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Vander Luis de Souza Freitas 1 Article
Clinical symptom profile of hospitalized COVID-19 Brazilian patients according to SARS-CoV-2 variants
Natália Satchiko Hojo-Souza, Vander Luis de Souza Freitas, Daniel Ludovico Guidoni, Fernanda Sumika Hojo de Souza
Epidemiol Health. 2023;45:e2023079.   Published online August 28, 2023
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AbstractAbstract AbstractSummary PDF
The aim of this study was to investigate the prevalence of the main symptoms in Brazilian coronavirus disease 2019 (COVID-19) patients hospitalized during 4 distinct waves, based on their infection with different severe acute respiratory disease coronavirus 2 (SARS-CoV-2) variants.
This study included hospitalized patients who tested positive for SARS-CoV-2 during 15 weeks around the peak of each of 4 waves: W1, ancestral strain/B.1 lineage (May 31 to September 12, 2020); W2, Gamma/P.1 variant (January 31 to May 15, 2021); W3, Omicron variant (December 5, 2021 to March 19, 2022); and W4, BA.4/BA.5 subvariants (May 22 to September 3, 2022). Symptom data were extracted from the Brazilian Severe Acute Respiratory Syndrome Database. Relative risks were calculated, and an analysis of symptom networks was performed.
Patients who were hospitalized during the prevalence of the Gamma/P.1 variant demonstrated a higher risk, primarily for symptoms such as fatigue, abdominal pain, low oxygen saturation, and sore throat, than patients hospitalized during the first wave. Conversely, patients who were hospitalized during the predominance of the Omicron variant exhibited a lower relative risk, particularly for symptoms such as loss of smell, loss of taste, diarrhea, fever, respiratory distress, and dyspnea. Similar results were observed in COVID-19 patients who were hospitalized during the wave of the Omicron subvariants BA.4/BA.5. A symptom network analysis, conducted to explore co-occurrence patterns among different variants, revealed significant differential profiles across the 4 waves, with the most notable difference observed between the W2 and W4 networks.
Overall, the relative risks and patterns of symptom co-occurrence associated with different SARS-CoV-2 variants may reflect disease severity.
Key Message
The study highlights the varying prevalence and distinct symptom profiles among Brazilian COVID-19 patients hospitalized during different waves linked to specific SARS-CoV-2 variants. It suggests that the manifestation of symptoms differs significantly across variant-driven waves, signifying potential shifts in disease severity. Specifically, patients during the Gamma/P.1 variant wave showed higher risks for symptoms like fatigue, abdominal pain, and respiratory impairment, while those during the Omicron wave exhibited lower risks for certain symptoms like loss of smell and taste, indicating changing symptomatology and potentially evolving disease impact linked to different variants.


Citations to this article as recorded by  
  • Risks of Adverse Outcomes for Hospitalized COVID-19 Patients during the Four Waves in Brazil According to SARS-CoV-2 Variants, Age Group, and Vaccine Status
    Natália Satchiko Hojo-Souza, Waasila Jassat, Daniel Ludovico Guidoni, Fernanda Sumika Hojo de Souza
    Viruses.2023; 15(10): 1997.     CrossRef

Epidemiol Health : Epidemiology and Health