Hospital admission and emergency care attendance risk for SARS-CoV-2 delta (B.1.617.2) compared with alpha (B.1.1.7) variants of concern: a cohort study

Background: The SARS-CoV-2 delta (B.1.617.2) variant was first detected in England in March, 2021. It has since rapidly become the predominant lineage, owing to high transmissibility. It is suspected that the delta variant is associated with more severe disease than the previously dominant alpha (B.1.1.7) variant. We aimed to characterise the severity of the delta variant compared with the alpha variant by determining the relative risk of hospital attendance outcomes. Methods: This cohort study was done among all patients with COVID-19 in England between March 29 and May 23, 2021, who were identified as being infected with either the alpha or delta SARS-CoV-2 variant through whole-genome sequencing. Individual-level data on these patients were linked to routine health-care datasets on vaccination, emergency care attendance, hospital admission, and mortality (data from Public Health England's Second Generation Surveillance System and COVID-19-associated deaths dataset; the National Immunisation Management System; and NHS Digital Secondary Uses Services and Emergency Care Data Set). The risk for hospital admission and emergency care attendance were compared between patients with sequencing-confirmed delta and alpha variants for the whole cohort and by vaccination status subgroups. Stratified Cox regression was used to adjust for age, sex, ethnicity, deprivation, recent international travel, area of residence, calendar week, and vaccination status. Findings: Individual-level data on 43 338 COVID-19-positive patients (8682 with the delta variant, 34 656 with the alpha variant; median age 31 years [IQR 17–43]) were included in our analysis. 196 (2·3%) patients with the delta variant versus 764 (2·2%) patients with the alpha variant were admitted to hospital within 14 days after the specimen was taken (adjusted hazard ratio [HR] 2·26 [95% CI 1·32–3·89]). 498 (5·7%) patients with the delta variant versus 1448 (4·2%) patients with the alpha variant were admitted to hospital or attended emergency care within 14 days (adjusted HR 1·45 [1·08–1·95]). Most patients were unvaccinated (32 078 [74·0%] across both groups). The HRs for vaccinated patients with the delta variant versus the alpha variant (adjusted HR for hospital admission 1·94 [95% CI 0·47–8·05] and for hospital admission or emergency care attendance 1·58 [0·69–3·61]) were similar to the HRs for unvaccinated patients (2·32 [1·29–4·16] and 1·43 [1·04–1·97]; p=0·82 for both) but the precision for the vaccinated subgroup was low. Interpretation: This large national study found a higher hospital admission or emergency care attendance risk for patients with COVID-19 infected with the delta variant compared with the alpha variant. Results suggest that outbreaks of the delta variant in unvaccinated populations might lead to a greater burden on health-care services than the alpha variant. Funding: Medical Research Council; UK Research and Innovation; Department of Health and Social Care; and National Institute for Health Research

Clínica Gil, Vol. 4, No. 23 - 24. Octubre - Diciembre

Responsabilidad médica; Notas terapéuticas; Paludismo y urticaria; Diatermia y principales indicaciones; Notas

Clínica Gil, Vol. 4, No. 21 - 22. Junio - Agosto

Sífilis pulmonar; Cuadros de la Clínica Gil; Notas terapéuticas; Tratamiento de la tricomonosis intestinal; Asociación médica; Proyecto de la Asociación médica; Notas

Boletín Clínico, Vol. 01, No. 07. Noviembre

Homenaje al Profesor Juan Bautista Londoño. Pag.293-300 * Tétanos y Sepsis. Pag.301-307 * Contribución al estudio de las Parasitosis Colombianas:TRICOFICIAS. Pag.316-326 * Muertes Ilustres - Profesor Santiago Ramon y Cajal. Pag.327 * Dos casos de Litiasis. Pag.328-329 * Obstetricia en clientela. Pag.330-331 * Servicio de Clínica Quirúrgica del Prof. Montoya y Flórez - Hoyos Duque Alfonso - Sarcoma de Mieloplaxia. Pag.332-335 * La Aldea y los Doctores. Pag.336-341Jubileo de un distinguido medico Robledo, Emilio p.297-298 Doctor J. B. Londono Robledo, Emilio p.299-300 Tetano y sepsis (varinillas-descenso) Londoño, Juan Bautista p.301-307 Historia de la clinica tropical Toro Villa, Gabriel p.308-212 Contribucion al estudio de las parasitosis colombianas; notas preliminares sobre algunas fungosis Restrepo Moreno, Alonso ; Jaramillo Arango, Alfonso ; Correa Henao, Alfredo p.316-326 Dos casos de litiasis Bernal Moreno, Jaime p.328-329 Obstetricia en clientela Bernal Nicholls, Alberto p.330-331 Enorme tumor del maxilar inferior (sarcoma de mieloplaxias) Hoyos Duque, Alfonso p.332-335 Una brillante hoja de servicios Byblos p.293-29

Letras y Encajes

Letras y Encajes publica su primer número en 1926, esta revista fue fundada por mujeres de la clase dirigente de Medellín, muchas de ellas socias de la institución cultural Centro Femenino de Estudios (Sofía Ospina de Navarro, Teresa Santamaría de González, Ángela Villa de Toro y Alicia Merizalde de Echavarría) a lo largo del tiempo se consolidó como la revista femenina más importante del país, dirigida a mujeres de la clase alta y media, abordaba temas que giraban alrededor del hogar, la religión, la literatura y la moda de la época. La revista circuló mensualmente hasta 1959. Sus principales redactoras eran mujeres, pero contaba con la colaboración ocasional de algunos hombres y con traducciones de autoras(es) extranjeras(os)