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英国埃克塞特大学Robert Challen团队研究了SARS-CoV-2关注变异体202012/1感染者的死亡风险。2021年3月10日，《英国医学杂志》发表了该研究。

为了确定与流行的SARS-CoV-2变异体相比，感染新型SARS-CoV-2变异体后的死亡率是否有任何变化，人们在2020年12月指定了一个关注变异体（VOC-202012/1）。研究组基于英国社区的covid-19检测中心使用TaqPath分析法（VOC-202012/1感染的替代测量）进行了一项配对队列研究。

2020年10月1日至2021年1月29日，共有54 906对配对的参与者检测出SARS-CoV-2阳性，随访至2021年2月12日。参与者在年龄、性别、种族、多重贫困指数、较低水平的地方当局地区和阳性标本的样本日期上相匹配，且仅在使用TaqPath分析的刺突蛋白基因的可检测性上存在差异。主要观察指标为首次SARS-CoV-2检测阳性后28天内的死亡情况。

在社区covid-19检测呈阳性的患者中，与先前流行变异感染相比，与VOC-202012/1感染相关的死亡危险比为1.64。在这一相对风险较低的群体中，每1000个确诊病例中，死亡人数从2.5人增加到4.1人。

研究结果表明，感染VOC-202012/01增加死亡风险的可能性很高。如果这一发现对其他人群具有普遍性，那么与先前的循环变异体相比，感染VOC-202012/1有可能导致大量额外的死亡率。

附：英文原文

Title: Risk of mortality in patients infected with SARS-CoV-2 variant of concern 202012/1: matched cohort study

Author: Robert Challen, Ellen Brooks-Pollock, Jonathan M Read, Louise Dyson, Krasimira Tsaneva-Atanasova, Leon Danon

Issue&Volume: 2021/03/10

Abstract:

Objective To establish whether there is any change in mortality from infection with a new variant of SARS-CoV-2, designated a variant of concern (VOC-202012/1) in December 2020, compared with circulating SARS-CoV-2 variants.

Design Matched cohort study.

Setting Community based (pillar 2) covid-19 testing centres in the UK using the TaqPath assay (a proxy measure of VOC-202012/1 infection).

Participants 54906 matched pairs of participants who tested positive for SARS-CoV-2 in pillar 2 between 1 October 2020 and 29 January 2021, followed-up until 12 February 2021. Participants were matched on age, sex, ethnicity, index of multiple deprivation, lower tier local authority region, and sample date of positive specimens, and differed only by detectability of the spike protein gene using the TaqPath assay.

Main outcome measure Death within 28 days of the first positive SARS-CoV-2 test result.

Results The mortality hazard ratio associated with infection with VOC-202012/1 compared with infection with previously circulating variants was 1.64 (95% confidence interval 1.32 to 2.04) in patients who tested positive for covid-19 in the community. In this comparatively low risk group, this represents an increase in deaths from 2.5 to 4.1 per 1000 detected cases.

Conclusions The probability that the risk of mortality is increased by infection with VOC-202012/01 is high. If this finding is generalisable to other populations, infection with VOC-202012/1 has the potential to cause substantial additional mortality compared with previously circulating variants. Healthcare capacity planning and national and international control policies are all impacted by this finding, with increased mortality lending weight to the argument that further coordinated and stringent measures are justified to reduce deaths from SARS-CoV-2.

DOI: 10.1136/bmj.n579

Source: https://www.bmj.com/content/372/bmj.n579

BMJ-British Medical Journal:《英国医学杂志》，创刊于1840年。隶属于BMJ出版集团，最新IF：93.333
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