Abstract
The alpha variant of the severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) is associated with higher transmissibility and possibly higher mortality compared with wild-type SARS-CoV-2. However, few data are available on the clinical course of infections with the alpha variant compared with wild-type SARS-CoV-2 in critically ill patients in intensive care units (ICUs). Therefore, we retrospectively analyzed patients admitted to our ICU due to SARS-CoV-2 Alpha variant infection and compared characteristics and course to patients with SARS-CoV-2 wild-type infection. The median age of patients with Alpha variant infections was 57 years compared to 62 years in the wild-type group. ICU survival was 41/80 (51%) in the Alpha variant group and 35/80 (44%) in the wild-type group (p = 0.429). Results of a matched-pair analysis based on age and sex illustrated that 45/58 patients (77.6%) in the Alpha variant group and 38/58 (65.5%) patients in the wild-type group required mechanical ventilation (p = 0.217). ICU survival was documented for 28/58 patients (48.3%) in the Alpha variant group and 27/58 patients (46.6%) in the wild-type group (p = 1). Thus, ICU mortality among patients with SARS-CoV-2 infections remains high. Although the Alpha variant group included younger patients requiring mechanical ventilation, no significant differences between patients with the SARS-CoV-2 Alpha variant and the SARS-CoV-2 wild-type, respectively, were detected with respect to clinical course and ICU mortality. For future VOCs, we believe it would be important to obtain valid and rapid data on the clinical course of critically ill patients who test positive for COVID-19 in order to perform appropriate epidemiological planning of intensive care capacity.
Highlights
The ongoing global coronavirus-19 disease (COVID-19) pandemic, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) [1,2], poses major challenges to health systems worldwide
Patients who were admitted to the intensive care units (ICUs) between 1 September 2020 and 5 May 2021 and tested positive for SARS-CoV-2 were included in the analysis
One hundred and sixty patients who were admitted to our ICU were included in this analysis
Summary
The ongoing global coronavirus-19 disease (COVID-19) pandemic, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) [1,2], poses major challenges to health systems worldwide. SARS-CoV-2 is a positive-sense single-stranded RNA virus whose genome is of a low stability and is more prone to mutation accumulation, with approximately. Not all genetic mutations lead to variation in major proteins and/or alter virus infectivity. Several mutations of SARS-CoV-2 have emerged [4]. These genetic variants affect the course of the disease by altered virulence, susceptibility to immune response and transmissibility. Four of these variants are classified as variants of concern (VOC)
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