ArticleBMJ public health2023
Turning point in COVID-19 severity and fatality during the pandemic: a national cohort study in Qatar.
Article in BMJ public health, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers.
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Who cites it
20 citing papers in PubMed.
- Two Versus One COVID-19 Vaccine Dose After Prior SARS-CoV-2 Infection: A Nationwide Retrospective Cohort Study.Open forum infectious diseases · 2026Article
- Risk of stroke following SARS-CoV-2 infection in a nationwide self-controlled case series study in qatar.Scientific reports · 2026Observational
- Longitudinal Analysis of Variations in Daily Step Counts and Long-Term Implications of COVID-19 Waves and Restriction Phases in Qatar's Step Into Health Program: Mixed Methods Study.JMIR public health and surveillance · 2026Article
- Global Estimates of COVID-19 Morbidity and Mortality: A Cohort Study and Mathematical Model Analysis.Influenza and other respiratory viruses · 2025Article
- CT-based phenotyping of COVID-19: cluster analysis of pulmonary and extrapulmonary imaging markers from a multicentre retrospective cohort study.Scientific reports · 2025Article
- Effectiveness and durability of a fourth dose of ancestral-strain mRNA vaccines against SARS-CoV-2 infection: a nationwide matched cohort study in Qatar.Scientific reports · 2025Article
- Immune histories and natural infection protection during the omicron era.Communications medicine · 2025Article
- Article
- Protection conferred by SARS-CoV-2 infection across a spectrum of reinfection symptoms and severities.BMJ open respiratory research · 2025Article
- Article
- Evaluating Hospital Admission Data as Indicators of COVID-19 Severity: A National Assessment in Qatar.Open forum infectious diseases · 2025Article
- Article
- BNT162b2 Versus mRNA-1273 Vaccines: Comparative Analysis of Long-Term Protection Against SARS-CoV-2 Infection and Severe COVID-19 in Qatar.Influenza and other respiratory viruses · 2024Article
- Risk of COVID-19 in Children throughout the Pandemic and the Role of Vaccination: A Narrative Review.Vaccines · 2024Review
- Article
- SARS-CoV-2 infection and effects of age, sex, comorbidity, and vaccination among older individuals: A national cohort study.Influenza and other respiratory viruses · 2023Article
- History of primary-series and booster vaccination and protection against Omicron reinfection.Science advances · 2023Article
- Effects of previous infection, vaccination, and hybrid immunity against symptomatic Alpha, Beta, and Delta SARS-CoV-2 infections: an observational study.EBioMedicine · 2023Observational
- Population immunity of natural infection, primary-series vaccination, and booster vaccination in Qatar during the COVID-19 pandemic: an observational study.EClinicalMedicine · 2023Article
- COVID-19-associated neurological sequelae: A case series on cerebral microbleeds and encephalopathy.Qatar medical journal · 2023Article
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Authors and funding
24 authors.
Funding
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Abstract
Objective: To assess the evolution of COVID-19 severity and fatality in a unique setting that consistently applied, throughout the pandemic, rigorous and standardised criteria for defining severe COVID-19 outcomes. Methods and analysis: We conducted a national cohort study on 312 109 Qatari citizens to investigate incidence of severe, critical or fatal COVID-19 classified according to the WHO criteria between 28 February 2020 and 21 April 2023. Incidence rates for severe, critical or fatal COVID-19 were estimated during the pre-omicron phase, first omicron wave, combined phases and throughout the pandemic. Results: Cumulative incidence of severe, critical or fatal COVID-19 after 3.14 years of follow-up was 0.45% (95% CI 0.43% to 0.47%). Incidence rate for severe, critical or fatal COVID-19 throughout the pandemic was 1.43 (95% CI 1.35 to 1.50) per 1000 person years. In the pre-omicron phase, first omicron wave, and combined phases, it was 2.01 (95% CI 1.90 to 2.13), 3.70 (95% CI 3.25 to 4.22) and 2.18 (95% CI 2.07 to 2.30) per 1000 person years, respectively. The post-first omicron phase saw a drastic drop to 0.10 (95% CI 0.08 to 0.14) per 1000 person years, a 95.4% reduction. Among all severe, critical and fatal cases, 99.5% occurred during the primary infection. Cumulative incidence of fatal COVID-19 was 0.042% (95% CI 0.036% to 0.050%), with an incidence rate of 0.13 (95% CI 0.11 to 0.16) per 1000 person years. In the post-first omicron phase, incidence rate of fatal COVID-19 decreased by 90.0% compared with earlier stages. Both severity and fatality exhibited an exponential increase with age and a linear increase with the number of coexisting conditions. Conclusion: The conclusion of the first omicron wave was a turning point in the severity of the pandemic. While vaccination and enhanced case management reduced severity gradually, the rapid accumulation of natural immunity during the first omicron wave appears to have played a critical role in driving this shift in severity.
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