Health system impacts of SARS-CoV − 2 variants of concern: a rapid review

Abstract

Background As of November 25th 2021, four SARS-CoV − 2 variants of concern (VOC: Alpha (B.1.1.7), Beta (B.1.351), Gamma (P.1), and Delta (B.1.617.2)) have been detected. Variable degrees of increased transmissibility of the VOC have been documented, with potential implications for hospital and health system capacity and control measures. This rapid review aimed to provide a synthesis of evidence related to health system responses to the emergence of VOC worldwide. Methods Seven databases were searched up to September 27, 2021, for terms related to VOC. Titles, abstracts, and full-text documents were screened independently by two reviewers. Data were extracted independently by two reviewers using a standardized form. Studies were included if they reported on at least one of the VOC and health system outcomes. Results Of the 4877 articles retrieved, 59 studies were included, which used a wide range of designs and methods. Most of the studies reported on Alpha, and all except two reported on impacts for capacity planning related to hospitalization, intensive care admissions, and mortality. Most studies (73.4%) observed an increase in hospitalization, but findings on increased admission to intensive care units were mixed (50%). Most studies (63.4%) that reported mortality data found an increased risk of death due to VOC, although health system capacity may influence this. No studies reported on screening staff and visitors or cohorting patients based on VOC. Conclusion While the findings should be interpreted with caution as most of the sources identified were preprints, evidence is trending towards an increased risk of hospitalization and, potentially, mortality due to VOC compared to wild-type SARS-CoV − 2. There is little evidence on the need for, and the effect of, changes to health system arrangements in response to VOC transmission.

Long covid outcomes at one year after mild SARS-CoV-2 infection: nationwide cohort study

“…Reports have shown that variants presented variable transmission patterns, virulence, severity of disease symptoms, and compromised vaccine protection. 56 57 58 59 In this study, we analysed the heterogeneity between the dominating SARS-CoV-2 variants and long term health outcomes after mild infection. Comparison of the wild-type strain and the alpha variant up to a year after infection showed no significant differences in health outcomes, and variants showed similarity in both early and late time periods.…”

“…Firstly, to quantify the risk for long term health outcomes associated with mild SARS-CoV-2 infection in unvaccinated people, we analysed a sub-cohort of unvaccinated SARS-CoV-2 infected and non-infected pairs during wild-type virus and alpha variant periods and compared all reported covid-19 outcomes between pairs (we did not include the delta variant owing to insufficient follow-up). We categorised age into six age groups: three children's subgroups (0-4, 5-11, and 12-18 years) and three adults' subgroups (41)(42)(43)(44)(45)(46)(47)(48)(49)(50)(51)(52)(53)(54)(55)(56)(57)(58)(59)(60), and >60) (supplementary table S2a). The follow-up period was from the second to 12th month after the PCR test, to target outcomes related to covid-19 after the acute period (first month).…”

Lessons Learned from the COVID-19 Pandemic and How Blood Operators Can Prepare for the Next Pandemic

“…Changes in the dominant SARS-CoV-2 variants of concern over time meant that blood operators needed to review policies focussed on enhancing staff safety and reducing transmission in the workplace [ 36 , 37 ] ( Table 1 ). We also spent considerable time understanding the safety of vaccine and the importance of vaccination in reducing the burden of disease in society [ 38 , 39 , 40 ].…”

Immunomodulatory effects of new phytotherapy on human macrophages and TLR4- and TLR7/8-mediated viral-like inflammation in mice

“…These studies have resulted in the implementation of the preventive anti-inflammatory remedies and pathogenetic therapies in SARS-CoV-2 patients, such as hydroxychloroquine, chloroquine, azithromycin, ivermectin, colchicine, thalidomide and glucocorticoids methylprednisolone and dexamethasone, the monoclonal antibody tocilizumab, convalescent plasma interferons, and intravenous immunoglobulin therapy ( 7 – 9 ). However, these types of medicine are often unaffordable in low-income countries ( 10 ), which become a natural reservoir of the virus and a prerequisite of the appearance of new mutations ( 11 ).…”