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1. Hospitalisation risk for COVID-19 patients infected with SARS-CoV-2 variant B.1.1.7: cohort analysis

Author

Nyberg, Tommy, Twohig, Katherine A., Harris, Ross J., Seaman, Shaun R., Flannagan, Joe, Allen, Hester, Charlett, Andre, De Angelis, Daniela, Dabrera, Gavin, and Presanis, Anne M.

Subjects
Statistics - Applications, Quantitative Biology - Populations and Evolution
Abstract

Objective: To evaluate the relationship between coronavirus disease 2019 (COVID-19) diagnosis with SARS-CoV-2 variant B.1.1.7 (also known as Variant of Concern 202012/01) and the risk of hospitalisation compared to diagnosis with wildtype SARS-CoV-2 variants. Design: Retrospective cohort, analysed using stratified Cox regression. Setting: Community-based SARS-CoV-2 testing in England, individually linked with hospitalisation data. Participants: 839,278 laboratory-confirmed COVID-19 patients, of whom 36,233 had been hospitalised within 14 days, tested between 23rd November 2020 and 31st January 2021 and analysed at a laboratory with an available TaqPath assay that enables assessment of S-gene target failure (SGTF). SGTF is a proxy test for the B.1.1.7 variant. Patient data were stratified by age, sex, ethnicity, deprivation, region of residence, and date of positive test. Main outcome measures: Hospitalisation between 1 and 14 days after the first positive SARS-CoV-2 test. Results: 27,710 of 592,409 SGTF patients (4.7%) and 8,523 of 246,869 non-SGTF patients (3.5%) had been hospitalised within 1-14 days. The stratum-adjusted hazard ratio (HR) of hospitalisation was 1.52 (95% confidence interval [CI] 1.47 to 1.57) for COVID-19 patients infected with SGTF variants, compared to those infected with non-SGTF variants. The effect was modified by age (P<0.001), with HRs of 0.93-1.21 for SGTF compared to non-SGTF patients below age 20 years, 1.29 in those aged 20-29, and 1.45-1.65 in age groups 30 years or older. Conclusions: The results suggest that the risk of hospitalisation is higher for individuals infected with the B.1.1.7 variant compared to wildtype SARS-CoV-2, likely reflecting a more severe disease. The higher severity may be specific to adults above the age of 30., Comment: 29 pages, 9 figures

Published
2021
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2. Fluoroquinolones and isoniazid-resistant tuberculosis: implications for the 2018 WHO guidance

Author

Stagg, Helen R, Bothamley, Graham H, Davidson, Jennifer A, Kunst, Heinke, Lalor, Maeve K, Lipman, Marc C, Loutet, Miranda G, Lozewicz, Stefan, Mohiyuddin, Tehreem, Abbara, Aula, Alexander, Eliza, Booth, Helen, Creer, Dean D, Harris, Ross J, Kon, Onn Min, Loebinger, Michael R, McHugh, Timothy D, Milburn, Heather J, Palchaudhuri, Paramita, Phillips, Patrick PJ, Schmok, Erik, Taylor, Lucy, Abubakar, Ibrahim, Baker, Lucy V, Barrett, Jessica C, Burgess, Helen, Cosgrove, Catherine, Dunleavy, Anne, Francis, Marie, Gupta, Urmi, Hamid, Shahid, Haselden, Brigitte M, Holden, Emma, Kahr, Vanessa, Lynn, William, Perrin, Felicity M, Rahman, Ananna, and Soobratty, Mohammad R

Subjects
Biomedical and Clinical Sciences, Clinical Sciences, Tuberculosis, Rare Diseases, Antimicrobial Resistance, Clinical Research, Infectious Diseases, Orphan Drug, Infection, Good Health and Well Being, Adolescent, Adult, Aged, Antitubercular Agents, Drug Therapy, Combination, Duration of Therapy, Ethambutol, Female, Fluoroquinolones, Humans, Isoniazid, Levofloxacin, Logistic Models, London, Male, Middle Aged, Practice Guidelines as Topic, Pyrazinamide, Recurrence, Retrospective Studies, Rifampin, Treatment Failure, Tuberculosis, Multidrug-Resistant, World Health Organization, Young Adult, London INH-R TB study group, Medical and Health Sciences, Respiratory System, Cardiovascular medicine and haematology
Abstract

2018 World Health Organization (WHO) guidelines for the treatment of isoniazid (H)-resistant (Hr) tuberculosis recommend a four-drug regimen: rifampicin (R), ethambutol (E), pyrazinamide (Z) and levofloxacin (Lfx), with or without H ([H]RZE-Lfx). This is used once Hr is known, such that patients complete 6 months of Lfx (≥6[H]RZE-6Lfx). This cohort study assessed the impact of fluoroquinolones (Fq) on treatment effectiveness, accounting for Hr mutations and degree of phenotypic resistance. This was a retrospective cohort study of 626 Hr tuberculosis patients notified in London, 2009-2013. Regimens were described and logistic regression undertaken of the association between regimen and negative regimen-specific outcomes (broadly, death due to tuberculosis, treatment failure or disease recurrence). Of 594 individuals with regimen information, 330 (55.6%) were treated with (H)RfZE (Rf=rifamycins) and 211 (35.5%) with (H)RfZE-Fq. The median overall treatment period was 11.9 months and median Z duration 2.1 months. In a univariable logistic regression model comparing (H)RfZE with and without Fqs, there was no difference in the odds of a negative regimen-specific outcome (baseline (H)RfZE, cluster-specific odds ratio 1.05 (95% CI 0.60-1.82), p=0.87; cluster NHS trust). Results varied minimally in a multivariable model. This odds ratio dropped (0.57, 95% CI 0.14-2.28) when Hr genotype was included, but this analysis lacked power (p=0.42). In a high-income setting, we found a 12-month (H)RfZE regimen with a short Z duration to be similarly effective for Hr tuberculosis with or without a Fq. This regimen may result in fewer adverse events than the WHO recommendations.

Published
2019

4. 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

Author

Koshy, Cherian, Ash, Amy, Wise, Emma, Moore, Nathan, Mori, Matilde, Cortes, Nick, Lynch, Jessica, Kidd, Stephen, Fairley, Derek, Curran, Tanya, McKenna, James, Adams, Helen, Fraser, Christophe, Golubchik, Tanya, Bonsall, David, Hassan-Ibrahim, Mohammed, Malone, Cassandra, Cogger, Benjamin, Wantoch, Michelle, Reynolds, Nicola, Warne, Ben, Maksimovic, Joshua, Spellman, Karla, McCluggage, Kathryn, John, Michaela, Beer, Robert, Afifi, Safiah, Morgan, Sian, Marchbank, Angela, Price, Anna, Kitchen, Christine, Gulliver, Huw, Merrick, Ian, Southgate, Joel, Guest, Martyn, Munn, Robert, Workman, Trudy, Connor, Thomas, Fuller, William, Bresner, Catherine, Snell, Luke, Patel, Amita, Charalampous, Themoula, Nebbia, Gaia, Batra, Rahul, Edgeworth, Jonathan, Robson, Samuel, Beckett, Angela, Aanensen, David, Underwood, Anthony, Yeats, Corin, Abudahab, Khalil, Taylor, Ben, Menegazzo, Mirko, Clark, Gemma, Smith, Wendy, Khakh, Manjinder, Fleming, Vicki, Lister, Michelle, Howson-Wells, Hannah, Berry, Louise, Boswell, Tim, Joseph, Amelia, Willingham, Iona, Jones, Carl, Holmes, Christopher, Bird, Paul, Helmer, Thomas, Fallon, Karlie, Tang, Julian, Raviprakash, Veena, Campbell, Sharon, Sheriff, Nicola, Blakey, Victoria, Williams, Lesley-Anne, Loose, Matthew, Holmes, Nadine, Moore, Christopher, Carlile, Matthew, Wright, Victoria, Sang, Fei, Debebe, Johnny, Coll, Francesc, Signell, Adrian, Betancor, Gilberto, Wilson, Harry, Eldirdiri, Sahar, Kenyon, Anita, Davis, Thomas, Pybus, Oliver, du Plessis, Louis, Zarebski, Alex, Raghwani, Jayna, Kraemer, Moritz, Francois, Sarah, Attwood, Stephen, Vasylyeva, Tetyana, Escalera Zamudio, Marina, Gutierrez, Bernardo, Torok, M. Estee, Hamilton, William, Goodfellow, Ian, Hall, Grant, Jahun, Aminu, Chaudhry, Yasmin, Hosmillo, Myra, Pinckert, Malte, Georgana, Iliana, Moses, Samuel, Lowe, Hannah, Bedford, Luke, Moore, Jonathan, Stonehouse, Susanne, Fisher, Chloe, Awan, Ali, BoYes, John, Breuer, Judith, Harris, Kathryn, Brown, Julianne, Shah, Divya, Atkinson, Laura, Lee, Jack, Storey, Nathaniel, Flaviani, Flavia, Alcolea-Medina, Adela, Williams, Rebecca, Vernet, Gabrielle, Chapman, Michael, Levett, Lisa, Heaney, Judith, Chatterton, Wendy, Pusok, Monika, Xu-McCrae, Li, Smith, Darren, Bashton, Matthew, Young, Gregory, Holmes, Alison, Randell, Paul, Cox, Alison, Madona, Pinglawathee, Bolt, Frances, Price, James, Mookerjee, Siddharth, Ragonnet-Cronin, Manon, F. Nascimento, Fabricia, Jorgensen, David, Siveroni, Igor, Johnson, Rob, Boyd, Olivia, Geidelberg, Lily, Volz, Erik, Rowan, Aileen, Taylor, Graham, Smollett, Katherine, Loman, Nicholas, Quick, Joshua, McMurray, Claire, Stockton, Joanne, Nicholls, Sam, Rowe, Will, Poplawski, Radoslaw, McNally, Alan, Martinez Nunez, Rocio, Mason, Jenifer, Robinson, Trevor, O'Toole, Elaine, Watts, Joanne, Breen, Cassie, Cowell, Angela, Sluga, Graciela, Machin, Nicholas, Ahmad, Shazaad, George, Ryan, Halstead, Fenella, Sivaprakasam, Venkat, Hogsden, Wendy, Illingworth, Chris, Jackson, Chris, Thomson, Emma, Shepherd, James, Asamaphan, Patawee, Niebel, Marc, Li, Kathy, Shah, Rajiv, Jesudason, Natasha, Tong, Lily, Broos, Alice, Mair, Daniel, Nichols, Jenna, Carmichael, Stephen, Nomikou, Kyriaki, Aranday-Cortes, Elihu, Johnson, Natasha, Starinskij, Igor, da Silva Filipe, Ana, Robertson, David, Orton, Richard, Hughes, Joseph, Vattipally, Sreenu, Singer, Joshua, Nickbakhsh, Seema, Hale, Antony, Macfarlane-Smith, Louissa, Harper, Katherine, Carden, Holli, Taha, Yusri, Payne, Brendan, Burton-Fanning, Shirelle, Waugh, Sheila, Collins, Jennifer, Eltringham, Gary, Rushton, Steven, O'Brien, Sarah, Bradley, Amanda, Maclean, Alasdair, Mollett, Guy, Blacow, Rachel, Templeton, Kate, McHugh, Martin, Dewar, Rebecca, Wastenge, Elizabeth, Dervisevic, Samir, Stanley, Rachael, Meader, Emma, Coupland, Lindsay, Smith, Louise, Graham, Clive, Barton, Edward, Padgett, Debra, Scott, Garren, Swindells, Emma, Greenaway, Jane, Nelson, Andrew, McCann, Clare, Yew, Wen, Andersson, Monique, Peto, Timothy, Justice, Anita, Eyre, David, Crook, Derrick, Sloan, Tim, Duckworth, Nichola, Walsh, Sarah, Chauhan, Anoop, Glaysher, Sharon, Bicknell, Kelly, Wyllie, Sarah, Elliott, Scott, Lloyd, Allyson, Impey, Robert, Levene, Nick, Monaghan, Lynn, Bradley, Declan, Wyatt, Tim, Allara, Elias, Pearson, Clare, Osman, Husam, Bosworth, Andrew, Robinson, Esther, Muir, Peter, Vipond, Ian, Hopes, Richard, Pymont, Hannah, Hutchings, Stephanie, Curran, Martin, Parmar, Surendra, Lackenby, Angie, Mbisa, Tamyo, Platt, Steven, Miah, Shahjahan, Bibby, David, Manso, Carmen, Hubb, Jonathan, Chand, Meera, Dabrera, Gavin, Ramsay, Mary, Bradshaw, Daniel, Thornton, Alicia, Myers, Richard, Schaefer, Ulf, Groves, Natalie, Gallagher, Eileen, Lee, David, Williams, David, Ellaby, Nicholas, Harrison, Ian, Hartman, Hassan, Manesis, Nikos, Patel, Vineet, Bishop, Chloe, Chalker, Vicki, Ledesma, Juan, Twohig, Katherine, Holden, Matthew, Shaaban, Sharif, Birchley, Alec, Adams, Alexander, Davies, Alisha, Gaskin, Amy, Plimmer, Amy, Gatica-Wilcox, Bree, McKerr, Caoimhe, Moore, Catherine, Williams, Chris, Heyburn, David, De Lacy, Elen, Hilvers, Ember, Downing, Fatima, Shankar, Giri, Jones, Hannah, Asad, Hibo, Coombes, Jason, Watkins, Joanne, Evans, Johnathan, Fina, Laia, Gifford, Laura, Gilbert, Lauren, Graham, Lee, Perry, Malorie, Morgan, Mari, Bull, Matthew, Cronin, Michelle, Pacchiarini, Nicole, Craine, Noel, Jones, Rachel, Howe, Robin, Corden, Sally, Rey, Sara, Kumziene-SummerhaYes, Sara, Taylor, Sarah, Cottrell, Simon, Jones, Sophie, Edwards, Sue, O'Grady, Justin, Page, Andrew, Mather, Alison, Baker, David, Rudder, Steven, Aydin, Alp, Kay, Gemma, Trotter, Alexander, Alikhan, Nabil-Fareed, de Oliveira Martins, Leonardo, Le-Viet, Thanh, Meadows, Lizzie, Casey, Anna, Ratcliffe, Liz, Simpson, David, Molnar, Zoltan, Thompson, Thomas, Acheson, Erwan, Masoli, Jane, Knight, Bridget, Ellard, Sian, Auckland, Cressida, Jones, Christopher, Mahungu, Tabitha, Irish-Tavares, Dianne, Haque, Tanzina, Hart, Jennifer, Witele, Eric, Fenton, Melisa, Dadrah, Ashok, Symmonds, Amanda, Saluja, Tranprit, Bourgeois, Yann, Scarlett, Garry, Loveson, Katie, Goudarzi, Salman, Fearn, Christopher, Cook, Kate, Dent, Hannah, Paul, Hannah, Partridge, David, Raza, Mohammad, Evans, Cariad, Johnson, Kate, Liggett, Steven, Baker, Paul, Bonner, Stephen, Essex, Sarah, Lyons, Ronan, Saeed, Kordo, Mahanama, Adhyana, Samaraweera, Buddhini, Silveira, Siona, Pelosi, Emanuela, Wilson-Davies, Eleri, Williams, Rachel, Kristiansen, Mark, Roy, Sunando, Williams, Charlotte, Cotic, Marius, Bayzid, Nadua, Westhorpe, Adam, Hartley, John, Jannoo, Riaz, Lowe, Helen, Karamani, Angeliki, Ensell, Leah, Prieto, Jacqui, Jeremiah, Sarah, Grammatopoulos, Dimitris, Pandey, Sarojini, Berry, Lisa, Jones, Katie, Richter, Alex, Beggs, Andrew, Best, Angus, Percival, Benita, Mirza, Jeremy, Megram, Oliver, Mayhew, Megan, Crawford, Liam, Ashcroft, Fiona, Moles-Garcia, Emma, Cumley, Nicola, Smith, Colin, Bucca, Giselda, Hesketh, Andrew, Blane, Beth, Girgis, Sophia, Leek, Danielle, Sridhar, Sushmita, Forrest, Sally, Cormie, Claire, Gill, Harmeet, Dias, Joana, Higginson, Ellen, Maes, Mailis, Young, Jamie, Kermack, Leanne, Gupta, Ravi, Ludden, Catherine, Peacock, Sharon, Palmer, Sophie, Churcher, Carol, Hadjirin, Nazreen, Carabelli, Alessandro, Brooks, Ellena, Smith, Kim, Galai, Katerina, McManus, Georgina, Ruis, Chris, Davidson, Rose, Rambaut, Andrew, Williams, Thomas, Balcazar, Carlos, Gallagher, Michael, O'Toole, Áine, Rooke, Stefan, Hill, Verity, Williamson, Kathleen, Stanton, Thomas, Michell, Stephen, Bewshea, Claire, Temperton, Ben, Michelsen, Michelle, Warwick-Dugdale, Joanna, Manley, Robin, Farbos, Audrey, Harrison, James, Sambles, Christine, Studholme, David, Jeffries, Aaron, Jackson, Leigh, Darby, Alistair, Hiscox, Julian, Paterson, Steve, Iturriza-Gomara, Miren, Jackson, Kathryn, Lucaci, Anita, Vamos, Edith, Hughes, Margaret, Rainbow, Lucille, Eccles, Richard, Nelson, Charlotte, Whitehead, Mark, Turtle, Lance, Haldenby, Sam, Gregory, Richard, Gemmell, Matthew, Wierzbicki, Claudia, Webster, Hermione, de Silva, Thushan, Smith, Nikki, Angyal, Adrienn, Lindsey, Benjamin, Groves, Danielle, Green, Luke, Wang, Dennis, Freeman, Timothy, Parker, Matthew, Keeley, Alexander, Parsons, Paul, Tucker, Rachel, Brown, Rebecca, Wyles, Matthew, Whiteley, Max, Zhang, Peijun, Gallis, Marta, Louka, Stavroula, Constantinidou, Chrystala, Unnikrishnan, Meera, Ott, Sascha, Cheng, Jeffrey, Bridgewater, Hannah, Frost, Lucy, Taylor-Joyce, Grace, Stark, Richard, Baxter, Laura, Alam, Mohammad, Brown, Paul, Aggarwal, Dinesh, Cerda, Alberto, Merrill, Tammy, Wilson, Rebekah, McClure, Patrick, Chappell, Joseph, Tsoleridis, Theocharis, Ball, Jonathan, Buck, David, Todd, John, Green, Angie, Trebes, Amy, MacIntyre-Cockett, George, de Cesare, Mariateresa, Alderton, Alex, Amato, Roberto, Ariani, Cristina, Beale, Mathew, Beaver, Charlotte, Bellis, Katherine, Betteridge, Emma, Bonfield, James, Danesh, John, Dorman, Matthew, Drury, Eleanor, Farr, Ben, Foulser, Luke, Goncalves, Sonia, Goodwin, Scott, Gourtovaia, Marina, Harrison, Ewan, Jackson, David, Jamrozy, Dorota, Johnston, Ian, Kane, Leanne, Kay, Sally, Keatley, Jon-Paul, Kwiatkowski, Dominic, Langford, Cordelia, Lawniczak, Mara, Letchford, Laura, Livett, Rich, Lo, Stephanie, Martincorena, Inigo, McGuigan, Samantha, Nelson, Rachel, Palmer, Steve, Park, Naomi, Patel, Minal, Prestwood, Liam, Puethe, Christoph, Quail, Michael, Rajatileka, Shavanthi, Scott, Carol, Shirley, Lesley, Sillitoe, John, Spencer Chapman, Michael, Thurston, Scott, Tonkin-Hill, Gerry, Weldon, Danni, Rajan, Diana, Bronner, Iraad, Aigrain, Louise, Redshaw, Nicholas, Lensing, Stefanie, Davies, Robert, Whitwham, Andrew, Liddle, Jennifier, Lewis, Kevin, Tovar-Corona, Jaime, Leonard, Steven, Durham, Jillian, Bassett, Andrew, McCarthy, Shane, Moll, Robin, James, Keith, Oliver, Karen, Makunin, Alex, Barrett, Jeff, Gunson, Rory, Twohig, Katherine A, Nyberg, Tommy, Zaidi, Asad, Thelwall, Simon, Sinnathamby, Mary A, Aliabadi, Shirin, Seaman, Shaun R, Harris, Ross J, Hope, Russell, Lopez-Bernal, Jamie, Charlett, Andre, De Angelis, Daniela, and Presanis, Anne M

Published
2022
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6. Serological surveillance of SARS-CoV-2: Six-month trends and antibody response in a cohort of public health workers

Author

Harris, Ross J., Whitaker, Heather J., Andrews, Nick J., Aiano, Felicity, Amin-Chowdhury, Zahin, Flood, Jessica, Borrow, Ray, Linley, Ezra, Ahmad, Shazaad, Stapley, Lorraine, Hallis, Bassam, Amirthalingam, Gayatri, Höschler, Katja, Parker, Ben, Horsley, Alex, Brooks, Timothy J.G., Brown, Kevin E., Ramsay, Mary E., and Ladhani, Shamez N.

Published
2021
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7. Persistence of SARS-CoV-2 N-Antibody Response in Healthcare Workers, London, UK

Author

Shrotri, Madhumita, Harris, Ross J., Rodger, Alison, Planche, Timothy, Sanderson, Frances, Mahungu, Tabitha, McGregor, Alastair, Heath, Paul T., Brown, Colin S., Dunning, Jake, Hopkins, Susan, Ladhani, Shamez, and Chand, Meera

Subjects
Health
Abstract

The durability of antibody responses to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus responsible for coronavirus disease (COVID-19), is of scientific and strategic interest for public health systems [...]

Published
2021
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9. Epidemiology of HIV infection and associated behaviours among people who inject drugs in England, Wales, and Northern Ireland: Nearly 40 years on

Author

Croxford, Sara, primary, Emanuel, Eva, additional, Shah, Ammi, additional, Chau, Cuong, additional, Hope, Vivian, additional, Desai, Monica, additional, Ijaz, Samreen, additional, Shute, Justin, additional, Edmundson, Claire, additional, Harris, Ross J., additional, Delpech, Valerie, additional, and Phipps, Emily, additional

Published
2022
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11. 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

Author

Twohig, Katherine A, Nyberg, Tommy, Zaidi, Asad, Thelwall, Simon, Sinnathamby, Mary A, Aliabadi, Shirin, Seaman, Shaun R, Harris, Ross J, Hope, Russell, Lopez-Bernal, Jamie, Gallagher, Eileen, Charlett, Andre, De Angelis, Daniela, Presanis, Anne M, Dabrera, Gavin, COVID-19 Genomics UK (COG-UK) Consortium, Nyberg, Tommy [0000-0002-9436-0626], Seaman, Shaun [0000-0003-3726-5937], De Angelis, Daniela [0000-0001-6619-6112], Presanis, Anne [0000-0003-3078-4427], and Apollo - University of Cambridge Repository

Subjects
Adult, Aged, 80 and over, Male, Emergency Medical Services, Adolescent, SARS-CoV-2, COVID-19, Middle Aged, Severity of Illness Index, Cohort Studies, Hospitalization, Young Adult, England, Child, Preschool, Humans, Female, Child, Aged, Proportional Hazards Models
Abstract

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.

Published
2022

12. 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

Author

Twohig, Katherine A, primary, Nyberg, Tommy, additional, Zaidi, Asad, additional, Thelwall, Simon, additional, Sinnathamby, Mary A, additional, Aliabadi, Shirin, additional, Seaman, Shaun R, additional, Harris, Ross J, additional, Hope, Russell, additional, Lopez-Bernal, Jamie, additional, Gallagher, Eileen, additional, Charlett, Andre, additional, De Angelis, Daniela, additional, Presanis, Anne M, additional, Dabrera, Gavin, additional, Koshy, Cherian, additional, Ash, Amy, additional, Wise, Emma, additional, Moore, Nathan, additional, Mori, Matilde, additional, Cortes, Nick, additional, Lynch, Jessica, additional, Kidd, Stephen, additional, Fairley, Derek, additional, Curran, Tanya, additional, McKenna, James, additional, Adams, Helen, additional, Fraser, Christophe, additional, Golubchik, Tanya, additional, Bonsall, David, additional, Hassan-Ibrahim, Mohammed, additional, Malone, Cassandra, additional, Cogger, Benjamin, additional, Wantoch, Michelle, additional, Reynolds, Nicola, additional, Warne, Ben, additional, Maksimovic, Joshua, additional, Spellman, Karla, additional, McCluggage, Kathryn, additional, John, Michaela, additional, Beer, Robert, additional, Afifi, Safiah, additional, Morgan, Sian, additional, Marchbank, Angela, additional, Price, Anna, additional, Kitchen, Christine, additional, Gulliver, Huw, additional, Merrick, Ian, additional, Southgate, Joel, additional, Guest, Martyn, additional, Munn, Robert, additional, Workman, Trudy, additional, Connor, Thomas, additional, Fuller, William, additional, Bresner, Catherine, additional, Snell, Luke, additional, Patel, Amita, additional, Charalampous, Themoula, additional, Nebbia, Gaia, additional, Batra, Rahul, additional, Edgeworth, Jonathan, additional, Robson, Samuel, additional, Beckett, Angela, additional, Aanensen, David, additional, Underwood, Anthony, additional, Yeats, Corin, additional, Abudahab, Khalil, additional, Taylor, Ben, additional, Menegazzo, Mirko, additional, Clark, Gemma, additional, Smith, Wendy, additional, Khakh, Manjinder, additional, Fleming, Vicki, additional, Lister, Michelle, additional, Howson-Wells, Hannah, additional, Berry, Louise, additional, Boswell, Tim, additional, Joseph, Amelia, additional, Willingham, Iona, additional, Jones, Carl, additional, Holmes, Christopher, additional, Bird, Paul, additional, Helmer, Thomas, additional, Fallon, Karlie, additional, Tang, Julian, additional, Raviprakash, Veena, additional, Campbell, Sharon, additional, Sheriff, Nicola, additional, Blakey, Victoria, additional, Williams, Lesley-Anne, additional, Loose, Matthew, additional, Holmes, Nadine, additional, Moore, Christopher, additional, Carlile, Matthew, additional, Wright, Victoria, additional, Sang, Fei, additional, Debebe, Johnny, additional, Coll, Francesc, additional, Signell, Adrian, additional, Betancor, Gilberto, additional, Wilson, Harry, additional, Eldirdiri, Sahar, additional, Kenyon, Anita, additional, Davis, Thomas, additional, Pybus, Oliver, additional, du Plessis, Louis, additional, Zarebski, Alex, additional, Raghwani, Jayna, additional, Kraemer, Moritz, additional, Francois, Sarah, additional, Attwood, Stephen, additional, Vasylyeva, Tetyana, additional, Escalera Zamudio, Marina, additional, Gutierrez, Bernardo, additional, Torok, M. Estee, additional, Hamilton, William, additional, Goodfellow, Ian, additional, Hall, Grant, additional, Jahun, Aminu, additional, Chaudhry, Yasmin, additional, Hosmillo, Myra, additional, Pinckert, Malte, additional, Georgana, Iliana, additional, Moses, Samuel, additional, Lowe, Hannah, additional, Bedford, Luke, additional, Moore, Jonathan, additional, Stonehouse, Susanne, additional, Fisher, Chloe, additional, Awan, Ali, additional, BoYes, John, additional, Breuer, Judith, additional, Harris, Kathryn, additional, Brown, Julianne, additional, Shah, Divya, additional, Atkinson, Laura, additional, Lee, Jack, additional, Storey, Nathaniel, additional, Flaviani, Flavia, additional, Alcolea-Medina, Adela, additional, Williams, Rebecca, additional, Vernet, Gabrielle, additional, Chapman, Michael, additional, Levett, Lisa, additional, Heaney, Judith, additional, Chatterton, Wendy, additional, Pusok, Monika, additional, Xu-McCrae, Li, additional, Smith, Darren, additional, Bashton, Matthew, additional, Young, Gregory, additional, Holmes, Alison, additional, Randell, Paul, additional, Cox, Alison, additional, Madona, Pinglawathee, additional, Bolt, Frances, additional, Price, James, additional, Mookerjee, Siddharth, additional, Ragonnet-Cronin, Manon, additional, F. Nascimento, Fabricia, additional, Jorgensen, David, additional, Siveroni, Igor, additional, Johnson, Rob, additional, Boyd, Olivia, additional, Geidelberg, Lily, additional, Volz, Erik, additional, Rowan, Aileen, additional, Taylor, Graham, additional, Smollett, Katherine, additional, Loman, Nicholas, additional, Quick, Joshua, additional, McMurray, Claire, additional, Stockton, Joanne, additional, Nicholls, Sam, additional, Rowe, Will, additional, Poplawski, Radoslaw, additional, McNally, Alan, additional, Martinez Nunez, Rocio, additional, Mason, Jenifer, additional, Robinson, Trevor, additional, O'Toole, Elaine, additional, Watts, Joanne, additional, Breen, Cassie, additional, Cowell, Angela, additional, Sluga, Graciela, additional, Machin, Nicholas, additional, Ahmad, Shazaad, additional, George, Ryan, additional, Halstead, Fenella, additional, Sivaprakasam, Venkat, additional, Hogsden, Wendy, additional, Illingworth, Chris, additional, Jackson, Chris, additional, Thomson, Emma, additional, Shepherd, James, additional, Asamaphan, Patawee, additional, Niebel, Marc, additional, Li, Kathy, additional, Shah, Rajiv, additional, Jesudason, Natasha, additional, Tong, Lily, additional, Broos, Alice, additional, Mair, Daniel, additional, Nichols, Jenna, additional, Carmichael, Stephen, additional, Nomikou, Kyriaki, additional, Aranday-Cortes, Elihu, additional, Johnson, Natasha, additional, Starinskij, Igor, additional, da Silva Filipe, Ana, additional, Robertson, David, additional, Orton, Richard, additional, Hughes, Joseph, additional, Vattipally, Sreenu, additional, Singer, Joshua, additional, Nickbakhsh, Seema, additional, Hale, Antony, additional, Macfarlane-Smith, Louissa, additional, Harper, Katherine, additional, Carden, Holli, additional, Taha, Yusri, additional, Payne, Brendan, additional, Burton-Fanning, Shirelle, additional, Waugh, Sheila, additional, Collins, Jennifer, additional, Eltringham, Gary, additional, Rushton, Steven, additional, O'Brien, Sarah, additional, Bradley, Amanda, additional, Maclean, Alasdair, additional, Mollett, Guy, additional, Blacow, Rachel, additional, Templeton, Kate, additional, McHugh, Martin, additional, Dewar, Rebecca, additional, Wastenge, Elizabeth, additional, Dervisevic, Samir, additional, Stanley, Rachael, additional, Meader, Emma, additional, Coupland, Lindsay, additional, Smith, Louise, additional, Graham, Clive, additional, Barton, Edward, additional, Padgett, Debra, additional, Scott, Garren, additional, Swindells, Emma, additional, Greenaway, Jane, additional, Nelson, Andrew, additional, McCann, Clare, additional, Yew, Wen, additional, Andersson, Monique, additional, Peto, Timothy, additional, Justice, Anita, additional, Eyre, David, additional, Crook, Derrick, additional, Sloan, Tim, additional, Duckworth, Nichola, additional, Walsh, Sarah, additional, Chauhan, Anoop, additional, Glaysher, Sharon, additional, Bicknell, Kelly, additional, Wyllie, Sarah, additional, Elliott, Scott, additional, Lloyd, Allyson, additional, Impey, Robert, additional, Levene, Nick, additional, Monaghan, Lynn, additional, Bradley, Declan, additional, Wyatt, Tim, additional, Allara, Elias, additional, Pearson, Clare, additional, Osman, Husam, additional, Bosworth, Andrew, additional, Robinson, Esther, additional, Muir, Peter, additional, Vipond, Ian, additional, Hopes, Richard, additional, Pymont, Hannah, additional, Hutchings, Stephanie, additional, Curran, Martin, additional, Parmar, Surendra, additional, Lackenby, Angie, additional, Mbisa, Tamyo, additional, Platt, Steven, additional, Miah, Shahjahan, additional, Bibby, David, additional, Manso, Carmen, additional, Hubb, Jonathan, additional, Chand, Meera, additional, Ramsay, Mary, additional, Bradshaw, Daniel, additional, Thornton, Alicia, additional, Myers, Richard, additional, Schaefer, Ulf, additional, Groves, Natalie, additional, Lee, David, additional, Williams, David, additional, Ellaby, Nicholas, additional, Harrison, Ian, additional, Hartman, Hassan, additional, Manesis, Nikos, additional, Patel, Vineet, additional, Bishop, Chloe, additional, Chalker, Vicki, additional, Ledesma, Juan, additional, Twohig, Katherine, additional, Holden, Matthew, additional, Shaaban, Sharif, additional, Birchley, Alec, additional, Adams, Alexander, additional, Davies, Alisha, additional, Gaskin, Amy, additional, Plimmer, Amy, additional, Gatica-Wilcox, Bree, additional, McKerr, Caoimhe, additional, Moore, Catherine, additional, Williams, Chris, additional, Heyburn, David, additional, De Lacy, Elen, additional, Hilvers, Ember, additional, Downing, Fatima, additional, Shankar, Giri, additional, Jones, Hannah, additional, Asad, Hibo, additional, Coombes, Jason, additional, Watkins, Joanne, additional, Evans, Johnathan, additional, Fina, Laia, additional, Gifford, Laura, additional, Gilbert, Lauren, additional, Graham, Lee, additional, Perry, Malorie, additional, Morgan, Mari, additional, Bull, Matthew, additional, Cronin, Michelle, additional, Pacchiarini, Nicole, additional, Craine, Noel, additional, Jones, Rachel, additional, Howe, Robin, additional, Corden, Sally, additional, Rey, Sara, additional, Kumziene-SummerhaYes, Sara, additional, Taylor, Sarah, additional, Cottrell, Simon, additional, Jones, Sophie, additional, Edwards, Sue, additional, O'Grady, Justin, additional, Page, Andrew, additional, Mather, Alison, additional, Baker, David, additional, Rudder, Steven, additional, Aydin, Alp, additional, Kay, Gemma, additional, Trotter, Alexander, additional, Alikhan, Nabil-Fareed, additional, de Oliveira Martins, Leonardo, additional, Le-Viet, Thanh, additional, Meadows, Lizzie, additional, Casey, Anna, additional, Ratcliffe, Liz, additional, Simpson, David, additional, Molnar, Zoltan, additional, Thompson, Thomas, additional, Acheson, Erwan, additional, Masoli, Jane, additional, Knight, Bridget, additional, Ellard, Sian, additional, Auckland, Cressida, additional, Jones, Christopher, additional, Mahungu, Tabitha, additional, Irish-Tavares, Dianne, additional, Haque, Tanzina, additional, Hart, Jennifer, additional, Witele, Eric, additional, Fenton, Melisa, additional, Dadrah, Ashok, additional, Symmonds, Amanda, additional, Saluja, Tranprit, additional, Bourgeois, Yann, additional, Scarlett, Garry, additional, Loveson, Katie, additional, Goudarzi, Salman, additional, Fearn, Christopher, additional, Cook, Kate, additional, Dent, Hannah, additional, Paul, Hannah, additional, Partridge, David, additional, Raza, Mohammad, additional, Evans, Cariad, additional, Johnson, Kate, additional, Liggett, Steven, additional, Baker, Paul, additional, Bonner, Stephen, additional, Essex, Sarah, additional, Lyons, Ronan, additional, Saeed, Kordo, additional, Mahanama, Adhyana, additional, Samaraweera, Buddhini, additional, Silveira, Siona, additional, Pelosi, Emanuela, additional, Wilson-Davies, Eleri, additional, Williams, Rachel, additional, Kristiansen, Mark, additional, Roy, Sunando, additional, Williams, Charlotte, additional, Cotic, Marius, additional, Bayzid, Nadua, additional, Westhorpe, Adam, additional, Hartley, John, additional, Jannoo, Riaz, additional, Lowe, Helen, additional, Karamani, Angeliki, additional, Ensell, Leah, additional, Prieto, Jacqui, additional, Jeremiah, Sarah, additional, Grammatopoulos, Dimitris, additional, Pandey, Sarojini, additional, Berry, Lisa, additional, Jones, Katie, additional, Richter, Alex, additional, Beggs, Andrew, additional, Best, Angus, additional, Percival, Benita, additional, Mirza, Jeremy, additional, Megram, Oliver, additional, Mayhew, Megan, additional, Crawford, Liam, additional, Ashcroft, Fiona, additional, Moles-Garcia, Emma, additional, Cumley, Nicola, additional, Smith, Colin, additional, Bucca, Giselda, additional, Hesketh, Andrew, additional, Blane, Beth, additional, Girgis, Sophia, additional, Leek, Danielle, additional, Sridhar, Sushmita, additional, Forrest, Sally, additional, Cormie, Claire, additional, Gill, Harmeet, additional, Dias, Joana, additional, Higginson, Ellen, additional, Maes, Mailis, additional, Young, Jamie, additional, Kermack, Leanne, additional, Gupta, Ravi, additional, Ludden, Catherine, additional, Peacock, Sharon, additional, Palmer, Sophie, additional, Churcher, Carol, additional, Hadjirin, Nazreen, additional, Carabelli, Alessandro, additional, Brooks, Ellena, additional, Smith, Kim, additional, Galai, Katerina, additional, McManus, Georgina, additional, Ruis, Chris, additional, Davidson, Rose, additional, Rambaut, Andrew, additional, Williams, Thomas, additional, Balcazar, Carlos, additional, Gallagher, Michael, additional, O'Toole, Áine, additional, Rooke, Stefan, additional, Hill, Verity, additional, Williamson, Kathleen, additional, Stanton, Thomas, additional, Michell, Stephen, additional, Bewshea, Claire, additional, Temperton, Ben, additional, Michelsen, Michelle, additional, Warwick-Dugdale, Joanna, additional, Manley, Robin, additional, Farbos, Audrey, additional, Harrison, James, additional, Sambles, Christine, additional, Studholme, David, additional, Jeffries, Aaron, additional, Jackson, Leigh, additional, Darby, Alistair, additional, Hiscox, Julian, additional, Paterson, Steve, additional, Iturriza-Gomara, Miren, additional, Jackson, Kathryn, additional, Lucaci, Anita, additional, Vamos, Edith, additional, Hughes, Margaret, additional, Rainbow, Lucille, additional, Eccles, Richard, additional, Nelson, Charlotte, additional, Whitehead, Mark, additional, Turtle, Lance, additional, Haldenby, Sam, additional, Gregory, Richard, additional, Gemmell, Matthew, additional, Wierzbicki, Claudia, additional, Webster, Hermione, additional, de Silva, Thushan, additional, Smith, Nikki, additional, Angyal, Adrienn, additional, Lindsey, Benjamin, additional, Groves, Danielle, additional, Green, Luke, additional, Wang, Dennis, additional, Freeman, Timothy, additional, Parker, Matthew, additional, Keeley, Alexander, additional, Parsons, Paul, additional, Tucker, Rachel, additional, Brown, Rebecca, additional, Wyles, Matthew, additional, Whiteley, Max, additional, Zhang, Peijun, additional, Gallis, Marta, additional, Louka, Stavroula, additional, Constantinidou, Chrystala, additional, Unnikrishnan, Meera, additional, Ott, Sascha, additional, Cheng, Jeffrey, additional, Bridgewater, Hannah, additional, Frost, Lucy, additional, Taylor-Joyce, Grace, additional, Stark, Richard, additional, Baxter, Laura, additional, Alam, Mohammad, additional, Brown, Paul, additional, Aggarwal, Dinesh, additional, Cerda, Alberto, additional, Merrill, Tammy, additional, Wilson, Rebekah, additional, McClure, Patrick, additional, Chappell, Joseph, additional, Tsoleridis, Theocharis, additional, Ball, Jonathan, additional, Buck, David, additional, Todd, John, additional, Green, Angie, additional, Trebes, Amy, additional, MacIntyre-Cockett, George, additional, de Cesare, Mariateresa, additional, Alderton, Alex, additional, Amato, Roberto, additional, Ariani, Cristina, additional, Beale, Mathew, additional, Beaver, Charlotte, additional, Bellis, Katherine, additional, Betteridge, Emma, additional, Bonfield, James, additional, Danesh, John, additional, Dorman, Matthew, additional, Drury, Eleanor, additional, Farr, Ben, additional, Foulser, Luke, additional, Goncalves, Sonia, additional, Goodwin, Scott, additional, Gourtovaia, Marina, additional, Harrison, Ewan, additional, Jackson, David, additional, Jamrozy, Dorota, additional, Johnston, Ian, additional, Kane, Leanne, additional, Kay, Sally, additional, Keatley, Jon-Paul, additional, Kwiatkowski, Dominic, additional, Langford, Cordelia, additional, Lawniczak, Mara, additional, Letchford, Laura, additional, Livett, Rich, additional, Lo, Stephanie, additional, Martincorena, Inigo, additional, McGuigan, Samantha, additional, Nelson, Rachel, additional, Palmer, Steve, additional, Park, Naomi, additional, Patel, Minal, additional, Prestwood, Liam, additional, Puethe, Christoph, additional, Quail, Michael, additional, Rajatileka, Shavanthi, additional, Scott, Carol, additional, Shirley, Lesley, additional, Sillitoe, John, additional, Spencer Chapman, Michael, additional, Thurston, Scott, additional, Tonkin-Hill, Gerry, additional, Weldon, Danni, additional, Rajan, Diana, additional, Bronner, Iraad, additional, Aigrain, Louise, additional, Redshaw, Nicholas, additional, Lensing, Stefanie, additional, Davies, Robert, additional, Whitwham, Andrew, additional, Liddle, Jennifier, additional, Lewis, Kevin, additional, Tovar-Corona, Jaime, additional, Leonard, Steven, additional, Durham, Jillian, additional, Bassett, Andrew, additional, McCarthy, Shane, additional, Moll, Robin, additional, James, Keith, additional, Oliver, Karen, additional, Makunin, Alex, additional, Barrett, Jeff, additional, and Gunson, Rory, additional

Published
2022
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13. 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

Author

Twohig, Katherine A, Nyberg, Tommy, Zaidi, Asad, Thelwall, Simon, Sinnathamby, Mary A, Aliabadi, Shirin, Seaman, Shaun R, Harris, Ross J, Hope, Russell, Lopez-Bernal, Jamie, Gallagher, Eileen, Charlett, Andre, De Angelis, Daniela, Presanis, Anne M, Dabrera, Gavin, and COVID-19 Genomics UK (COG-UK) consortium

Abstract

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.

Published
2021

20. Characterising post-COVID syndrome more than 6 months after acute infection in adults; prospective longitudinal cohort study, England

Author

Amin-Chowdhury, Zahin, primary, Harris, Ross J, additional, Aiano, Felicity, additional, Zavala, Maria, additional, Bertran, Marta, additional, Borrow, Ray, additional, Linley, Ezra, additional, Ahmad, Shazaad, additional, Parker, Ben, additional, Horsley, Alex, additional, Hallis, Bassam, additional, Flood, Jessica, additional, Brown, Kevin E, additional, Amirthalingam, Gayatri, additional, Ramsay, Mary E, additional, Andrews, Nick, additional, and Ladhani, Shamez N, additional

Published
2021
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21. Completeness of tuberculosis (TB) notification: inventory studies and capture-recapture analyses, six European Union countries, 2014 to 2016

Author

Straetemans, Masja, Bakker, Mirjam I, Alba, Sandra, Mergenthaler, Christina, Rood, Ente, Andersen, Peter H, Schimmel, Henrieke, Simunovic, Aleksandar, Svetina, Petra, Carvalho, Carlos, Lyytikäinen, Outi, Abubakar, Ibrahim, Harris, Ross J, Ködmön, Csaba, van der Werf, Marieke J, and van Hest, Rob

Subjects
Portugal, tuberculosis, Croatia, statistics, Denmark, Slovenia, surveillance, epidemiology, Finland, Netherlands
Published
2020

24. Serological surveillance of SARS-CoV-2: Six-month trends and antibody response in a cohort of public health workers

Author

Harris, Ross J, primary, Whitaker, Heather J, additional, Andrews, Nick J, additional, Aiano, Felicity, additional, Amin-Chowdhury, Zahin, additional, Flood, Jessica, additional, Borrow, Ray, additional, Linley, Ezra, additional, Ahmad, Shazaad, additional, Stapley, Lorraine, additional, Hallis, Bassam, additional, Amirthalingam, Gayatri, additional, Höschler, Katja, additional, Parker, Ben, additional, Horsley, Alex, additional, Brooks, Timothy J G, additional, Brown, Kevin E, additional, Ramsay, Mary E, additional, and Ladhani, Shamez N, additional

Published
2020
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26. Completeness of tuberculosis (TB) notification: inventory studies and capture-recapture analyses, six European Union countries, 2014 to 2016

Author

Straetemans, Masja, primary, Bakker, Mirjam I, additional, Alba, Sandra, additional, Mergenthaler, Christina, additional, Rood, Ente, additional, Andersen, Peter H, additional, Schimmel, Henrieke, additional, Simunovic, Aleksandar, additional, Svetina, Petra, additional, Carvalho, Carlos, additional, Lyytikäinen, Outi, additional, Abubakar, Ibrahim, additional, Harris, Ross J, additional, Ködmön, Csaba, additional, van der Werf, Marieke J, additional, and van Hest, Rob, additional

Published
2020
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28. The cost-effectiveness of one-time birth cohort screening for hepatitis C as part of the NHS health check programme in England

Author

Williams, Jack, Miners, Alec, Harris, Ross J, Mendal, Sema, Simmons, Ruth, Ireland, Georgina, Hickman, Matthew, Gore, Charles, and Vickerman, Peter

Subjects
National Health Programs, Cost-Benefit Analysis, Mass Screening, Hepatitis C, health care economics and organizations, Health services, Bristol Population Health Science Institute
Abstract

ObjectivesWe aim to evaluate the cost-effectiveness of one-time HCV screening for individuals born between 1950 and 1979 as part of the NHS health check in England, a health check for adults aged 40-74 years old in primary care.MethodsA Markov model was developed to analyse add-on HCV testing to the NHS health check for individuals in birth cohorts between 1950 and 1979, versus current background HCV testing only, over a lifetime time horizon. The model used data from a back-calculation model of the burden of HCV in England, sentinel surveillance of HCV testing, and published literature. Results are presented from a health service perspective in pounds (GBP) in 2017, as incremental cost-effectiveness ratios (ICERs) per quality adjusted life years (QALY) gained.ResultsBase case ICERs ranged from £7,648 to £24,434, and £18,681 to £46,024, across birth cohorts when considering two sources of HCV transition probabilities. The intervention ismost likely to be cost-effective for those born in the 1970’s, and potentially cost-effective for those born from 1955-1969. The model results were most sensitive to the source of HCV transition probabilities, the probability of referral and receiving treatment, and the HCV prevalence amongst testers. The maximum value of future research across all birth cohorts was £11.3 million at £20,000 per QALY gained.ConclusionsBirth cohort screening is likely to be cost-effective for younger birth cohorts, although considerable uncertainty exists for other birth cohorts. Further studies are warranted to reduce uncertainty in cost-effectiveness and consider the acceptability of the intervention.

Published
2019

29. Recapture or precapture? Fallibility of standard capture-recapture methods in the presence of referrals between sources

Author

Jones, Hayley E, Hickman, Matthew, Welton, Nicky J, De Angelis, Daniela, Harris, Ross J, Ades, AE, De Angelis, Daniela [0000-0001-6619-6112], and Apollo - University of Cambridge Repository

Subjects
Population Density, model selection, bias, Models, Statistical, Substance-Related Disorders, Data Collection, prevalence estimation, England, Data Interpretation, Statistical, Epidemiologic Research Design, log-linear models, Linear Models, Humans, problem drug use, parameter identifiability, Referral and Consultation
Abstract

Capture-recapture methods, largely developed in ecology, are now commonly used in epidemiology to adjust for incomplete registries and to estimate the size of difficult-to-reach populations such as problem drug users. Overlapping lists of individuals in the target population, taken from administrative data sources, are considered analogous to overlapping "captures" of animals. Log-linear models, incorporating interaction terms to account for dependencies between sources, are used to predict the number of unobserved individuals and, hence, the total population size. A standard assumption to ensure parameter identifiability is that the highest-order interaction term is 0. We demonstrate that, when individuals are referred directly between sources, this assumption will often be violated, and the standard modeling approach may lead to seriously biased estimates. We refer to such individuals as having been "precaptured," rather than truly recaptured. Although sometimes an alternative identifiable log-linear model could accommodate the referral structure, this will not always be the case. Further, multiple plausible models may fit the data equally well but provide widely varying estimates of the population size. We demonstrate an alternative modeling approach, based on an interpretable parameterization and driven by careful consideration of the relationships between the sources, and we make recommendations for capture-recapture in practice.

Published
2018
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34. A comparison of two biological markers of recent hepatitis C virus (HCV) infection: implications for the monitoring of interventions and strategies to reduce HCV transmission among people who inject drugs

Author

Hope, Vivian D, primary, Harris, Ross J, additional, Vickerman, Peter, additional, Platt, Lucy, additional, Shute, Justin, additional, Cullen, Katelyn J, additional, Ijaz, Samreen, additional, Mandal, Sema, additional, Ncube, Fortune, additional, Desai, Monica, additional, and Parry, John V, additional

Published
2018
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37. Enhanced surveillance of HIV-1 drug resistance in recently infected MSM in the UK

Author

Cunningham, Emma, primary, Chan, Yuen-Ting, additional, Aghaizu, Adamma, additional, Bibby, David F., additional, Murphy, Gary, additional, Tosswill, Jennifer, additional, Harris, Ross J., additional, Myers, Richard, additional, Field, Nigel, additional, Delpech, Valerie, additional, Cane, Patricia A., additional, Gill, O. Noel, additional, and Mbisa, Jean L., additional

Published
2016
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38. In reply

Author

Stagg, Helen R., primary, Harris, Ross J., additional, and Lipman, Marc C., additional

Published
2016
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41. Updated tests for small-study effects in meta-analyses

Author

Harbord, Roger M., Harris, Ross J., and Sterne, Jonathan A.C.

Subjects
meta-analysis, publication bias, small-study effects, funnel plots, metabias, Research Methods/ Statistical Methods
Abstract

This article describes an updated version of the metabias command, which provides statistical tests for funnel plot asymmetry. In addition to the previously implemented tests, metabias implements two new tests that are recommended in the recently updated Cochrane Handbook for Systematic Reviews of Interventions (Higgins and Green 2008). The first new test, proposed by Harbord, Egger, and Sterne (2006, Statistics in Medicine 25: 3443–3457), is a modified version of the commonly used test proposed by Egger et al. (1997, British Medical Journal 315: 629–634). It regresses Z/√V against √V, where Z is the efficient score and V is Fisher’s information (the variance of Z under the null hypothesis). The second new test is Peters’ test, which is based on a weighted linear regression of the intervention effect estimate on the reciprocal of the sample size. Both of these tests maintain better control of the false-positive rate than the test proposed by Egger at al., while retaining similar power.

Published
2009
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42. metan: fixed- and random-effects meta-analysis

Author

Harris, Ross J., Bradburn, Michael J., Deeks, Jonathan J., Harbord, Roger M., Altman, Douglas G., and Sterne, Jonathan A.C.

Subjects
meta-analysis, forest plot, metan, Research Methods/ Statistical Methods
Abstract

This article describes updates of the meta-analysis command metan and options that have been added since the command’s original publication (Bradburn, Deeks, and Altman, metan — an alternative meta-analysis command, Stata Technical Bulletin Reprints, vol. 8, pp. 86–100). These include version 9 graphics with flexible display options, the ability to meta-analyze precalculated effect estimates, and the ability to analyze subgroups by using the by() option. Changes to the output, saved variables, and saved results are also described.

Published
2008
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45. Development of a combined database for meta-epidemiological research

Author

Savović, Jelena, primary, Harris, Ross J., additional, Wood, Lesley, additional, Beynon, Rebecca, additional, Altman, Doug, additional, Als-Nielsen, Bodil, additional, Balk, Ethan M., additional, Deeks, Jonathan, additional, Gluud, Lise Lotte, additional, Gluud, Christian, additional, loannidis, John P. A., additional, Jűni, Peter, additional, Moher, David, additional, Pildal, Julie, additional, Schulz, Kenneth F., additional, and Sterne, Jonathan A. C., additional

Published
2011
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47. Development of a combined database for meta-epidemiological research

Author

Savović, Jelena, primary, Harris, Ross J., additional, Wood, Lesley, additional, Beynon, Rebecca, additional, Altman, Doug, additional, Als-Nielsen, Bodil, additional, Balk, Ethan M., additional, Deeks, Jonathan, additional, Gluud, Lise Lotte, additional, Gluud, Christian, additional, Ioannidis, John P. A., additional, Jűni, Peter, additional, Moher, David, additional, Pildal, Julie, additional, Schulz, Kenneth F., additional, and Sterne, Jonathan A. C., additional

Published
2010
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50. An A-Mazing Logo Experiment.

Author

Harris, Ross J.

Abstract

Discusses what can be done with a LOGO turtle robot, how it is different from doing LOGO with the computer-screen turtle, and the educational value of the device. Sample programs are provided, including one in which the robot turtle can be commanded to react to meeting an obstacle. (JN)

Published
1983

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