Evidence map›Paper›PMID 36436752›Full record

ArticleInternational journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases2023

Outcomes of laboratory-confirmed SARS-CoV-2 infection during resurgence driven by Omicron lineages BA.4 and BA.5 compared with previous waves in the Western Cape Province, South Africa.

Mary-Ann Davies, Erna Morden, Petro Rousseau, Juanita Arendse, Jamy-Lee Bam, Linda Boloko, Keith Cloete, Cheryl Cohen, Nicole Chetty, Pierre Dane and 38 more

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Article in International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 43 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
43citing papers in PubMed, 2 pooled it
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1 · What the graph read from it

What it found

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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.

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3 · Its place in the literature

Who cites it

43 citing papers in PubMed, 2 syntheses or guidelines pooled it.

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  10. SARS-CoV-2 Viral Replication Persists in the Human Lung for Several Weeks after Symptom Onset.American journal of respiratory and critical care medicine · 2024
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

48 authors.

Mary-Ann DaviesHealth Intelligence, Western Cape Government: Health, Cape Town, South Africa; Centre for Infectious Disease Epidemiology and Research, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa; Division of Public Health Medicine, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa. Electronic address: mary-ann.davies@uct.ac.za.
Erna MordenHealth Intelligence, Western Cape Government: Health, Cape Town, South Africa; Division of Public Health Medicine, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa.
Petro RousseauNational Department of Health, Pretoria, South Africa.
Juanita ArendseWestern Cape Government: Health, Cape Town, South Africa.
Jamy-Lee BamHealth Intelligence, Western Cape Government: Health, Cape Town, South Africa.
Linda BolokoGroote Schuur Hospital, Western Cape Government: Health, Cape Town, South Africa; Division of Infectious Diseases and HIV Medicine, Department of Medicine, University of Cape Town, Cape Town, South Africa.
Keith CloeteWestern Cape Government: Health, Cape Town, South Africa.
Cheryl CohenNational Institute for Communicable Diseases, National Health Laboratory Service, Johannesburg, South Africa; School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
Nicole ChettyHealth Intelligence, Western Cape Government: Health, Cape Town, South Africa; Centre for Infectious Disease Epidemiology and Research, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa.
Pierre DaneHealth Intelligence, Western Cape Government: Health, Cape Town, South Africa; Centre for Infectious Disease Epidemiology and Research, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa.
Alexa HeekesHealth Intelligence, Western Cape Government: Health, Cape Town, South Africa; Centre for Infectious Disease Epidemiology and Research, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa.
Nei-Yuan HsiaoDivision of Medical Virology, University of Cape Town, Cape Town, South Africa; National Health Laboratory Service, South Africa.
Mehreen HunterHealth Intelligence, Western Cape Government: Health, Cape Town, South Africa; Division of Public Health Medicine, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa.
Hannah HusseyHealth Intelligence, Western Cape Government: Health, Cape Town, South Africa; Division of Public Health Medicine, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa; Metro Health Services, Western Cape Government: Health, Cape Town, South Africa.
Theuns JacobsHealth Intelligence, Western Cape Government: Health, Cape Town, South Africa.
Waasila JassatNational Institute for Communicable Diseases, National Health Laboratory Service, Johannesburg, South Africa.
Saadiq KariemWestern Cape Government: Health, Cape Town, South Africa.
Reshma KassanjeeCentre for Infectious Disease Epidemiology and Research, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa.
Inneke LaenenHealth Intelligence, Western Cape Government: Health, Cape Town, South Africa; Division of Health Systems and Public Health, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa.
Sue Le RouxWestern Cape Government: Health, Cape Town, South Africa; Karl Bremer Hospital, Western Cape Government: Health, Cape Town, South Africa.
Richard LessellsKwaZulu-Natal Research, Innovation & Sequencing Platform, University of KwaZulu-Natal, Durban, South Africa.
Hassan MahomedMetro Health Services, Western Cape Government: Health, Cape Town, South Africa; Division of Health Systems and Public Health, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa.
Deborah MaughanGroote Schuur Hospital, Western Cape Government: Health, Cape Town, South Africa; Department of Medicine, University of Cape Town, Cape Town, South Africa.
Graeme MeintjesGroote Schuur Hospital, Western Cape Government: Health, Cape Town, South Africa; Department of Medicine, University of Cape Town, Cape Town, South Africa.
Marc MendelsonGroote Schuur Hospital, Western Cape Government: Health, Cape Town, South Africa; Division of Infectious Diseases and HIV Medicine, Department of Medicine, University of Cape Town, Cape Town, South Africa.
Ayanda MnguniKhayelitsha District Hospital, Western Cape Government: Health, Cape Town, South Africa.
Melvin MoodleyHealth Intelligence, Western Cape Government: Health, Cape Town, South Africa.
Katy MurieWestern Cape Government: Health, Cape Town, South Africa; Metro Health Services, Western Cape Government: Health, Cape Town, South Africa.
Jonathan NaudeMitchells Plain Hospital, Western Cape Government: Health, Cape Town, South Africa.
Ntobeko A B NtusiGroote Schuur Hospital, Western Cape Government: Health, Cape Town, South Africa; Department of Medicine, University of Cape Town, Cape Town, South Africa; South African Medical Research Council Extramural Unit on Intersection of Noncommunicable Diseases and Infectious Diseases, Cape Town, South Africa.
Masudah PalekerHealth Intelligence, Western Cape Government: Health, Cape Town, South Africa; Division of Health Systems and Public Health, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa.
Arifa ParkerTygerberg Hospital, Western Cape Government: Health, Cape Town, South Africa; Division of Infectious Diseases, Department of Medicine, Stellenbosch University, Stellenbosch, South Africa; Division of General Medicine, Department of Medicine, Stellenbosch University, Stellenbosch, South Africa.
David PienaarRural Health Services, Western Cape Government: Health, Cape Town, South Africa.
Wolfgang PreiserNational Health Laboratory Service, South Africa; Division of Medical Virology, University of Stellenbosch, Stellenbosch, South Africa.
Hans ProzeskyTygerberg Hospital, Western Cape Government: Health, Cape Town, South Africa; Division of Infectious Diseases, Department of Medicine, Stellenbosch University, Stellenbosch, South Africa.
Peter RaubenheimerGroote Schuur Hospital, Western Cape Government: Health, Cape Town, South Africa; Department of Medicine, University of Cape Town, Cape Town, South Africa.
Liezel RossouwWestern Cape Government: Health, Cape Town, South Africa.
Neshaad SchruederTygerberg Hospital, Western Cape Government: Health, Cape Town, South Africa; Division of General Medicine, Department of Medicine, Stellenbosch University, Stellenbosch, South Africa.
Barry SmithWestern Cape Government: Health, Cape Town, South Africa; Karl Bremer Hospital, Western Cape Government: Health, Cape Town, South Africa.
Mariette SmithHealth Intelligence, Western Cape Government: Health, Cape Town, South Africa; Centre for Infectious Disease Epidemiology and Research, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa.
Wesley SolomonNational Department of Health, Pretoria, South Africa.
Greg SymonsGroote Schuur Hospital, Western Cape Government: Health, Cape Town, South Africa; Department of Medicine, University of Cape Town, Cape Town, South Africa.
Jantjie TaljaardTygerberg Hospital, Western Cape Government: Health, Cape Town, South Africa; Division of Infectious Diseases, Department of Medicine, Stellenbosch University, Stellenbosch, South Africa.
Sean WassermanGroote Schuur Hospital, Western Cape Government: Health, Cape Town, South Africa; Division of Infectious Diseases and HIV Medicine, Department of Medicine, University of Cape Town, Cape Town, South Africa; Wellcome Centre for Infectious Disease Research in Africa, Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town, South Africa.
Robert J WilkinsonThe Francis Crick Institute, London, UK; Department of Infectious Diseases, Imperial College London, London, UK; Wellcome Centre for Infectious Disease Research in Africa, Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town, South Africa.
Milani WolmaransNational Department of Health, Pretoria, South Africa.
Nicole WolterNational Institute for Communicable Diseases, National Health Laboratory Service, Johannesburg, South Africa; School of Pathology, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa.
Andrew BoulleHealth Intelligence, Western Cape Government: Health, Cape Town, South Africa; Centre for Infectious Disease Epidemiology and Research, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa; Division of Public Health Medicine, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesWe aimed to compare the clinical severity of Omicron BA.4/BA.5 infection with BA.1 and earlier variant infections among laboratory-confirmed SARS-CoV-2 cases in the Western Cape, South Africa, using timing of infection to infer the lineage/variant causing infection.

methodsWe included public sector patients aged ≥20 years with laboratory-confirmed COVID-19 between May 01-May 21, 2022 (BA.4/BA.5 wave) and equivalent previous wave periods. We compared the risk between waves of (i) death and (ii) severe hospitalization/death (all within 21 days of diagnosis) using Cox regression adjusted for demographics, comorbidities, admission pressure, vaccination, and previous infection.

resultsAmong 3793 patients from the BA.4/BA.5 wave and 190,836 patients from previous waves, the risk of severe hospitalization/death was similar in the BA.4/BA.5 and BA.1 waves (adjusted hazard ratio [aHR] 1.12; 95% confidence interval [CI] 0.93; 1.34). Both Omicron waves had a lower risk of severe outcomes than previous waves. Previous infection (aHR 0.29, 95% CI 0.24; 0.36) and vaccination (aHR 0.17; 95% CI 0.07; 0.40 for at least three doses vs no vaccine) were protective.

conclusionDisease severity was similar among diagnosed COVID-19 cases in the BA.4/BA.5 and BA.1 periods in the context of growing immunity against SARS-CoV-2 due to previous infection and vaccination, both of which were strongly protective.

Indexed as

COVID-19HospitalizationHumansLaboratoriesSARS-CoV-2South AfricaBA.4BA.5COVID-19Death, Severe hospitalizationOmicron

Identifiers

PMID36436752
PMCPMC9686046

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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.