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Comparison of SARS-CoV-2 Variants of Concern Alpha (B.1.1.7) vs. Beta (B.1.351) in Critically Ill Patients: A Multicenter Cohort Study

OBJECTIVES: The clinical outcomes of the Beta (B.1.351) variant of concern (VOC) of the SARS-CoV-2 virus remain poorly understood. In early 2021, northeastern France experienced an outbreak of Beta that was not observed elsewhere. This outbreak slightly preceded and then overlapped with a second out...

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Autores principales: Louis, Guillaume, Belveyre, Thibaut, Goetz, Christophe, Gibot, Sébastien, Dunand, Paul, Conrad, Marie, Gaci, Rostane, Gette, Sébastien, Ouamara, Nadia, Perez, Pascale, Cadoz, Cyril, Picard, Yoann, Mellati, Nouchan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8960192/
https://www.ncbi.nlm.nih.gov/pubmed/35360736
http://dx.doi.org/10.3389/fmed.2022.828402
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author Louis, Guillaume
Belveyre, Thibaut
Goetz, Christophe
Gibot, Sébastien
Dunand, Paul
Conrad, Marie
Gaci, Rostane
Gette, Sébastien
Ouamara, Nadia
Perez, Pascale
Cadoz, Cyril
Picard, Yoann
Mellati, Nouchan
author_facet Louis, Guillaume
Belveyre, Thibaut
Goetz, Christophe
Gibot, Sébastien
Dunand, Paul
Conrad, Marie
Gaci, Rostane
Gette, Sébastien
Ouamara, Nadia
Perez, Pascale
Cadoz, Cyril
Picard, Yoann
Mellati, Nouchan
author_sort Louis, Guillaume
collection PubMed
description OBJECTIVES: The clinical outcomes of the Beta (B.1.351) variant of concern (VOC) of the SARS-CoV-2 virus remain poorly understood. In early 2021, northeastern France experienced an outbreak of Beta that was not observed elsewhere. This outbreak slightly preceded and then overlapped with a second outbreak of the better understood VOC Alpha (B.1.1.7) in the region. This situation allowed us to contemporaneously compare Alpha and Beta in terms of the characteristics, management, and outcomes of critically ill patients. METHODS: A multicenter prospective cohort study was conducted on all consecutive adult patients who had laboratory confirmed SARS CoV-2 infection, underwent variant screening, and were admitted to one of four intensive care units (ICU) for acute respiratory failure between January 9th and May 15th, 2021. Primary outcome was 60-day mortality. Differences between Alpha and Beta in terms of other outcomes, patient variables, management, and vaccination characteristics were also explored by univariate analysis. The factors that associated with 60-day death in Alpha- and Beta-infected patients were examined with logistic regression analysis. RESULTS: In total, 333 patients (median age, 63 years; 68% male) were enrolled. Of these, 174 and 159 had Alpha and Beta, respectively. The two groups did not differ significantly in terms of 60-day mortality (19 vs. 23%), 28-day mortality (17 vs. 20%), need for mechanical ventilation (60 vs. 61%), mechanical ventilation duration (14 vs. 15 days), other management variables, patient demographic variables, comorbidities, or clinical variables on ICU admission. The vast majority of patients were unvaccinated (94%). The remaining 18 patients had received a partial vaccine course and 2 were fully vaccinated. The vaccinated patients were equally likely to have Alpha and Beta. CONCLUSIONS: Beta did not differ from Alpha in terms of patient characteristics, management, or outcomes in critically ill patients. TRIAL REGISTRATION: ClinicalTrials.gov, identifier: NCT04906850.
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spelling pubmed-89601922022-03-30 Comparison of SARS-CoV-2 Variants of Concern Alpha (B.1.1.7) vs. Beta (B.1.351) in Critically Ill Patients: A Multicenter Cohort Study Louis, Guillaume Belveyre, Thibaut Goetz, Christophe Gibot, Sébastien Dunand, Paul Conrad, Marie Gaci, Rostane Gette, Sébastien Ouamara, Nadia Perez, Pascale Cadoz, Cyril Picard, Yoann Mellati, Nouchan Front Med (Lausanne) Medicine OBJECTIVES: The clinical outcomes of the Beta (B.1.351) variant of concern (VOC) of the SARS-CoV-2 virus remain poorly understood. In early 2021, northeastern France experienced an outbreak of Beta that was not observed elsewhere. This outbreak slightly preceded and then overlapped with a second outbreak of the better understood VOC Alpha (B.1.1.7) in the region. This situation allowed us to contemporaneously compare Alpha and Beta in terms of the characteristics, management, and outcomes of critically ill patients. METHODS: A multicenter prospective cohort study was conducted on all consecutive adult patients who had laboratory confirmed SARS CoV-2 infection, underwent variant screening, and were admitted to one of four intensive care units (ICU) for acute respiratory failure between January 9th and May 15th, 2021. Primary outcome was 60-day mortality. Differences between Alpha and Beta in terms of other outcomes, patient variables, management, and vaccination characteristics were also explored by univariate analysis. The factors that associated with 60-day death in Alpha- and Beta-infected patients were examined with logistic regression analysis. RESULTS: In total, 333 patients (median age, 63 years; 68% male) were enrolled. Of these, 174 and 159 had Alpha and Beta, respectively. The two groups did not differ significantly in terms of 60-day mortality (19 vs. 23%), 28-day mortality (17 vs. 20%), need for mechanical ventilation (60 vs. 61%), mechanical ventilation duration (14 vs. 15 days), other management variables, patient demographic variables, comorbidities, or clinical variables on ICU admission. The vast majority of patients were unvaccinated (94%). The remaining 18 patients had received a partial vaccine course and 2 were fully vaccinated. The vaccinated patients were equally likely to have Alpha and Beta. CONCLUSIONS: Beta did not differ from Alpha in terms of patient characteristics, management, or outcomes in critically ill patients. TRIAL REGISTRATION: ClinicalTrials.gov, identifier: NCT04906850. Frontiers Media S.A. 2022-03-10 /pmc/articles/PMC8960192/ /pubmed/35360736 http://dx.doi.org/10.3389/fmed.2022.828402 Text en Copyright © 2022 Louis, Belveyre, Goetz, Gibot, Dunand, Conrad, Gaci, Gette, Ouamara, Perez, Cadoz, Picard and Mellati. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Medicine
Louis, Guillaume
Belveyre, Thibaut
Goetz, Christophe
Gibot, Sébastien
Dunand, Paul
Conrad, Marie
Gaci, Rostane
Gette, Sébastien
Ouamara, Nadia
Perez, Pascale
Cadoz, Cyril
Picard, Yoann
Mellati, Nouchan
Comparison of SARS-CoV-2 Variants of Concern Alpha (B.1.1.7) vs. Beta (B.1.351) in Critically Ill Patients: A Multicenter Cohort Study
title Comparison of SARS-CoV-2 Variants of Concern Alpha (B.1.1.7) vs. Beta (B.1.351) in Critically Ill Patients: A Multicenter Cohort Study
title_full Comparison of SARS-CoV-2 Variants of Concern Alpha (B.1.1.7) vs. Beta (B.1.351) in Critically Ill Patients: A Multicenter Cohort Study
title_fullStr Comparison of SARS-CoV-2 Variants of Concern Alpha (B.1.1.7) vs. Beta (B.1.351) in Critically Ill Patients: A Multicenter Cohort Study
title_full_unstemmed Comparison of SARS-CoV-2 Variants of Concern Alpha (B.1.1.7) vs. Beta (B.1.351) in Critically Ill Patients: A Multicenter Cohort Study
title_short Comparison of SARS-CoV-2 Variants of Concern Alpha (B.1.1.7) vs. Beta (B.1.351) in Critically Ill Patients: A Multicenter Cohort Study
title_sort comparison of sars-cov-2 variants of concern alpha (b.1.1.7) vs. beta (b.1.351) in critically ill patients: a multicenter cohort study
topic Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8960192/
https://www.ncbi.nlm.nih.gov/pubmed/35360736
http://dx.doi.org/10.3389/fmed.2022.828402
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