@article{Davies2023,
abstract = {Objectives: We aimed to compare the clinical severity of Omicron BA.4/BA.5 infection with BA.1 and ear- lier variant infections among laboratory-confirmed SARS-CoV-2 cases in the Western Cape, South Africa, using timing of infection to infer the lineage/variant causing infection. Methods: We included public sector patients aged ≥20 years with laboratory-confirmed COVID-19 be- tween May 01-May 21, 2022 (BA.4/BA.5 wave) and equivalent previous wave periods. We compared the risk between waves of (i) death and (ii) severe hospitalization/death (all within 21 days of diagnosis) using Cox regression adjusted for demographics, comorbidities, admission pressure, vaccination, and pre- vious infection. Results: Among 3793 patients from the BA.4/BA.5 wave and 190,836 patients from previous waves, the risk of severe hospitalization/death was similar in the BA.4/BA.5 and BA.1 waves (adjusted hazard ratio [aHR] 1.12; 95{\%} confidence interval [CI] 0.93; 1.34). Both Omicron waves had a lower risk of severe out- comes than previous waves. Previous infection (aHR 0.29, 95{\%} CI 0.24; 0.36) and vaccination (aHR 0.17; 95{\%} CI 0.07; 0.40 for at least three doses vs no vaccine) were protective. Conclusion: Disease severity was similar among diagnosed COVID-19 cases in the BA .4/BA .5 and BA .1 pe- riods in the context of growing immunity against SARS-CoV-2 due to previous infection and vaccination, both of which were strongly protective},
author = {Davies, Mary-Ann and Morden, Erna and Rousseau, Petro and Arendse, Juanita and Bam, Jamy-Lee and Boloko, Linda and Cloete, Keith and Cohen, Cheryl and Chetty, Nicole and Dane, Pierre and Heekes, Alexa and Hsiao, Nei-Yuan and Hunter, Mehreen and Hussey, Hannah and Jacobs, Theuns and Jassat, Waasila and Kariem, Saadiq and Kassanjee, Reshma and Laenen, Inneke and Roux, Sue Le and Lessells, Richard and Mahomed, Hassan and Maughan, Deborah and Meintjes, Graeme A and Mendelson, Marc and Mnguni, Ayanda and Moodley, Melvin and Murie, Katy and Naude, Jonathan and Ntusi, Ntobeko A B and Paleker, Masudah and Parker, Arifa and Pienaar, David and Preiser, Wolfgang and Prozesky, Hans and Raubenheimer, Peter and Rossouw, Liezel and Schrueder, Neshaad and Smith, Barry and Smith, Mariette and Solomon, Wesley and Symons, Greg and Taljaard, Jantjie and Wasserman, Sean and Wilkinson, Robert J and Wolmarans, Milani and Wolter, Nicole and Boulle, Andrew},
doi = {10.1016/J.IJID.2022.11.024},
file = {:C$\backslash$:/Users/01462563/AppData/Local/Mendeley Ltd./Mendeley Desktop/Downloaded/Davies et al. - 2023 - Outcomes of laboratory-confirmed SARS-CoV-2 infection during resurgence driven by Omicron lineages BA.4 and BA.5.pdf:pdf},
issn = {1201-9712},
journal = {International Journal of Infectious Diseases},
keywords = {OA,OA{\_}PMC,OA{\_}repository,fund{\_}ack,genomics{\_}fund{\_}ack,original},
mendeley-tags = {OA,OA{\_}PMC,OA{\_}repository,fund{\_}ack,genomics{\_}fund{\_}ack,original},
month = {feb},
pages = {63--68},
pmid = {36436752},
publisher = {Elsevier},
title = {{Outcomes of laboratory-confirmed SARS-CoV-2 infection during resurgence driven by Omicron lineages BA.4 and BA.5 compared with previous waves in the Western Cape Province, South Africa}},
url = {https://linkinghub.elsevier.com/retrieve/pii/S1201971222006154},
volume = {127},
year = {2023}
}

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Results: Among 3793 patients from the BA.4/BA.5 wave and 190,836 patients from previous waves, the risk of severe hospitalization/death was similar in the BA.4/BA.5 and BA.1 waves (adjusted hazard ratio [aHR] 1.12; 95% confidence interval [CI] 0.93; 1.34). Both Omicron waves had a lower risk of severe out- comes than previous waves. Previous infection (aHR 0.29, 95% CI 0.24; 0.36) and vaccination (aHR 0.17; 95% CI 0.07; 0.40 for at least three doses vs no vaccine) were protective. 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