Increased risk of severe COVID-19 in hospitalized patients with SARS-CoV-2 Alpha variant infection: a multicentre matched cohort study

Guillaume Martin-Blondel (1, 2) , François-Xavier Lescure (3) , Lambert Assoumou (4) , Charlotte Charpentier (5) , Jean-Marc Chapplain (6) , Thomas Perpoint (7) , Gaspard Grouteau (1) , Hugues Cordel (8) , Gilles Pialoux (9) , Jérome Pacanowski (10) , Michael Thy (3) , Adeline Bauvois (11) , Didier Laureillard (12) , Fadia Hamrouni (4) , Michèle Algarte-Genin (4) , Julien Poissy (13) , Diane Descamps (5) , Dominique Costagliola (4) , Guillaume Martin-Blondel (2, 1) , Pierre Delobel (2, 1) , Gaspard Grouteau (1) , Jean Roch Le Henaff , Vincent Mear , Sandra Lagarrigues , Alais Frelat (14) , Thomas De Nadai (15, 16) , Zara Steinmeyer (17) , Arnaud Del Bello , Stéphanie Ruiz (18) , Benjamine Sarton (19, 17) , Elise Noel-Savina (20) , Jacques Izopet (2, 21) , Nathan Peiffer-Smadja (5) , Michael Thy (3) , Mathilde Gare (22, 23) , Diane Le Pluart (24) , François-Xavier Lescure (5, 3) , Christophe Rioux (25) , Laurène Deconinck , Yazdan Yazdanpanah , Diane Descamps , Charlotte Charpentier , Jean-Marc Chapplain , Pierre Tattevin , Thomas Perpoint , Maude Bouscambert-Duchamp , Hodane Yonis , Paul Chabert , Hugues Cordel , Youssouf Mohamed-Kassim , Nolan Hassold , Segolène Brichler , Julien Caliez , Thomas Rambaud , Marilucy Lopez-Sublet , Frédéric Adnet , Gilles Pialoux , Christia Palacios , Marwa Bachir , Marine Nadal , Mathieu Turpin , Antoine Parrot , Djeneba Fofana , Jérome Pacanowski , Karine Lacombe , Emmanuelle Gras , Laura Levi , Laure Surgers , Ines Devred , Nadia Valin , Thibault Chiarabini , Jean Luc Meynard , Adeline Bauvois , Clara Duran , Elyanne Gault , Jean-Emmanuel Kahn , Elisabeth Rouveix , Guillaume Geri , Didier Laureillard , Albert Sotto , Paul Loubet , Claire Roger , Marc Lambert (26) , Ady Assaf , Laurence Bocket , Firouzé Bani-Sadr , Yohan N’guyen , Juliette Romaru , Maxime Hentzien , Thomas Gabas , Amélie Chabrol , Cecilia Billiou , Philippe Menager , Christophe Billy , Jean-Jacques Laurichesse , Fabrice Ketty N. Simba , Pauline Caraux Paz , Liliane Tinang , Agathe Bounhiol , Catherine Burnat , Sandrine Soriot-Thomas , Damien Basille , Jean Philippe Lanoix , Yoan Zerbib , Yoann Zerbib , Anne Pouvaret , Fanny Lanternier , Helene Mascitti , Aurélien Dinh , Benjamin Davido , Philippe Lesprit , Eric Farfour , Mathilde Neuville , Linda Nait Allaoua , Michèle Lejaille , Nathalie De Castro , Jean-Michel Molina , Diane Ponscarme , Mariagrazia Tateo , Geoffroy Liegeon , Ines Boussen , Pauline Huriez , André Cabié , Valentine Campana , Isabelle Calmont , Jean-Marie Turmel , Guitteaud Karine , Pierre-François Sandrine , Athéna Marquise , Ornella Cabras , Mélanie Lehoux , Cyrille Chabartier , Vincent Dubee , Diama Ndiaye , Caroline Lefeuvre , Achille Kouatchet , Duc Nguyen , Camille Tumiotto , Pierre Sioniac , Alexandre Boyer , Jean-François Faucher , Edouard Desvaux , Sylvie Rogez , Paul Le Turnier , François Raffi , Emmanuel Canet , Antoine Roquilly , Louise Castain , Solène Secher , Véronique Mondain , Lionel Piroth , Christelle Auvray , Pascal Chavanet , Marielle Buisson , Sophie Mahy , François-Xavier Catherine , Clementine Esteve , Michel Duong , Carole Charles , Sandrine Gohier , Céline Schaffer , Olivier Robineau , Perrine Bortolotti , Maxime Pradier , Francois Goehringer , Alice Corbel , Jeanne Kotzyba , Kévin Alexandre , Gaetan Beduneau , Elodie Alessandri-Gradt , Martin Martinot , Simon Gravier , Ciprian Ion , Victoire De Lastours , Roza Rahli , Valérie Garrait , Laurent Richier , Mounira Smati-Lafarge , Guillemette Frémont , Pierre Louis Nivose , Marie Hélène André , Magdalena Gerin , Aicha Hamdi , Naomi Sayre , Stephanie Cossec , Sophie Alviset , Pierre Alain Billy , Marie Gousseff , Emmanuel Forestier , Anne-Laure Destrem , Olivier Rogeaux , Alexie Bosch , Sabrina Bryant , Gaëlle Bourgeois , Ophélie dos Santos Schaller , Marie-Christine Carret , Nicolas Ettahar , Haciba Moudjahed , Nathalie Leone , Mehdi Djennaoui , Nicolas Lefebvre , Axel Ursenbach , François Danion , Yvon Ruch , Morgane Solis , Hamid Merdji , Loïc Kassègne , Fanny Pommeret , Emeline Colomba Blameble , Merad Manssouria , Annabelle Stoclin , Franck Griscelli , Sophie Deriaz , Eric Oziol , Laurent Favier , Julien Obiols , Pascal Gicquel , Christophe Rapp , Laurence Louvet , Paul Ihout , Jean-Benoit Zabbé , Laurent Bellec , Tomasz Chroboczek , Sandrine Mégessier , Marie Lacoste , Benjamin Viala , Thibaut Challan-Belval , Chloé Wackenheim , Paule Letertre-Gibert , Olivier Grossi

1 Service Maladies infectieuses et tropicales [CHU Toulouse]
2 Infinity - Institut Toulousain des Maladies Infectieuses et Inflammatoires
3 Services de Maladies Infectieuses et Tropicales [CHU Bichat]
4 THERAVIR - Stratégies thérapeutiques contre l'infection VIH et les maladies virales associées [iPLesp]
5 IAME (UMR_S_1137 / U1137) - Infection, Anti-microbiens, Modélisation, Evolution
6 Centre Hospitalier Universitaire de Rennes [CHU Rennes] = Rennes University Hospital [Ponchaillou]
7 Service des Maladies Infectieuses et Tropicales [Lyon]
8 Service de maladies infectieuses et tropicales [CHU Avicenne]
9 CHU Tenon [AP-HP]
10 CHU Saint-Antoine [AP-HP]
11 Service de médecine interne [CHU Ambroise Paré]
12 CHU Nîmes - Centre Hospitalier Universitaire de Nîmes
13 UGSF - Unité de Glycobiologie Structurale et Fonctionnelle - UMR 8576
14 Service Obstétrique [CHU Toulouse]
15 Gérontopôle
16 Institut du Vieillissement
17 CHU Toulouse - Centre Hospitalier Universitaire de Toulouse
18 Pôle Anesthésie Réanimation [CHU de Toulouse]
19 ToNIC - Toulouse NeuroImaging Center
20 Pôle Clinique des Voies respiratoires [CHU Toulouse]
21 Laboratoire Virologie [CHU Toulouse]
22 MERIT - UMR_D 261 - Mère et enfant en milieu tropical : pathogènes, système de santé et transition épidémiologique
23 CERPAGE - Centre d’Etude et de Recherche sur les Pathologies Associéees à la Grossesse et à l’Enfance [Cotonou, Bénin]
24 Hôpital Foch [Suresnes]
25 AP-HP - Hôpital Bichat - Claude Bernard [Paris]
26 RID-AGE - Facteurs de Risque et Déterminants Moléculaires des Maladies liées au Vieillissement - U 1167

Background: The impact of the variant of concern (VOC) Alpha on the severity of COVID-19 has been debated. We report our analysis in France. Methods: We conducted an exposed/unexposed cohort study with retrospective data collection, comparing patients infected by VOC Alpha to contemporaneous patients infected by historical lineages. Participants were matched on age (± 2.5 years), sex and region of hospitalization. The primary endpoint was the proportion of hospitalized participants with severe COVID-19, defined as a WHO-scale > 5 or by the need of a non-rebreather mask, occurring up to day 29 after admission. We used a logistic regression model stratified on each matched pair and accounting for factors known to be associated with the severity of the disease. Results: We included 650 pairs of patients hospitalized between Jan 1, 2021, and Feb 28, 2021, in 47 hospitals. Median age was 70 years and 61.3% of participants were male. The proportion of participants with comorbidities was high in both groups (85.0% vs 90%, p = 0.004). Infection by VOC Alpha was associated with a higher odds of severe COVID-19 (41.7% vs 38.5%-aOR = 1.33 95% CI [1.03-1.72]). Conclusion: Infection by the VOC Alpha was associated with a higher odds of severe COVID-19.

Mots clés: COVID-19; SARS-CoV-2; Variant of concern Alpha; Severity; COVID-19

Domaines: Maladies infectieuses; Maladies émergentes; Santé publique et épidémiologie

Guillaume Martin-Blondel, François-Xavier Lescure, Lambert Assoumou, Charlotte Charpentier, Jean-Marc Chapplain, et al.. Increased risk of severe COVID-19 in hospitalized patients with SARS-CoV-2 Alpha variant infection: a multicentre matched cohort study. BMC Infectious Diseases, 2022, 22, pp.540. ⟨10.1186/s12879-022-07508-x⟩. ⟨hal-03727828⟩