Changing character and waning impact of COVID-19 at a tertiary centre in Cape Town, South Africa
Southern African Journal of Infectious Diseases
| Field | Value | |
| Title | Changing character and waning impact of COVID-19 at a tertiary centre in Cape Town, South Africa | |
| Creator | Hermans, Lucas E. Booysen, Petro Boloko, Linda Adriaanse, Marguerite de Wet, Timothy J. Lifson, Aimee R. Wadee, Naweed Papavarnavas, Nectarios Marais, Gert Hsiao, Nei-yuan Rosslee, Michael-Jon Symons, Gregory Calligaro, Gregory L. Iranzadeh, Arash Wilkinson, Robert J. Ntusi, Ntobeko A.B. Williamson, Carolyn Davies, Mary-Ann Meintjes, Graeme Wasserman, Sean | |
| Description | Background: The emergence of genetic variants of SARS-CoV-2 was associated with changing epidemiological characteristics throughout coronavirus disease 2019 (COVID-19) pandemic in population-based studies. Individual-level data on the clinical characteristics of infection with different SARS-CoV-2 variants in African countries is less well documented.Objectives: To describe the evolving clinical differences observed with the various SARS-CoV-2 variants of concern and compare the Omicron-driven wave in infections to the previous Delta-driven wave.Method: We performed a retrospective observational cohort study among patients admitted to a South African referral hospital with COVID-19 pneumonia. Patients were stratified by epidemiological wave period, and in a subset, the variants associated with each wave were confirmed by genomic sequencing. Outcomes were analysed by Cox proportional hazard models.Results: We included 1689 patients were included, representing infection waves driven predominantly by ancestral, Beta, Delta and Omicron BA1/BA2 BA4/BA5 variants. Crude 28-day mortality was 25.8% (34/133) in the Omicron wave period versus 37.1% (138/374) in the Delta wave period (hazard ratio [HR] 0.68 [95% CI 0.47–1.00] p = 0.049); this effect persisted after adjustment for age, gender, HIV status and presence of cardiovascular disease (adjusted HR [aHR] 0.43 [95% CI 0.28–0.67] p 0.001). Hospital-wide SARS-CoV-2 admissions and deaths were highest during the Delta wave period, with a decoupling of SARS-CoV-2 deaths and overall deaths thereafter.Conclusion: There was lower in-hospital mortality during Omicron-driven waves compared with the prior Delta wave, despite patients admitted during the Omicron wave being at higher risk.Contribution: This study summarises clinical characteristics associated with SARS-CoV-2 variants during the COVID-19 pandemic at a South African tertiary hospital, demonstrating a waning impact of COVID-19 on healthcare services over time despite epidemic waves driven by new variants. Findings suggest the absence of increasing virulence from later variants and protection from population and individual-level immunity. | |
| Publisher | AOSIS Publishing | |
| Date | 2023-12-18 | |
| Identifier | 10.4102/sajid.v38i1.550 | |
| Source | Southern African Journal of Infectious Diseases; Vol 38, No 1 (2023); 9 pages 2313-1810 2312-0053 | |
| Language | eng | |
| Relation |
The following web links (URLs) may trigger a file download or direct you to an alternative webpage to gain access to a publication file format of the published article:
https://sajid.co.za/index.php/sajid/article/view/550/1329
https://sajid.co.za/index.php/sajid/article/view/550/1330
https://sajid.co.za/index.php/sajid/article/view/550/1331
https://sajid.co.za/index.php/sajid/article/view/550/1332
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