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Clinical severity of SARS-CoV-2 Omicron BA.4 and BA.5 lineages compared to BA.1 and Delta in South Africa

Author

Listed:
  • Nicole Wolter

    (National Institute for Communicable Diseases (NICD) of the National Health Laboratory Service
    University of the Witwatersrand)

  • Waasila Jassat

    (National Institute for Communicable Diseases (NICD) of the National Health Laboratory Service
    Right to Care)

  • Sibongile Walaza

    (National Institute for Communicable Diseases (NICD) of the National Health Laboratory Service
    University of the Witwatersrand)

  • Richard Welch

    (National Institute for Communicable Diseases (NICD) of the National Health Laboratory Service
    Right to Care)

  • Harry Moultrie

    (University of the Witwatersrand
    National Institute for Communicable Diseases (NICD) of the National Health Laboratory Service)

  • Michelle J. Groome

    (University of the Witwatersrand
    National Institute for Communicable Diseases (NICD) of the National Health Laboratory Service)

  • Daniel Gyamfi Amoako

    (National Institute for Communicable Diseases (NICD) of the National Health Laboratory Service
    University of KwaZulu-Natal)

  • Josie Everatt

    (National Institute for Communicable Diseases (NICD) of the National Health Laboratory Service)

  • Jinal N. Bhiman

    (National Institute for Communicable Diseases of the National Health Laboratory Service
    University of the Witwatersrand)

  • Cathrine Scheepers

    (National Institute for Communicable Diseases of the National Health Laboratory Service
    University of the Witwatersrand)

  • Naume Tebeila

    (National Institute for Communicable Diseases (NICD) of the National Health Laboratory Service)

  • Nicola Chiwandire

    (National Institute for Communicable Diseases (NICD) of the National Health Laboratory Service)

  • Mignon du Plessis

    (National Institute for Communicable Diseases (NICD) of the National Health Laboratory Service
    University of the Witwatersrand)

  • Nevashan Govender

    (National Institute for Communicable Diseases (NICD) of the National Health Laboratory Service)

  • Arshad Ismail

    (University of Venda
    National Institute for Communicable Diseases of the National Health Laboratory Service)

  • Allison Glass

    (University of the Witwatersrand
    Lancet Laboratories)

  • Koleka Mlisana

    (University of the Witwatersrand
    National Health Laboratory Service (NHLS)
    University of KwaZulu Natal)

  • Wendy Stevens

    (University of the Witwatersrand
    National Health Laboratory Service (NHLS))

  • Florette K. Treurnicht

    (University of the Witwatersrand
    National Health Laboratory Service (NHLS))

  • Kathleen Subramoney

    (University of the Witwatersrand
    National Health Laboratory Service (NHLS))

  • Zinhle Makatini

    (University of the Witwatersrand
    National Health Laboratory Service (NHLS))

  • Nei-yuan Hsiao

    (National Health Laboratory Service (NHLS)
    University of Cape Town)

  • Raveen Parboosing

    (University of the Witwatersrand
    National Health Laboratory Service (NHLS)
    University of KwaZulu-Natal)

  • Jeannette Wadula

    (University of the Witwatersrand
    National Health Laboratory Service (NHLS)
    CH Baragwanath Academic Hospital)

  • Hannah Hussey

    (University of Cape Town)

  • Mary-Ann Davies

    (University of Cape Town)

  • Andrew Boulle

    (University of Cape Town)

  • Anne von Gottberg

    (National Institute for Communicable Diseases (NICD) of the National Health Laboratory Service
    University of the Witwatersrand)

  • Cheryl Cohen

    (National Institute for Communicable Diseases (NICD) of the National Health Laboratory Service
    University of the Witwatersrand)

Abstract

Omicron lineages BA.4 and BA.5 drove a fifth wave of COVID-19 cases in South Africa. Here, we use the presence/absence of the S-gene target as a proxy for SARS-CoV-2 variant/lineage for infections diagnosed using the TaqPath PCR assay between 1 October 2021 and 26 April 2022. We link national COVID-19 individual-level data including case, laboratory test and hospitalisation data. We assess severity using multivariable logistic regression comparing the risk of hospitalisation and risk of severe disease, once hospitalised, for Delta, BA.1, BA.2 and BA.4/BA.5 infections. After controlling for factors associated with hospitalisation and severe outcome respectively, BA.4/BA.5-infected individuals had a similar odds of hospitalisation (aOR 1.24, 95% CI 0.98–1.55) and severe outcome (aOR 0.72, 95% CI 0.41–1.26) compared to BA.1-infected individuals. Newly emerged Omicron lineages BA.4/BA.5 showed similar severity to the BA.1 lineage and continued to show reduced clinical severity compared to the Delta variant.

Suggested Citation

  • Nicole Wolter & Waasila Jassat & Sibongile Walaza & Richard Welch & Harry Moultrie & Michelle J. Groome & Daniel Gyamfi Amoako & Josie Everatt & Jinal N. Bhiman & Cathrine Scheepers & Naume Tebeila & , 2022. "Clinical severity of SARS-CoV-2 Omicron BA.4 and BA.5 lineages compared to BA.1 and Delta in South Africa," Nature Communications, Nature, vol. 13(1), pages 1-8, December.
    • Handle: RePEc:nat:natcom:v:13:y:2022:i:1:d:10.1038_s41467-022-33614-0
    DOI: 10.1038/s41467-022-33614-0
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    1. Roanne Keeton & Marius B. Tincho & Amkele Ngomti & Richard Baguma & Ntombi Benede & Akiko Suzuki & Khadija Khan & Sandile Cele & Mallory Bernstein & Farina Karim & Sharon V. Madzorera & Thandeka Moyo-, 2022. "T cell responses to SARS-CoV-2 spike cross-recognize Omicron," Nature, Nature, vol. 603(7901), pages 488-492, March.
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