Evidence map›Paper›PMID 35043121›Full record

ArticlemedRxiv : the preprint server for health sciences2022

Outcomes of laboratory-confirmed SARS-CoV-2 infection in the Omicron-driven fourth wave compared with previous waves in the Western Cape Province, South Africa.

Mary-Ann Davies, Reshma Kassanjee, Petro Rosseau, Erna Morden, Leigh Johnson, Wesley Solomon, Nei-Yuan Hsiao, Hannah Hussey, Graeme Meintjes, Masudah Paleker and 37 more

Open access · greenAbstract readPreprint
In one paragraph

Article in medRxiv : the preprint server for health sciences, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
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

1 citing paper in PubMed, 64 citations in OpenAlex.

  1. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

47 authors at 6 institutions in 2 countries.

Mary-Ann DaviesHealth Intelligence, Western Cape Government: Health, South Africa.
Reshma KassanjeeCentre for Infectious Disease Epidemiology and Research, School of Public Health and Family Medicine, University of Cape Town, South Africa.
Petro RosseauNational Department of Health, South Africa.
Erna MordenHealth Intelligence, Western Cape Government: Health, South Africa.
Leigh JohnsonCentre for Infectious Disease Epidemiology and Research, School of Public Health and Family Medicine, University of Cape Town, South Africa.
Wesley SolomonNational Department of Health, South Africa.
Nei-Yuan HsiaoDivision of Medical Virology, University of Cape Town, Cape Town, Western Cape, South Africa.
Hannah HusseyHealth Intelligence, Western Cape Government: Health, South Africa.
Graeme MeintjesGroote Schuur Hospital, Western Cape Government: Health.
Masudah PalekerHealth Intelligence, Western Cape Government: Health, South Africa.
Theuns JacobsHealth Intelligence, Western Cape Government: Health, South Africa.
Peter RaubenheimerGroote Schuur Hospital, Western Cape Government: Health.
Alexa HeekesHealth Intelligence, Western Cape Government: Health, South Africa.
Pierre DaneHealth Intelligence, Western Cape Government: Health, South Africa.
Jamy-Lee BamHealth Intelligence, Western Cape Government: Health, South Africa.
Mariette SmithHealth Intelligence, Western Cape Government: Health, South Africa.
Wolfgang PreiserNational Health Laboratory Service, South Africa.
David PienaarRural Health Services, Western Cape Government: Health.
Marc MendelsonGroote Schuur Hospital, Western Cape Government: Health.
Jonathan NaudeMitchells Plain Hospital, Western Cape Government: Health.
Neshaad SchruederTygerberg Hospital, Western Cape Government: Health.
Ayanda MnguniKhayelitsha District Hospital, Western Cape Government: Health.
Sue Le RouxGroote Schuur Hospital, Western Cape Government: Health.
Katie MurieWestern Cape Government: Health, South Africa.
Hans ProzeskyTygerberg Hospital, Western Cape Government: Health.
Hassan MahomedDivision of Health Systems and Public Health, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University.
Liezel RossouwWestern Cape Government: Health, South Africa.
Sean WassermanGroote Schuur Hospital, Western Cape Government: Health.
Deborah MaughanGroote Schuur Hospital, Western Cape Government: Health.
Linda BolokoGroote Schuur Hospital, Western Cape Government: Health.
Barry SmithGroote Schuur Hospital, Western Cape Government: Health.
Jantjie TaljaardTygerberg Hospital, Western Cape Government: Health.
Greg SymonsGroote Schuur Hospital, Western Cape Government: Health.
Ntobeko NtusiGroote Schuur Hospital, Western Cape Government: Health.
Arifa ParkerTygerberg Hospital, Western Cape Government: Health.
Nicole WolterNational Institute for Communicable Diseases, National Health Laboratory Service, South Africa.
Waasila JassatNational Institute for Communicable Diseases, National Health Laboratory Service, South Africa.
Cheryl CohenNational Institute for Communicable Diseases, National Health Laboratory Service, South Africa.
Richard LessellsKwaZulu-Natal Research, Innovation & Sequencing Platform, University of KwaZulu-Natal, Durban, South Africa.
Robert J WilkinsonThe Francis Crick Institute, Midland Road, London, NW1 1AT, UK.
Juanita ArendseWestern Cape Government: Health, South Africa.
Saadiq KariemWestern Cape Government: Health, South Africa.
Melvin MoodleyHealth Intelligence, Western Cape Government: Health, South Africa.
Krish VallabhjeeWestern Cape Government: Health, South Africa.
Milani WolmaransNational Department of Health, South Africa.
Keith CloeteWestern Cape Government: Health, South Africa.
Andrew BoulleHealth Intelligence, Western Cape Government: Health, South Africa.
Western Cape Department of Health · ZAUniversity of Cape Town · ZANational Health Laboratory Service · ZAStellenbosch University · ZAThe Francis Crick Institute · GBUniversity of KwaZulu-Natal · ZA

Funding

Observational Antiretroviral Studies In Southern Africa (OASIS) CollaborationU01AI069924 · NIAID · UNIVERSITAT BERN · PI Cleophas Chimbetete, Mary-Ann Davies · 2006 to 2026
$55.9M
B positive_A population based evaluation of expanded ART access in pregnancyR01HD080465 · NICHD · UNIVERSITY OF CAPE TOWN · PI KALK, EMMA KATE · 2014 to 2019
$4.3M
NIAID NIH HHS U01 AI069924NICHD NIH HHS R01 HD080465Wellcome Trust
6 · The paper itself

Abstract

objectivesWe aimed to compare COVID-19 outcomes in the Omicron-driven fourth wave with prior waves in the Western Cape, the contribution of undiagnosed prior infection to differences in outcomes in a context of high seroprevalence due to prior infection, and whether protection against severe disease conferred by prior infection and/or vaccination was maintained.

methodsIn this cohort study, we included public sector patients aged ≥20 years with a laboratory confirmed COVID-19 diagnosis between 14 November-11 December 2021 (wave four) and equivalent prior wave periods. We compared the risk between waves of the following outcomes using Cox regression: death, severe hospitalization or death and any hospitalization or death (all ≤14 days after diagnosis) adjusted for age, sex, comorbidities, geography, vaccination and prior infection.

resultsWe included 5,144 patients from wave four and 11,609 from prior waves. Risk of all outcomes was lower in wave four compared to the Delta-driven wave three (adjusted Hazard Ratio (aHR) [95% confidence interval (CI)] for death 0.27 [0.19; 0.38]. Risk reduction was lower when adjusting for vaccination and prior diagnosed infection (aHR:0.41, 95% CI: 0.29; 0.59) and reduced further when accounting for unascertained prior infections (aHR: 0.72). Vaccine protection was maintained in wave four (aHR for outcome of death: 0.24; 95% CI: 0.10; 0.58).

conclusionsIn the Omicron-driven wave, severe COVID-19 outcomes were reduced mostly due to protection conferred by prior infection and/or vaccination, but intrinsically reduced virulence may account for an approximately 25% reduced risk of severe hospitalization or death compared to Delta.

Identifiers

PMID35043121
PMCPMC8764730
OpenAlexW4206765951

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
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Registered trials

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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.