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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...
Autores principales: | , , , , , , , , , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2023
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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. |
format | Online Article Text |
id | pubmed-10022204 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
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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