Trends in cases, hospitalizations, and mortality related to the Omicron BA.4/BA.5 subvariants in South Africa

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dc.contributor.author Jassat, Waasila
dc.contributor.author Karim, Salim S. Abdool
dc.contributor.author Ozougwu, Lovelyn
dc.contributor.author Welch, Richard
dc.contributor.author Mudara, Caroline
dc.contributor.author Masha, Maureen
dc.contributor.author Rousseau, Petro
dc.contributor.author Wolmarans, Milani
dc.contributor.author Selikow, Anthony
dc.contributor.author Govender, Nevashan
dc.contributor.author Walaza, sibongile
dc.contributor.author Von Gottberg, Anne
dc.contributor.author Wolter, Nicole
dc.contributor.author Groome, Michelle J.
dc.contributor.author Pisa, Pedro Terrence
dc.contributor.author Sanne, Ian
dc.contributor.author Govender, Sharlene
dc.contributor.author Cohen, Cheryl
dc.contributor.author Groome, Michelle J.
dc.date.accessioned 2024-04-24T10:08:38Z
dc.date.available 2024-04-24T10:08:38Z
dc.date.issued 2023-04-15
dc.description.abstract BACKGROUND : In this study, we compared admission incidence risk and the risk of mortality in the Omicron BA.4/BA.5 wave to previous waves. METHODS : Data from South Africa’s SARS-CoV-2 case linelist, national COVID-19 hospital surveillance system, and Electronic Vaccine Data System were linked and analyzed. Wave periods were defined when the country passed a weekly incidence of 30 cases/ 100 000 population. In-hospital case fatality ratios (CFRs) during the Delta, Omicron BA.1/BA.2, and Omicron BA.4/BA.5 waves were compared using post-imputation random effect multivariable logistic regression models. RESULTS : The CFR was 25.9% (N=37 538 of 144 778), 10.9% (N=6123 of 56 384), and 8.2% (N=1212 of 14 879) in the Delta, Omicron BA.1/BA.2, and Omicron BA.4/BA.5 waves, respectively. After adjusting for age, sex, race, comorbidities, health sector, and province, compared with the Omicron BA.4/BA.5 wave, patients had higher risk of mortality in the Omicron BA.1/BA.2 wave (adjusted odds ratio [aOR], 1.3; 95% confidence interval [CI]: 1.2–1.4) and Delta wave (aOR, 3.0; 95% CI: 2.8–3.2). Being partially vaccinated (aOR, 0.9; 95% CI: .9–.9), fully vaccinated (aOR, 0.6; 95% CI: .6–.7), and boosted (aOR, 0.4; 95% CI: .4–.5) and having prior laboratory-confirmed infection (aOR, 0.4; 95% CI: .3–.4) were associated with reduced risks of mortality. CONCLUSIONS : Overall, admission incidence risk and in-hospital mortality, which had increased progressively in South Africa’s first 3 waves, decreased in the fourth Omicron BA.1/BA.2 wave and declined even further in the fifth Omicron BA.4/BA.5 wave. Mortality risk was lower in those with natural infection and vaccination, declining further as the number of vaccine doses increased. en_US
dc.description.department Human Nutrition en_US
dc.description.librarian am2024 en_US
dc.description.sdg SDG-03:Good heatlh and well-being en_US
dc.description.uri https://academic.oup.com/cid/ en_US
dc.identifier.citation Jassat, W., Karim, S.S.A., Ozougwu, L. et al. 2023, 'Trends in cases, hospitalizations, and mortality related to the Omicron BA.4/BA.5 subvariants in South Africa', Clinical Infectious Diseases, vol. 76, no. 8, pp. 1468-1475. https://DOI.org/10.1093/cid/ciac921. en_US
dc.identifier.issn 1058-4838 (print)
dc.identifier.issn 1537-6591 (online)
dc.identifier.other 10.1093/cid/ciac921
dc.identifier.uri http://hdl.handle.net/2263/95743
dc.language.iso en en_US
dc.publisher Oxford University Press en_US
dc.rights © The Author(s) 2022. This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence. en_US
dc.subject Hospital admissions en_US
dc.subject Mortality en_US
dc.subject Omicron BA.4 en_US
dc.subject Omicron BA.5. en_US
dc.subject COVID-19 pandemic en_US
dc.subject Coronavirus disease 2019 (COVID-19) en_US
dc.subject Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) en_US
dc.subject SDG-03: Good health and well-being en_US
dc.title Trends in cases, hospitalizations, and mortality related to the Omicron BA.4/BA.5 subvariants in South Africa en_US
dc.type Article en_US


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