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Original article Clinical symptom profile of hospitalized COVID-19 Brazilian patients according to SARS-CoV-2 variants
Natália Satchiko Hojo-Souza2orcid , Vander Luis de Souza Freitas1orcid , Daniel Ludovico Guidoni1orcid , Fernanda Hojo de Souza1orcid
Epidemiol Health 2023;e2023079
DOI: https://doi.org/10.4178/epih.e2023079 [Accepted]
Published online: August 28, 2023
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1Federal University of Ouro Preto, Ouro Preto, Brazil
2Laboratory of Immunopathology, René Rachou Institute, Oswaldo Cruz Foundation, Belo Horizonte, Brazil
Corresponding author:  Fernanda Hojo de Souza,
Email: fsumika@ufop.edu.br
Received: 2 March 2023   • Revised: 14 July 2023   • Accepted: 8 August 2023

The aim of this study was to investigate the prevalence of the main symptoms in Brazilian COVID-19 patients hospitalized during 4 distinct waves, based on their infection with different 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 (2020/05/31 to 2020/09/12); W2, Gamma/P.1 variant (2021/01/31 to 2021/05/15); W3, Omicron variant (2021/12/05 to 2022/03/19); and W4, BA.4/BA.5 subvariants (2022/05/22 to 2022/09/03). 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.

Epidemiol Health : Epidemiology and Health