B117 variant COVID-19 strain has 67% increased death risk, study says
For every 3 people who would have died from the previous dominant strains of SARS-CoV-2, 5 will die if they are infected with the B117 variant of concern (VOC), according to a UK study yesterday in Eurosurveillance.
The researchers determined that B117 has a 67% increased risk of 28-day mortality and an absolute death risk that increased with age and comorbidities, which is in line with recent studies in Nature and BMJ.
The researchers analyzed 184,786 COVID-19 test results from Nov 16, 2020, to Jan 11, 2021, that assessed spike gene target failure (SGTF), an indicator for B117. Of these, 91,775 (49.7%) were B117 cases, which led to 419 (48.3%) of the deaths. Participants were followed through death, 7 days prior to vaccination, or Feb 5, whichever came first.
Throughout the study, B117 became the dominant strain, going from 1.2% of the UK cumulative total in week 1 to 31.5% by week 8. The researchers found that while the infected groups were demographically similar, people with B117 tended to be younger (0.9% above 80 years vs 1.6%) and healthier (2.9% with more than two comorbidities vs 3.8%).
The hazard risk of B117 was 67% greater than the previous strain (95% confidence interval [CI], 1.34 to 2.09), according to the data. This translates to a 24.3% and 14.7% death rate for males and females at least 85 years old with two or more comorbidities, respectively, versus 16.7% and 9.7% from previous strains. However, the absolute death is much smaller in those below 65 with no comorbidities for both males (0.14% vs 0.09%) and females (0.07% vs 0.05%).
The results suggest that age and comorbidity effects on B117’s outcomes are collinear and similar to their effects on previous strains. Because of this, the researchers write that vaccine priorities do not have to change.
Mar 18 Euro Surveill study
CDC survey shows remote learning in pandemic strains children, parents
The Centers for Disease Control and Prevention (CDC) today published a survey that shows that American families have been strained by school closures during the COVID-19 pandemic and suffer high levels of stress when children are given online instruction.
The survey, conducted Oct 8 through Nov 13, 2020, included 1,290 respondents who have children ages 5 through 12 enrolled in public or private school: 45.7% reported that their child received virtual instruction, 30.9% in-person instruction, and 23.4% combined instruction.
“For 11 of 17 stress and well-being indicators concerning child mental health and physical activity and parental emotional distress, findings were worse for parents of children receiving virtual or combined instruction than were those for parents of children receiving in-person instruction,” the CDC said.
Among parents with children in online school, 24.7% reported worsened mental or emotional health of children, compared with 15.9% of children learning in person. Children who attended online school also had significantly decreased physical activity (62.9% vs 52.1%) and time spent outside (58.0% vs 42.4%), when compared with children given in-person instruction.
Parents of children receiving virtual instruction were also more likely than parents of children receiving combined instruction to report experiencing emotional distress (54.0% vs 42.9%), report loss of work (42.7% vs 30.6%), and have a conflict between working and providing child care (14.6% vs 8.3%).
“These findings suggest that virtual instruction might present more risks than does in-person instruction related to child and parental mental and emotional health and some health-supporting behaviors, such as engaging in physical activity, with combined instruction falling between,” the authors concluded.
Mar 19 MMWR study
COVID-19 linked with preeclampsia, stillbirth, and more in pregnant women
Maternal COVID-19 infection is associated with pregnancy complications such as preeclampsia, preterm birth, and stillbirth, and the disease is particularly associated with conditions that risk maternal and neonatal death, according to a review of 42 studies.
The study, published today in CMAJ, used unadjusted data covering 438,548 pregnant women from studies published through Jan 29.
COVID-19 was associated with preeclampsia (odds ratio [OR], 1.33; 95% confidence interval [CI], 1.03 to 1.73; I2= 31%; based on 23 studies), preterm birth (OR 1.82; 95% CI, 1.38 to 2.39; I2= 64%; 18 studies), and stillbirth (OR 2.11; 95% CI, 1.14 to 3.90; I2= 24%; 6 studies). COVID-19 was not associated with gestational diabetes, cesarean delivery, postpartum hemorrhage, or neonatal death, but some associations were found when comparing severity.
Compared with mild COVID, severe infection was tied to greater risk of most outcomes, notably with an OR of 4.16 for preeclampsia and 4.29 for preterm birth. It also showed an association with gestational diabetes (OR, 1.99; 95% CI, 1.09 to 3.64; I2= 14%; 5 studies), cesarean deliveries (OR, 2.58; 95% CI, 1.64 to 4.06; I2= 43%; 8 studies), and low birth weight (OR, 1.89; 95% CI, 1.14 to 3.12; I2= 0%; 2 studies). Similarly, symptomatic COVID was associated with a greater effect on preterm birth (OR, 2.29; I2= 57%) and cesarean delivery (OR, 1.57; I2= 1%) than asymptomatic COVID-19.
The findings differ from prior findings from case reports and case series, according to a CMAJ news release. “Our meta-analysis of recent good-quality cohort studies with comparative data does not align with these previous reviews, and provides clear evidence that symptomatic or severe COVID-19 is associated with a considerable risk of preeclampsia, preterm birth and low birth weight,” the study authors write.
“Clinicians should be aware of these adverse outcomes when managing pregnancies in patients with COVID-19 and adopt effective strategies to prevent or reduce risks to patients and fetuses,” the researchers add.
Mar 19 CMAJ study
Mar 19 CMAJ news release