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COVID-19: Original 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
DOI: https://doi.org/10.4178/epih.e2023079
  • 5,493 View
  • 136 Download
  • 3 Web of Science
  • 3 Crossref
AbstractAbstract AbstractSummary PDF
Abstract
OBJECTIVES
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.
METHODS
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.
RESULTS
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.
CONCLUSIONS
Overall, the relative risks and patterns of symptom co-occurrence associated with different SARS-CoV-2 variants may reflect disease severity.
Summary
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

Citations to this article as recorded by  
  • Gastrointestinal symptoms in COVID-19 and disease severity: a Japanese registry-based retrospective cohort study
    Yuta Matsubara, Hiroki Kiyohara, Yohei Mikami, Kosaku Nanki, Ho Namkoong, Shotaro Chubachi, Hiromu Tanaka, Shuhei Azekawa, Shinya Sugimoto, Yusuke Yoshimatsu, Tomohisa Sujino, Kaoru Takabayashi, Naoki Hosoe, Toshiro Sato, Makoto Ishii, Naoki Hasegawa, Yuk
    Journal of Gastroenterology.2024; 59(3): 195.     CrossRef
  • Prevalence and Factors Associated with Olfactory Dysfunction in Individuals with COVID-19 in Brazil: A Study of 20,669 Cases from 2020 to 2021
    Carlos Dornels Freire de Souza, Amanda Júlia de Arruda Magalhães, Yasmin Vitória Silva Nobre, Carlos Alberto Souza, André Luis Oliveira do Nascimento, Luísa Robalinho de Faria, Márcio Bezerra-Santos, Anderson da Costa Armstrong, Jandir Mendonça Nicácio, O
    Medical Principles and Practice.2024; 33(2): 164.     CrossRef
  • 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
COVID-19: Original Article
Viral shedding patterns of symptomatic SARS-CoV-2 infections by periods of variant predominance and vaccination status in Gyeonggi Province, Korea
Gawon Choi, Ah-Young Lim, Sojin Choi, Kunhee Park, Soon Young Lee, Jong-Hun Kim
Epidemiol Health. 2023;45:e2023008.   Published online December 21, 2022
DOI: https://doi.org/10.4178/epih.e2023008
  • 5,193 View
  • 138 Download
  • 2 Web of Science
  • 2 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
We compared the viral cycle threshold (Ct) values of infected patients to better understand viral kinetics by vaccination status during different periods of variant predominance in Gyeonggi Province, Korea.
METHODS
We obtained case-specific data from the coronavirus disease 2019 (COVID-19) surveillance system, Gyeonggi in-depth epidemiological report system, and Health Insurance Review & Assessment Service from January 2020 to January 2022. We defined periods of variant predominance and explored Ct values by analyzing viral sequencing test results. Using a generalized additive model, we performed a nonlinear regression analysis to determine viral kinetics over time.
RESULTS
Cases in the Delta variant’s period of predominance had higher viral shedding patterns than cases in other periods. The temporal change of viral shedding did not vary by vaccination status in the Omicron-predominant period, but viral shedding decreased in patients who had completed their third vaccination in the Delta-predominant period. During the Delta-predominant and Omicron-predominant periods, the time from symptom onset to peak viral shedding based on the E gene was approximately 2.4 days (95% confidence interval [CI], 2.2 to 2.5) and 2.1 days (95% CI, 2.0 to 2.1), respectively.
CONCLUSIONS
In one-time tests conducted to diagnose COVID-19 in a large population, although no adjustment for individual characteristics was conducted, it was confirmed that viral shedding differed by the predominant strain and vaccination history. These results show the value of utilizing hundreds of thousands of test data produced at COVID-19 screening test centers.
Summary
Korean summary
코로나19 선별진료소에서는 확진 검사를 위해 수십만 건에서 수백만 건까지의 일회성 검사를 시행해왔다. 검사를 받은 개인의 특성과 관련된 데이터 제한으로 인해 분석 시 이를 보정할 수는 없지만, 대규모 인구집단에서 얻어진 검사 결과는 SARS-CoV-2 배출 특성을 평가하는 데 활용될 수 있다. 이번 연구에서는 바이러스 변이의 종류와 백신 접종 이력에 따라 증상 발생 후 시간 경과에 따라 바이러스 배출량이 달라지는 것을 확인하였다. 이러한 대규모 선별 검사자료는 향후에도 유용하게 활용 가능하다.
Key Message
The screening center for COVID-19 has conducted hundreds of thousands to millions of one-time confirmation tests for diagnosis. Although individual characteristics cannot be adjusted for due to data limitations, the test results from a large population can still be utilized to evaluate SARS-CoV-2 shedding. We confirmed that viral shedding varied over time after symptom onset, depending on the type of virus variant and vaccination history.

Citations

Citations to this article as recorded by  
  • Deisolation in the Healthcare Setting Following Recent COVID-19 Infection
    Samuel W. L. Baumgart, Aidan McLachlan, Hayden Kenny, Genevieve McKew, Susan Maddocks, Sharon C.-A. Chen, Jen Kok
    Viruses.2024; 16(7): 1131.     CrossRef
  • Viral load dynamics in asymptomatic and symptomatic patients during Omicron BA.2 outbreak in Shanghai, China, 2022: A longitudinal cohort study
    Jingwen Ai, Jiaxin Zhou, Yang Li, Feng Sun, Shijia Ge, Haocheng Zhang, Yanpeng Wu, Yan Wang, Yilin Zhang, Hongyu Wang, Jianpeng Cai, Xian Zhou, Sen Wang, Rong Li, Zhen Feng, Xiangyanyu Xu, Xuemei Yan, Yuchen Zhao, Juanjuan Zhang, Hongjie Yu, Wenhong Zhang
    Virologica Sinica.2024;[Epub]     CrossRef
COVID-19: Brief Communication
Dynamics of hospitalizations and in-hospital deaths from COVID-19 in northeast Brazil: a retrospective analysis based on the circulation of SARS-CoV-2 variants and vaccination coverage
Paulo Ricardo Martins-Filho, Adriano Antunes de Souza Araújo, Lucindo José Quintans-Júnior, Bárbara dos Santos Soares, Waneska de Souza Barboza, Taise Ferreira Cavalcante, Victor Santana Santos
Epidemiol Health. 2022;44:e2022036.   Published online April 5, 2022
DOI: https://doi.org/10.4178/epih.e2022036
  • 10,884 View
  • 347 Download
  • 14 Web of Science
  • 15 Crossref
AbstractAbstract AbstractSummary PDF
Abstract
This study investigated the dynamics of hospitalizations and in-hospital deaths from coronavirus disease 2019 (COVID-19) throughout the pandemic in northeast Brazil, the Brazilian region with the worst socioeconomic indicators. In total, 141,445 cases, 8,213 hospital admissions, and 1,644 in-hospital deaths from COVID-19 were registered from March 14, 2020 to February 5, 2022. The overall rates of hospitalization and in-hospital deaths were 5.8% and 20.0%, respectively. The hospitalization and death rates significantly decreased over time, which may have been related to progress in vaccination. During the spread of the Gamma variant (January to June 2021), most hospitalized individuals were young adults, and approximately 40% of deaths occurred in this age group. During the predominance of Delta (July to December 2021), over 75% of deaths occurred among the elderly and unvaccinated or partially vaccinated individuals. This rate decreased to 42.3% during the transmission of the Omicron variant (January to February 2022), during which 34.6% of deaths were recorded among fully vaccinated individuals (2 doses) and 23.1% among those who received full vaccination and a booster. The Omicron-driven third wave was associated with a rise in the proportion of deaths among vaccinated individuals, especially among those who had not received a booster dose.
Summary
Key Message
The Omicron-driven third wave in Brazil was associated with a rise in the proportion of deaths among vaccinated individuals, especially among those who had not received a booster dose

Citations

Citations to this article as recorded by  
  • Understanding SARS-CoV-2 spike glycoprotein clusters and their impact on immunity of the population from Rio Grande do Norte, Brazil
    Diego Gomes Teixeira, João Firmino Rodrigues-Neto, Dayse Caroline Severiano da Cunha, Selma Maria Bezerra Jeronimo
    Infection, Genetics and Evolution.2024; 118: 105556.     CrossRef
  • The effectiveness of vaccination on the COVID-19 epidemic in California
    Elijah Huang, Siddharth Kurkure, Yui Seo, Kristie Lau, Jose Puglisi
    American Journal of Infection Control.2024; 52(11): 1252.     CrossRef
  • Asthma as a risk factor and allergic rhinitis as a protective factor for COVID-19 severity: a case-control study
    Martha Débora Lira Tenório, Gabriel Valentim dos Santos Menezes Siqueira, Gustavo Costa Caldas, Roque Pacheco de Almeida, Amélia Ribeiro de Jesus, Paulo Ricardo Martins-Filho
    European Archives of Oto-Rhino-Laryngology.2024;[Epub]     CrossRef
  • Clinical profile analysis of SARS-CoV-2 community infections during periods with omicron BA.2, BA.4/5, and XBB dominance in Hong Kong: a prospective cohort study
    Yawei Wang, Hau Chi So, Nicole Ngai Yung Tsang, Siu Kan Kwok, Benjamin J Cowling, Gabriel M Leung, Dennis Kai Ming Ip
    The Lancet Infectious Diseases.2024;[Epub]     CrossRef
  • Case-fatality rates and risk of death from COVID-19 and influenza A/H3N2 in Brazil: A nationwide ecological study
    Paulo Ricardo Martins-Filho, Jerocílio Maciel de Oliveira Júnior, Cliomar Alves dos Santos
    Enfermedades Infecciosas y Microbiología Clínica.2023; 41(3): 199.     CrossRef
  • SARS-CoV-2 infection and mortality in pediatric patients with hematological malignancies and solid tumors
    João Eduardo Andrade Tavares de Aguiar, Marcos Antônio Lima Carvalho, Simone Santana Viana, Paulo Ricardo Martins-Filho, Rosana Cipolotti
    Pediatric Hematology and Oncology.2023; 40(4): 429.     CrossRef
  • Comparison of Epidemiologic and Clinical COVID-19 Profiles in Children in Argentina, During Circulation of Original and Variant (Alpha, Gamma and Lambda) Strains
    Angela Gentile, María Del Valle Juárez, Lucia Romero Bollon, Valeria Aprea, Erika Matteucci, Andrea Falaschi, Martin Brizuela, Cristina Euliarte, Gabriela Gregorio, Maria Paula Della Latta, Carlota Russ, Gabriela Nidia Ensinck, Liliana Saraceni, Miriam Br
    Pediatric Infectious Disease Journal.2023; 42(2): 136.     CrossRef
  • Case-fatality rates and risk of death from COVID-19 and influenza A/H3N2 in Brazil: A nationwide ecological study
    Paulo Ricardo Martins-Filho, Jerocílio Maciel de Oliveira Júnior, Cliomar Alves dos Santos
    Enfermedades infecciosas y microbiologia clinica (English ed.).2023; 41(3): 199.     CrossRef
  • Impact of inactivated vaccines on decrease of viral RNA levels in individuals with the SARS-CoV-2 Omicron (BA.2) variant: A retrospective cohort study in Shanghai, China
    Peng Yang, Bianli Dang, Wen Kang, Xiaofeng Li, Tianping Wang, Ruijuan Li, Meijuan Peng, Yushen Liu, Linxu Wang, Yan Cheng, Suhuai Yu, Min Wei, Han Gao, Wenzhen Kang, Lei Shang
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  • Comparison of the disease severity with infection of severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) Delta and Omicron variants: A meta‐analysis
    Ying Qiu, Zhenghao Li, Fan Lin, Yilin Yang, Lanxuan Yang, Ting Li
    MedComm – Future Medicine.2023;[Epub]     CrossRef
  • Clinical Characteristics and Risk Factors for Mortality in Critical COVID-19 Patients Aged 50 Years or Younger During Omicron Wave in Korea: Comparison With Patients Older Than 50 Years of Age
    Hye Jin Shi, Jinyoung Yang, Joong Sik Eom, Jae-Hoon Ko, Kyong Ran Peck, Uh Jin Kim, Sook In Jung, Seulki Kim, Hyeri Seok, Miri Hyun, Hyun Ah Kim, Bomi Kim, Eun-Jeong Joo, Hae Suk Cheong, Cheon Hoo Jun, Yu Mi Wi, Jungok Kim, Sungmin Kym, Seungjin Lim, Yoon
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  • Prevalence of SARS-CoV-2 infection among urban cleaning and solid waste management workers during transmission of the Omicron variant in Brazil
    Paulo Ricardo Martins-Filho, Joyce Thayane da Conceição dos Santos, Márcia Santos Rezende, Fernanda Oliveira de Carvalho, Érica Santos dos Reis, Waneska de Souza Barboza, Taise Ferreira Cavalcante, Cliomar Alves dos Santos, Lucindo José Quintans-Júnior,
    Epidemiology and Health.2023;[Epub]     CrossRef
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    Taimoor Ahmad, Mujahid Abdullah, Abdul Mueed, Faisal Sultan, Ayesha Khan, Adnan Ahmad Khan, Huzaifa Ahmad Cheema
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  • The increase in SARS-CoV-2 lineages during 2020–2022 in a state in the Brazilian Northeast is associated with a number of cases
    Moises Thiago de Souza Freitas, Ludmila Oliveira Carvalho Sena, Kiyoshi Ferreira Fukutani, Cliomar Alves dos Santos, Francisco das Chagas Barros Neto, Julienne Sousa Ribeiro, Erica Santos dos Reis, Valdir de Queiroz Balbino, Sérgio de Sá Paiva Leitão, Mar
    Frontiers in Public Health.2023;[Epub]     CrossRef
  • 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
    Epidemiology and Health.2023; 45: e2023079.     CrossRef
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