Evidence map›Paper›PMID 33857406›Full record

ArticleThe Lancet. Infectious diseases2021

Genomic characteristics and clinical effect of the emergent SARS-CoV-2 B.1.1.7 lineage in London, UK: a whole-genome sequencing and hospital-based cohort study.

Dan Frampton, Tommy Rampling, Aidan Cross, Heather Bailey, Judith Heaney, Matthew Byott, Rebecca Scott, Rebecca Sconza, Joseph Price, Marios Margaritis and 19 more

Open access · hybridAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in The Lancet. Infectious diseases, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 271 papers.

0numbers the graph read from it
0cells of the map it votes in
271citing papers in PubMed
29.0field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

271 citing papers in PubMed, 455 citations in OpenAlex.

  1. Trial
  2. Trial
  3. Gamma SARS-CoV-2 variant of concern infection repercussions on pregnancy outcomes: A translational cohort study.International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics · 2026
    Article
  4. Article
  5. Article
  6. Observational
  7. Article
  8. Article
  9. Article
  10. Article
  11. Review
  12. Review
  13. Article
  14. Article
  15. Article
  16. Article
  17. Article
  18. Genomic surveillance of SARS-CoV-2 evolution by a centralised pipeline and weekly focused sequencing, Austria, January 2021 to March 2023.Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin · 2024
    Article
  19. Article
  20. Article

211 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

29 authors at 7 institutions in 1 country.

Dan FramptonDivision of Infection and Immunity, University College London, London, UK; Advanced Pathogen Diagnostics Unit, University College London Hospitals NHS Foundation Trust, London, UK; The Francis Crick Institute, London, UK.
Tommy RamplingDepartment of Clinical Virology, University College London Hospitals NHS Foundation Trust, London, UK.
Aidan CrossNorth Middlesex University Hospital NHS Trust, London, UK.
Heather BaileyInstitute for Global Health, University College London, London, UK.
Judith HeaneyAdvanced Pathogen Diagnostics Unit, University College London Hospitals NHS Foundation Trust, London, UK; The Francis Crick Institute, London, UK.
Matthew ByottAdvanced Pathogen Diagnostics Unit, University College London Hospitals NHS Foundation Trust, London, UK; The Francis Crick Institute, London, UK.
Rebecca ScottNorth Middlesex University Hospital NHS Trust, London, UK.
Rebecca SconzaGreat Ormond Street Institute of Child Health, University College London, London, UK.
Joseph PriceNorth Middlesex University Hospital NHS Trust, London, UK.
Marios MargaritisDepartment of Clinical Virology, University College London Hospitals NHS Foundation Trust, London, UK; London School of Hygiene & Tropical Medicine, London, UK.
Malin BergstromDepartment of Clinical Virology, University College London Hospitals NHS Foundation Trust, London, UK.
Moira J SpyerGreat Ormond Street Institute of Child Health, University College London, London, UK; Advanced Pathogen Diagnostics Unit, University College London Hospitals NHS Foundation Trust, London, UK; The Francis Crick Institute, London, UK.
Patricia B MiralhesDepartment of Clinical Virology, University College London Hospitals NHS Foundation Trust, London, UK.
Paul GrantAdvanced Pathogen Diagnostics Unit, University College London Hospitals NHS Foundation Trust, London, UK; North Middlesex University Hospital NHS Trust, London, UK.
Stuart KirkHealth Services Laboratories, London, UK.
Chris ValerioNorth Middlesex University Hospital NHS Trust, London, UK.
Zaheer MangeraDivision of Infection and Immunity, University College London, London, UK.
Thaventhran PrabhaharNorth Middlesex University Hospital NHS Trust, London, UK.
Jeronimo Moreno-CuestaNorth Middlesex University Hospital NHS Trust, London, UK.
Nish ArulkumaranBloomsbury Institute of Intensive Care Medicine, University College London, London, UK.
Mervyn SingerBloomsbury Institute of Intensive Care Medicine, University College London, London, UK.
Gee Yen ShinDepartment of Clinical Virology, University College London Hospitals NHS Foundation Trust, London, UK.
Emilie SanchezDepartment of Clinical Virology, University College London Hospitals NHS Foundation Trust, London, UK.
Stavroula M ParaskevopoulouDepartment of Clinical Virology, University College London Hospitals NHS Foundation Trust, London, UK.
Deenan PillayDivision of Infection and Immunity, University College London, London, UK.
Rachel A McKendryLondon Centre for Nanotechnology, University College London, London, UK; Division of Medicine, University College London, London, UK.
Mariyam MirfendereskyNorth Middlesex University Hospital NHS Trust, London, UK.
Catherine F HoulihanDivision of Infection and Immunity, University College London, London, UK; Department of Clinical Virology, University College London Hospitals NHS Foundation Trust, London, UK.
Eleni NastouliGreat Ormond Street Institute of Child Health, University College London, London, UK; Advanced Pathogen Diagnostics Unit, University College London Hospitals NHS Foundation Trust, London, UK; Department of Clinical Virology, University College London Hospitals NHS Foundation Trust, London, UK; The Francis Crick Institute, London, UK. Electronic address: e.nastouli@ucl.ac.uk.
University College London · GBNorth Middlesex University Hospital NHS Trust · GBThe Francis Crick Institute · GBUniversity College London Hospitals NHS Foundation Trust · GBBury College · GBGreat Ormond Street Hospital · GBLondon Centre for Nanotechnology · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundEmergence of variants with specific mutations in key epitopes in the spike protein of SARS-CoV-2 raises concerns pertinent to mass vaccination campaigns and use of monoclonal antibodies. We aimed to describe the emergence of the B.1.1.7 variant of concern (VOC), including virological characteristics and clinical severity in contemporaneous patients with and without the variant.

methodsIn this cohort study, samples positive for SARS-CoV-2 on PCR that were collected from Nov 9, 2020, for patients acutely admitted to one of two hospitals on or before Dec 20, 2020, in London, UK, were sequenced and analysed for the presence of VOC-defining mutations. We fitted Poisson regression models to investigate the association between B.1.1.7 infection and severe disease (defined as point 6 or higher on the WHO ordinal scale within 14 days of symptoms or positive test) and death within 28 days of a positive test and did supplementary genomic analyses in a cohort of chronically shedding patients and in a cohort of remdesivir-treated patients. Viral load was compared by proxy, using PCR cycle threshold values and sequencing read depths.

findingsOf 496 patients with samples positive for SARS-CoV-2 on PCR and who met inclusion criteria, 341 had samples that could be sequenced. 198 (58%) of 341 had B.1.1.7 infection and 143 (42%) had non-B.1.1.7 infection. We found no evidence of an association between severe disease and death and lineage (B.1.1.7 vs non-B.1.1.7) in unadjusted analyses (prevalence ratio [PR] 0·97 [95% CI 0·72-1·31]), or in analyses adjusted for hospital, sex, age, comorbidities, and ethnicity (adjusted PR 1·02 [0·76-1·38]). We detected no B.1.1.7 VOC-defining mutations in 123 chronically shedding immunocompromised patients or in 32 remdesivir-treated patients. Viral load by proxy was higher in B.1.1.7 samples than in non-B.1.1.7 samples, as measured by cycle threshold value (mean 28·8 [SD 4·7] vs 32·0 [4·8]; p=0·0085) and genomic read depth (1280 [1004] vs 831 [682]; p=0·0011).

interpretationEmerging evidence exists of increased transmissibility of B.1.1.7, and we found increased virus load by proxy for B.1.1.7 in our data. We did not identify an association of the variant with severe disease in this hospitalised cohort.

fundingUniversity College London Hospitals NHS Trust, University College London/University College London Hospitals NIHR Biomedical Research Centre, Engineering and Physical Sciences Research Council.

Indexed as

Genome, ViralSeverity of Illness IndexWhole Genome SequencingAgedAged, 80 and overCohort StudiesCOVID-19FemaleHumansLondonMaleMiddle AgedPhylogenySARS-CoV-2United KingdomViral Load

Identifiers

PMID33857406
PMCPMC8041359
OpenAlexW3155452054

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.