G.
Thole, Herbert W.
Anscombe, Cat
Ashton, Philip M.
Green, Edward
Barnes, Kayla G.
Cornick, Jen
Turner, Ann
Witte, Desiree
Nthala, Sharon
Thom, Chikondi
Kanyandula, Felistas
Ainani, Anna
Mtike, Natasha
Tambala, Hope
N’goma, Veronica
Mwafulirwa, Dorah
Asima, Erick
Morton, Ben
Gmeiner, Markus
Gundah, Zaziwe
Kawalazira, Gift
French, Neil
Feasey, Nicholas
Heyderman, Robert S.
Swarthout, Todd D.
Jambo, Kondwani C.
Different clinical features in Malawian outpatients presenting with COVID-19 prior to and during Omicron variant dominance: A prospective observational study
title Different clinical features in Malawian outpatients presenting with COVID-19 prior to and during Omicron variant dominance: A prospective observational study
title_full Different clinical features in Malawian outpatients presenting with COVID-19 prior to and during Omicron variant dominance: A prospective observational study
title_fullStr Different clinical features in Malawian outpatients presenting with COVID-19 prior to and during Omicron variant dominance: A prospective observational study
title_full_unstemmed Different clinical features in Malawian outpatients presenting with COVID-19 prior to and during Omicron variant dominance: A prospective observational study
title_short Different clinical features in Malawian outpatients presenting with COVID-19 prior to and during Omicron variant dominance: A prospective observational study
title_sort different clinical features in malawian outpatients presenting with covid-19 prior to and during omicron variant dominance: a prospective observational study
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10022204/
https://www.ncbi.nlm.nih.gov/pubmed/36963090
http://dx.doi.org/10.1371/journal.pgph.0001575
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