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Zhao S, Lou J, Chong MKC, Cao L, Zheng H, Chen Z, Chan RWY, Zee BCY, Chan PKS, Wang MH. Inferring the Association between the Risk of COVID-19 Case Fatality and N501Y Substitution in SARS-CoV-2. Viruses 2021; 13:638. [PMID: 33918060 PMCID: PMC8070306 DOI: 10.3390/v13040638] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 04/05/2021] [Accepted: 04/06/2021] [Indexed: 02/07/2023] Open
Abstract
As COVID-19 is posing a serious threat to global health, the emerging mutation in SARS-CoV-2 genomes, for example, N501Y substitution, is one of the major challenges against control of the pandemic. Characterizing the relationship between mutation activities and the risk of severe clinical outcomes is of public health importance for informing the healthcare decision-making process. Using a likelihood-based approach, we developed a statistical framework to reconstruct a time-varying and variant-specific case fatality ratio (CFR), and to estimate changes in CFR associated with a single mutation empirically. For illustration, the statistical framework is implemented to the COVID-19 surveillance data in the United Kingdom (UK). The reconstructed instantaneous CFR gradually increased from 1.0% in September to 2.2% in November 2020 and stabilized at this level thereafter, which monitors the mortality risk of COVID-19 on a real-time basis. We identified a link between the SARS-CoV-2 mutation activity at molecular scale and COVID-19 mortality risk at population scale, and found that the 501Y variants may slightly but not significantly increase 18% of fatality risk than the preceding 501N variants. We found no statistically significant evidence of change in COVID-19 mortality risk associated with 501Y variants, and highlighted the real-time estimating potentials of the modelling framework.
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Affiliation(s)
- Shi Zhao
- JC School of Public Health and Primary Care, Chinese University of Hong Kong, Hong Kong, China; (J.L.); (M.K.C.C.); (L.C.); (H.Z.); (B.C.Y.Z.)
- CUHK Shenzhen Research Institute, Shenzhen 518000, China
| | - Jingzhi Lou
- JC School of Public Health and Primary Care, Chinese University of Hong Kong, Hong Kong, China; (J.L.); (M.K.C.C.); (L.C.); (H.Z.); (B.C.Y.Z.)
| | - Marc K. C. Chong
- JC School of Public Health and Primary Care, Chinese University of Hong Kong, Hong Kong, China; (J.L.); (M.K.C.C.); (L.C.); (H.Z.); (B.C.Y.Z.)
- CUHK Shenzhen Research Institute, Shenzhen 518000, China
| | - Lirong Cao
- JC School of Public Health and Primary Care, Chinese University of Hong Kong, Hong Kong, China; (J.L.); (M.K.C.C.); (L.C.); (H.Z.); (B.C.Y.Z.)
- CUHK Shenzhen Research Institute, Shenzhen 518000, China
| | - Hong Zheng
- JC School of Public Health and Primary Care, Chinese University of Hong Kong, Hong Kong, China; (J.L.); (M.K.C.C.); (L.C.); (H.Z.); (B.C.Y.Z.)
| | - Zigui Chen
- Department of Microbiology, Chinese University of Hong Kong, Hong Kong, China; (Z.C.); (P.K.S.C.)
| | - Renee W. Y. Chan
- Department of Pediatrics, Chinese University of Hong Kong, Hong Kong, China;
- Hong Kong Hub of Pediatric Excellence, Chinese University of Hong Kong, Shatin, N.T., Hong Kong, China
- CUHK-UMCU Joint Research Laboratory of Respiratory Virus & Immunobiology, Chinese University of Hong Kong, Shatin, N.T., Hong Kong, China
- Li Ka Shing Institute of Health Sciences, Faculty of Medicine, Chinese University of Hong Kong, Shatin, N.T., Hong Kong, China
| | - Benny C. Y. Zee
- JC School of Public Health and Primary Care, Chinese University of Hong Kong, Hong Kong, China; (J.L.); (M.K.C.C.); (L.C.); (H.Z.); (B.C.Y.Z.)
- CUHK Shenzhen Research Institute, Shenzhen 518000, China
| | - Paul K. S. Chan
- Department of Microbiology, Chinese University of Hong Kong, Hong Kong, China; (Z.C.); (P.K.S.C.)
| | - Maggie H. Wang
- JC School of Public Health and Primary Care, Chinese University of Hong Kong, Hong Kong, China; (J.L.); (M.K.C.C.); (L.C.); (H.Z.); (B.C.Y.Z.)
- CUHK Shenzhen Research Institute, Shenzhen 518000, China
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