Observational cohort study of the clinical outcomes associated with B.1.1.7/SGTF among hospitalized COVID-19 patients in Lebanon.

IF 1.7 4区医学 Q3 HEALTH CARE SCIENCES & SERVICES Eastern Mediterranean Health Journal Pub Date : 2023-04-27 DOI:10.26719/emhj.23.052

Fatima Dakroub, Mohammad Yassine, Soha Fakhredine, Ali Msheik, Hassan Rahal, Ghadir Hayek, Ali Akl, Rana Zaarour, Haidar Akl

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Abstract

Background: The B.1.1.7 SARS-CoV-2 variant results in spike gene target failure (SGTF) in reverse transcription-quantitative polymerase chain reaction (RT-PCR) assays. Few studies have been published on the clinical impact of B.1.1.7/SGTF.

Aims: To assess the incidence of B.1.1.7/SGTF and its associated clinical characteristics among hospitalized COVID-19 patients.

Methods: This observational, single-centre, cohort study was conducted between December 2020 and February 2021 and included 387 hospitalized COVID-19 patients. The Kaplan-Meier method was used for survival analysis, and logistic regression to identify risk factors associated with B.1.1.7/SGTF.

Results: By February 2021, B.1.1.7/SGTF (88%) dominated the SARS-CoV-2 PCR results in a Lebanese hospital. Of the 387 eligible COVID-19 patients confirmed by SARS-CoV-2 RT-PCR, 154 (40%) were non-SGTF and 233 (60%) were B.1.1.1.7/SGTF; this was associated with a higher mortality rate among female patients [22/51 (43%) vs 7/37 (19%); P = 0.0170]. Among patients in the B.1.1.7/SGTF group, most were aged ≥ 65 years [162/233 (70%) vs 74/154 (48%); P < 0.0001]. Independent predictors of B.1.1.7/SGTF infection were hypertension (OR = 0.415; CI: 0.242-0.711; P = 0.0010), age ≥ 65 years (OR = 0.379; CI: 0.231-0.622; P < 0.0001), smoking (OR = 1.698; CI: 1.023-2.819; P = 0.0410), and cardiovascular disease (OR = 3.812; CI: 2.215-6.389; P < 0.0001). Only non-SGTF patients experienced multi-organ failure [5/154 (4%) vs 0/233 (0%); P = 0.0096].

Conclusion: There was a clear difference between the clinical features associated with B.1.1.7/SGTF and non-SGTF lineages. Tracking viral evolution and its clinical impact is crucial for proper understanding and management of the COVID-19 pandemic.

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黎巴嫩住院COVID-19患者B.1.1.7/SGTF相关临床结局的观察性队列研究

背景:B.1.1.7 SARS-CoV-2变异在逆转录-定量聚合酶链反应(RT-PCR)检测中导致刺突基因靶失败(SGTF)。很少有关于B.1.1.7/SGTF临床影响的研究发表。目的:了解新冠肺炎住院患者B.1.1.7/SGTF的发病率及其相关临床特征。方法:该观察性、单中心、队列研究于2020年12月至2021年2月进行，纳入387例住院的COVID-19患者。生存率分析采用Kaplan-Meier法，logistic回归分析与B.1.1.7/SGTF相关的危险因素。结果:截至2021年2月，黎巴嫩某医院SARS-CoV-2 PCR结果以B.1.1.7/SGTF(88%)为主。在387例符合条件的SARS-CoV-2 RT-PCR确诊的COVID-19患者中，154例(40%)为非SGTF, 233例(60%)为B.1.1.1.7/SGTF;这与女性患者较高的死亡率相关[22/51 (43%)vs 7/37 (19%);P = 0.0170]。在B.1.1.7/SGTF组中，大多数患者年龄≥65岁[162/233 (70%)vs 74/154 (48%);P < 0.0001]。B.1.1.7/SGTF感染的独立预测因子为高血压(OR = 0.415;置信区间:0.242—-0.711;P = 0.0010)，年龄≥65岁(OR = 0.379;置信区间:0.231—-0.622;P < 0.0001)，吸烟(OR = 1.698;置信区间:1.023—-2.819;P = 0.0410)，心血管疾病(OR = 3.812;置信区间:2.215—-6.389;P < 0.0001)。只有非sgtf患者出现多器官功能衰竭[5/154 (4%)vs 0/233 (0%);P = 0.0096]。结论:B.1.1.7/SGTF与非SGTF谱系的临床特征存在明显差异。跟踪病毒进化及其临床影响对于正确理解和管理COVID-19大流行至关重要。

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来源期刊

Eastern Mediterranean Health Journal HEALTH CARE SCIENCES & SERVICESPUBLIC, ENV-PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

CiteScore

3.30

自引率

4.80%

发文量

112

期刊介绍： The Eastern Mediterranean Health Journal, established in 1995, is the flagship health periodical of the World Health Organization Regional Office for the Eastern Mediterranean. The mission of the Journal is to contribute to improving health in the Eastern Mediterranean Region by publishing and publicising quality health research and information with emphasis on public health and the strategic health priorities of the Region. It aims to: further public health knowledge, policy, practice and education; support health policy-makers, researchers and practitioners; and enable health professionals to remain informed of developments in public health. The EMHJ: -publishes original peer-reviewed research and reviews in all areas of public health of relevance to the Eastern Mediterranean Region -encourages, in particular, research related to the regional health priorities, namely: health systems strengthening; emergency preparedness and response; communicable diseases; noncommunicable diseases and mental health; reproductive, maternal, child health and nutrition -provides up-to-date information on public health developments with special reference to the Region. The Journal addresses all members of the health profession, health educational institutes, as well as governmental and nongovernmental organizations in the area of public health within and outside the Region.