小柯机器人

英国伦敦卫生与热带医学院Nicholas G. Davies等研究人员发现，社区检测出的SARS-CoV-2变种B.1.1.7出现死亡率增加。该项研究成果于2021年3月15日在线发表在《自然》杂志上。

研究人员分析了一个数据集，该数据将2020年9月1日至2021年2月14日在英格兰发生的2,245,263例SARS-CoV-2阳性检测与17,452例COVID-19死亡相关联。对于这些检测中的1,146,534例（51％）是否存在B.1.1 .7可以被鉴定，因为该谱系中的突变阻止了突刺基因靶标的PCR扩增（S基因靶标失效，SGTF）。根据已知SGTF状态的4,945例死亡，并且在调整了年龄、性别、种族、贫困、养老院、地方当局、测试时间等因素后，研究人员估计，与SGTF相关的死亡危险要高55％（95％CI 39–72％）。

这对应于55-69岁男性的绝对死亡风险在社区检测出阳性测试后28天内从0.6％增加到0.9％（95％CI 0.8-1.0％）。在纠正SGTF的错误分类和SGTF状态的缺失后，研究人员估计与B.1.1.7相关的死亡危险增加61％（42–82％）。这些分析表明，B.1.1.7不仅比先前存在的SARS-CoV-2变异体更易传播，而且还可能导致更严重的疾病。

据了解，SARS-CoV-2谱系B.1.1.7是2020年9月在英国首次发现的变种，并已传播到全球多个国家。几项研究已经确定，B.1.1.7比已有的变体更易传播，但尚未确定它是否导致疾病严重性的改变。

附：英文原文

Title: Increased mortality in community-tested cases of SARS-CoV-2 lineage B.1.1.7

Author: Nicholas G. Davies, Christopher I. Jarvis, W. John Edmunds, Nicholas P. Jewell, Karla Diaz-Ordaz, Ruth H. Keogh

Issue&Volume: 2021-03-15

Abstract: SARS-CoV-2 lineage B.1.1.7, a variant first detected in the UK in September 20201, has spread to multiple countries worldwide. Several studies have established that B.1.1.7 is more transmissible than preexisting variants, but have not identified whether it leads to any change in disease severity2. Here we analyse a dataset linking 2,245,263 positive SARS-CoV-2 community tests and 17,452 COVID-19 deaths in England from 1 September 2020 to 14 February 2021. For 1,146,534 (51%) of these tests, the presence or absence of B.1.1.7 can be identified because of mutations in this lineage preventing PCR amplification of the spike gene target (S gene target failure, SGTF1). Based on 4,945 deaths with known SGTF status, we estimate that the hazard of death associated with SGTF is 55% (95% CI 39–72%) higher after adjustment for age, sex, ethnicity, deprivation, care home residence, local authority of residence and test date. This corresponds to the absolute risk of death for a 55–69-year-old male increasing from 0.6% to 0.9% (95% CI 0.8–1.0%) within 28 days after a positive test in the community. Correcting for misclassification of SGTF and missingness in SGTF status, we estimate a 61% (42–82%) higher hazard of death associated with B.1.1.7. Our analysis suggests that B.1.1.7 is not only more transmissible than preexisting SARS-CoV-2 variants, but may also cause more severe illness.

DOI: 10.1038/s41586-021-03426-1

Source: https://www.nature.com/articles/s41586-021-03426-1

Nature：《自然》，创刊于1869年。隶属于施普林格·自然出版集团，最新IF：69.504
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