The emergence of novel SARS-CoV-2 variant P.1 in Amazonas (Brazil) was temporally associated with a change in the age and gender profile of COVID-19 mortality

Detalhes bibliográficos
Autor(a) principal: Freitas, Andre Ricardo Ribas
Data de Publicação: 2021
Outros Autores: Beckedorff , Otto Albuquerque, Cavalcanti, Luciano Pamplona de Góes, Siqueira , Andre M, Castro, Daniel Barros de, Costa , Cristiano Fernandes da, Lemos, Daniele Rocha Queiróz, Barros, Eliana N C
Tipo de documento: preprint
Idioma: por
Título da fonte: SciELO Preprints
Texto Completo: https://preprints.scielo.org/index.php/scielo/preprint/view/2030
Resumo: Background Since the end of 2020, there has been a great deal of international concern about the variants of SARS-COV-2 B.1.1.7, identified in the United Kingdom; B.1.351 discovered in South Africa and P.1, originating from the Brazilian state of Amazonas. The three variants were associated with an increase in transmissibility and worsening of the epidemiological situation in the places where they expanded. The lineage B.1.1.7 was associated with the increase in case fatality rate in the United Kingdom. There are still no studies on the case fatality rate of the other two variants. The aim of this study was to analyze the mortality profile before and after the emergence of the P.1 strain in the Amazonas state. Methods We analyzed data from the Influenza Epidemiological Surveillance Information System, SIVEP-Gripe (Sistema de Informação de Vigilância Epidemiológica da Gripe), comparing two distinct epidemiological periods: during the peak of the first wave, between April and May 2020, and in January 2021 (the second wave), the month in which the new variant came to predominate. We calculated mortality rates, overall case fatality rate and case fatality rate among hospitalized patients; all rates were calculated by age and gender and 95% confidence intervals (95% CI) were determined. Findings We observed that in the second wave there were a higher incidence and an increase in the proportion of cases of COVID-19 in the younger age groups. There was also an increase in the proportion of women among Severe Acute Respiratory Infection (SARI) cases from 40% (2,709) in the first wave to 47% (2,898) in the second wave and in the proportion of deaths due to COVID-19 between the two periods varying from 34% (1,051) to 47% (1,724), respectively. In addition, the proportion of deaths among people between 20 and 59 years old has increased in both sexes. The case fatality rate among those hospitalized in the population between 20 and 39 years old during the second wave was 2.7 times the rate observed in the first wave (female rate ratio = 2.71; 95% CI: 1.9-3.9], p <0.0001; male rate ratio = 2.70, 95%CI:2.0-3.7), and in the general population the rate ratios were 1.15 (95% CI: 1.1-1.2) in females and 0.78 (95% CI: 0.7-0.8) in males]. Interpretation Based on this prompt analysis of the epidemiological scenario in the Amazonas state, the observed changes in the pattern of mortality due to COVID-19 between age groups and gender simultaneously with the emergence of the P.1 strain suggest changes in the pathogenicity and virulence profile of this new variant. Further studies are needed to better understanding of SARS-CoV-2 variants profile and their impact for the health population.
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spelling The emergence of novel SARS-CoV-2 variant P.1 in Amazonas (Brazil) was temporally associated with a change in the age and gender profile of COVID-19 mortalityA emergência da nova variante P.1 do SARS-CoV-2 no Amazonas (Brasil) foi temporalmente associada a uma mudança no perfil da mortalidade devido a COVID-19, segundo sexo e idadecovid-19P.1variantSARS-CoV-2covid-19P.1variantSARS-CoV-2Background Since the end of 2020, there has been a great deal of international concern about the variants of SARS-COV-2 B.1.1.7, identified in the United Kingdom; B.1.351 discovered in South Africa and P.1, originating from the Brazilian state of Amazonas. The three variants were associated with an increase in transmissibility and worsening of the epidemiological situation in the places where they expanded. The lineage B.1.1.7 was associated with the increase in case fatality rate in the United Kingdom. There are still no studies on the case fatality rate of the other two variants. The aim of this study was to analyze the mortality profile before and after the emergence of the P.1 strain in the Amazonas state. Methods We analyzed data from the Influenza Epidemiological Surveillance Information System, SIVEP-Gripe (Sistema de Informação de Vigilância Epidemiológica da Gripe), comparing two distinct epidemiological periods: during the peak of the first wave, between April and May 2020, and in January 2021 (the second wave), the month in which the new variant came to predominate. We calculated mortality rates, overall case fatality rate and case fatality rate among hospitalized patients; all rates were calculated by age and gender and 95% confidence intervals (95% CI) were determined. Findings We observed that in the second wave there were a higher incidence and an increase in the proportion of cases of COVID-19 in the younger age groups. There was also an increase in the proportion of women among Severe Acute Respiratory Infection (SARI) cases from 40% (2,709) in the first wave to 47% (2,898) in the second wave and in the proportion of deaths due to COVID-19 between the two periods varying from 34% (1,051) to 47% (1,724), respectively. In addition, the proportion of deaths among people between 20 and 59 years old has increased in both sexes. The case fatality rate among those hospitalized in the population between 20 and 39 years old during the second wave was 2.7 times the rate observed in the first wave (female rate ratio = 2.71; 95% CI: 1.9-3.9], p <0.0001; male rate ratio = 2.70, 95%CI:2.0-3.7), and in the general population the rate ratios were 1.15 (95% CI: 1.1-1.2) in females and 0.78 (95% CI: 0.7-0.8) in males]. Interpretation Based on this prompt analysis of the epidemiological scenario in the Amazonas state, the observed changes in the pattern of mortality due to COVID-19 between age groups and gender simultaneously with the emergence of the P.1 strain suggest changes in the pathogenicity and virulence profile of this new variant. Further studies are needed to better understanding of SARS-CoV-2 variants profile and their impact for the health population.Introdução Desde o final de 2020 tem havido grande preocupação internacional com as variantes do SARS-COV-2: B.1.1.7, identificada no Reino Unido; B.1.351, descoberta na África do Sul e P.1, que emergiu inicialmente estado brasileiro do Amazonas. As três variantes foram associadas a aumento na transmissibilidade e piora da situação epidemiológica nos locais onde se expandiram. A linhagem B.1.1.7 foi associada ao aumento da taxa de letalidade no Reino Unido. Ainda não existem estudos conclusivos sobre letalidade das outras duas variantes. O objetivo deste estudo foi analisar o perfil de mortalidade antes e depois da emergência da linhagem P.1 no Amazonas. Métodos Analisamos os dados do sistema nacional de vigilância epidemiológica, comparando dois momentos epidemiológicos distintos: durante o pico da primeira onda, entre abril e maio de 2020, e em janeiro de 2021, mês em que a nova variante passou a predominar. Calculamos as taxas de mortalidade, letalidade e letalidade entre pacientes internados, todas as taxas foram calculadas por idade e por sexo e determinados os intervalos de confiança de 95%. Achados Observamos que na segunda onda houve maior incidência e aumento na proporção de casos de COVID-19 nas faixas etárias mais jovens. Observou-se, também, um aumento na proporção de mulheres entre os casos de SARI de 40% (2.709) na primeira onda para 47% (2.898) na segunda onda e entre mortes por COVID-19 de 34% (1,051) para 47% (1.724), respectivamente. Além disso, a proporção de mortes entre 20 e 59 anos aumentou em ambos os sexos. A letalidade entre os hospitalizados na população entre 20 e 39 anos durante a segunda onda foi 2.7 vezes a primeira onda [razão de taxas sexo feminino=2,71; CI(95%)=1,9-3,9], p<0.0001; razão de taxas sexo masculino=2.70(2.0-3.7)), na população geral as razões de taxa foram 1,15(1,1-1,2) no sexo feminino e 0,78(0,7-0,8) no sexo masculino. Interpretação Observamos mudanças no padrão de mortalidade por COVID-19 entre as faixas etárias e sexo simultaneamente à emergência da linhagem P.1, sugerindo mudanças nos perfis de patogenicidade e virulência, novos estudos são necessários para melhor compreensão das variantes do SARS-CoV-2 e suas consequências na saúde da população.SciELO PreprintsSciELO PreprintsSciELO Preprints2021-03-26info:eu-repo/semantics/preprintinfo:eu-repo/semantics/publishedVersionapplication/pdfhttps://preprints.scielo.org/index.php/scielo/preprint/view/203010.1590/SciELOPreprints.2030porhttps://preprints.scielo.org/index.php/scielo/article/view/2030/3320Copyright (c) 2021 Andre Ricardo Ribas Freitas, Otto Albuquerque Beckedorff , Luciano Pamplona de Góes Cavalcanti, Andre M Siqueira , Daniel Barros de Castro, Cristiano Fernandes da Costa , Daniele Rocha Queiróz Lemos, Eliana N C Barroshttps://creativecommons.org/licenses/by/4.0info:eu-repo/semantics/openAccessFreitas, Andre Ricardo RibasBeckedorff , Otto Albuquerque Cavalcanti, Luciano Pamplona de Góes Siqueira , Andre M Castro, Daniel Barros de Costa , Cristiano Fernandes da Lemos, Daniele Rocha Queiróz Barros, Eliana N C reponame:SciELO Preprintsinstname:SciELOinstacron:SCI2021-03-22T23:20:26Zoai:ops.preprints.scielo.org:preprint/2030Servidor de preprintshttps://preprints.scielo.org/index.php/scieloONGhttps://preprints.scielo.org/index.php/scielo/oaiscielo.submission@scielo.orgopendoar:2021-03-22T23:20:26SciELO Preprints - SciELOfalse
dc.title.none.fl_str_mv The emergence of novel SARS-CoV-2 variant P.1 in Amazonas (Brazil) was temporally associated with a change in the age and gender profile of COVID-19 mortality
A emergência da nova variante P.1 do SARS-CoV-2 no Amazonas (Brasil) foi temporalmente associada a uma mudança no perfil da mortalidade devido a COVID-19, segundo sexo e idade
title The emergence of novel SARS-CoV-2 variant P.1 in Amazonas (Brazil) was temporally associated with a change in the age and gender profile of COVID-19 mortality
spellingShingle The emergence of novel SARS-CoV-2 variant P.1 in Amazonas (Brazil) was temporally associated with a change in the age and gender profile of COVID-19 mortality
Freitas, Andre Ricardo Ribas
covid-19
P.1
variant
SARS-CoV-2
covid-19
P.1
variant
SARS-CoV-2
title_short The emergence of novel SARS-CoV-2 variant P.1 in Amazonas (Brazil) was temporally associated with a change in the age and gender profile of COVID-19 mortality
title_full The emergence of novel SARS-CoV-2 variant P.1 in Amazonas (Brazil) was temporally associated with a change in the age and gender profile of COVID-19 mortality
title_fullStr The emergence of novel SARS-CoV-2 variant P.1 in Amazonas (Brazil) was temporally associated with a change in the age and gender profile of COVID-19 mortality
title_full_unstemmed The emergence of novel SARS-CoV-2 variant P.1 in Amazonas (Brazil) was temporally associated with a change in the age and gender profile of COVID-19 mortality
title_sort The emergence of novel SARS-CoV-2 variant P.1 in Amazonas (Brazil) was temporally associated with a change in the age and gender profile of COVID-19 mortality
author Freitas, Andre Ricardo Ribas
author_facet Freitas, Andre Ricardo Ribas
Beckedorff , Otto Albuquerque
Cavalcanti, Luciano Pamplona de Góes
Siqueira , Andre M
Castro, Daniel Barros de
Costa , Cristiano Fernandes da
Lemos, Daniele Rocha Queiróz
Barros, Eliana N C
author_role author
author2 Beckedorff , Otto Albuquerque
Cavalcanti, Luciano Pamplona de Góes
Siqueira , Andre M
Castro, Daniel Barros de
Costa , Cristiano Fernandes da
Lemos, Daniele Rocha Queiróz
Barros, Eliana N C
author2_role author
author
author
author
author
author
author
dc.contributor.author.fl_str_mv Freitas, Andre Ricardo Ribas
Beckedorff , Otto Albuquerque
Cavalcanti, Luciano Pamplona de Góes
Siqueira , Andre M
Castro, Daniel Barros de
Costa , Cristiano Fernandes da
Lemos, Daniele Rocha Queiróz
Barros, Eliana N C
dc.subject.por.fl_str_mv covid-19
P.1
variant
SARS-CoV-2
covid-19
P.1
variant
SARS-CoV-2
topic covid-19
P.1
variant
SARS-CoV-2
covid-19
P.1
variant
SARS-CoV-2
description Background Since the end of 2020, there has been a great deal of international concern about the variants of SARS-COV-2 B.1.1.7, identified in the United Kingdom; B.1.351 discovered in South Africa and P.1, originating from the Brazilian state of Amazonas. The three variants were associated with an increase in transmissibility and worsening of the epidemiological situation in the places where they expanded. The lineage B.1.1.7 was associated with the increase in case fatality rate in the United Kingdom. There are still no studies on the case fatality rate of the other two variants. The aim of this study was to analyze the mortality profile before and after the emergence of the P.1 strain in the Amazonas state. Methods We analyzed data from the Influenza Epidemiological Surveillance Information System, SIVEP-Gripe (Sistema de Informação de Vigilância Epidemiológica da Gripe), comparing two distinct epidemiological periods: during the peak of the first wave, between April and May 2020, and in January 2021 (the second wave), the month in which the new variant came to predominate. We calculated mortality rates, overall case fatality rate and case fatality rate among hospitalized patients; all rates were calculated by age and gender and 95% confidence intervals (95% CI) were determined. Findings We observed that in the second wave there were a higher incidence and an increase in the proportion of cases of COVID-19 in the younger age groups. There was also an increase in the proportion of women among Severe Acute Respiratory Infection (SARI) cases from 40% (2,709) in the first wave to 47% (2,898) in the second wave and in the proportion of deaths due to COVID-19 between the two periods varying from 34% (1,051) to 47% (1,724), respectively. In addition, the proportion of deaths among people between 20 and 59 years old has increased in both sexes. The case fatality rate among those hospitalized in the population between 20 and 39 years old during the second wave was 2.7 times the rate observed in the first wave (female rate ratio = 2.71; 95% CI: 1.9-3.9], p <0.0001; male rate ratio = 2.70, 95%CI:2.0-3.7), and in the general population the rate ratios were 1.15 (95% CI: 1.1-1.2) in females and 0.78 (95% CI: 0.7-0.8) in males]. Interpretation Based on this prompt analysis of the epidemiological scenario in the Amazonas state, the observed changes in the pattern of mortality due to COVID-19 between age groups and gender simultaneously with the emergence of the P.1 strain suggest changes in the pathogenicity and virulence profile of this new variant. Further studies are needed to better understanding of SARS-CoV-2 variants profile and their impact for the health population.
publishDate 2021
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