Genomic characteristics and clinical effect of the emergent SARS-CoV-2 B.1.1.7 lineage in London, UK: a whole-genome sequencing and hospital-based cohort study
Study (n=496) found emerging evidence of increased transmissibility of B.1.1.7, and increased virus load but no evidence of a link between severe disease and death and lineage (B.1.1.7 vs non-B.1.1.7) in unadjusted or adjusted (hospital/sex/age/comorbidities/ethnicity) analyses.
Source:
The Lancet Infectious Diseases
SPS commentary:
A commentary notes that although limited by a much smaller dataset, this study has important advantages over the three community studies, such as the use of whole-genome sequencing, recruitment of hospitalised patients, and a population reflective of the spectrum of severity in whom increased virulence will have the greatest effect on outcomes. It adds the finding that lineage B.1.1.7 infection did not confer increased risk of severe disease and mortality in this high-risk cohort is reassuring but requires further confirmation in larger studies. It also notes that genetic drift and selection pressures (in particular with passive antibody treatments and vaccination) will continue to engender changes in SARS-CoV-2 and might result in the emergence of variants of high consequence—variants that are more virulent, escape from host immunity, or are resistant to treatment. Therefore, active, timely, and broad-based genomic surveillance is crucial for their early detection, though it also points out that careful epidemiologic and clinical assessment, coupled with a healthy scepticism, is important when assessing claims of the effect of these variants.