In:
PLOS Global Public Health, Public Library of Science (PLoS), Vol. 3, No. 3 ( 2023-3-8), p. e0001575-
Abstract:
The SARS-CoV-2 Omicron variant has resulted in a high number of cases, but a relatively low incidence of severe disease and deaths, compared to the pre-Omicron variants. Therefore, we assessed the differences in symptom prevalence between Omicron and pre-Omicron infections in a sub-Saharan African population. We collected data from outpatients presenting at two primary healthcare facilities in Blantyre, Malawi, from November 2020 to March 2022. Eligible participants were aged 〉 1month old, with signs suggestive of COVID-19, and those not suspected of COVID-19, from whom we collected nasopharyngeal swabs for SARS-CoV-2 PCR testing, and sequenced positive samples to identify infecting-variants. In addition, we calculated the risk of presenting with a given symptom in individuals testing SARS-CoV-2 PCR positive before and during the Omicron variant-dominated period. Among 5176 participants, 6.4% were under 5, and 77% were aged 18 to 50 years. SARS-CoV-2 infection prevalence peaked in January 2021 (Beta), July 2021 (Delta), and December 2021 (Omicron). We found that cough (risk ratio (RR), 1.50; 95% confidence interval (CI), 1.00 to 2.30), fatigue (RR 2.27; 95% CI, 1.29 to 3.86) and headache (RR 1.64; 95% CI, 1.15 to 2.34) were associated with a high risk of SARS-CoV-2 infection during the pre-Omicron period. In comparison, only headache (RR 1.41; 95% CI, 1.07 to 1.86) did associate with a high risk of SARS-CoV-2 infection during the Omicron-dominated period. In conclusion, clinical symptoms associated with Omicron infection differed from prior variants and were harder to identify clinically with current symptom guidelines. Our findings encourage regular review of case definitions and testing policies to ensure case ascertainment.
Type of Medium:
Online Resource
ISSN:
2767-3375
DOI:
10.1371/journal.pgph.0001575
DOI:
10.1371/journal.pgph.0001575.g001
DOI:
10.1371/journal.pgph.0001575.g002
DOI:
10.1371/journal.pgph.0001575.t001
DOI:
10.1371/journal.pgph.0001575.t002
DOI:
10.1371/journal.pgph.0001575.t003
DOI:
10.1371/journal.pgph.0001575.t004
DOI:
10.1371/journal.pgph.0001575.t005
DOI:
10.1371/journal.pgph.0001575.s001
DOI:
10.1371/journal.pgph.0001575.s002
DOI:
10.1371/journal.pgph.0001575.s003
DOI:
10.1371/journal.pgph.0001575.s004
DOI:
10.1371/journal.pgph.0001575.s005
DOI:
10.1371/journal.pgph.0001575.s006
DOI:
10.1371/journal.pgph.0001575.s007
Language:
English
Publisher:
Public Library of Science (PLoS)
Publication Date:
2023
detail.hit.zdb_id:
3101394-6
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