Spread of B.1.1.7 in Germany: Does the Corona variant really lead to more severe disease courses? – Knowledge

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The share of the corona variant B.1.1.7 in infections in Germany is increasing rapidly. B.1.1.7 is now detected in three out of four samples, as the Robert Koch Institute (RKI) recently announced.

The question is: does the increase in the variant also affect the disease progression of Covid-19 patients in intensive care units? Leading intensive care physicians in Germany disagree on this.

“There is a clear signal from England that the variants ensure a higher mortality rate in Covid-19 patients,” says Uwe Janssens, member of the executive board of the German Interdisciplinary Association for Intensive Care and Emergency Medicine, the Tagesspiegel. Janssens bases his statement on two studies.

The first study was published this week in the journal “Nature”. In this, the scientists from the London School of Hygiene and Tropical Medicine expect a 55 percent higher risk of death from infections with B.1.1.7 compared to the original virus. They took into account known risk factors such as age, gender and ethnicity.

Study results worry intensive care physicians

The absolute risk of death from a coronavirus infection for a man from the group of 55 to 69-year-olds increases from 0.6 to 0.9 percent within four weeks of a positive test. The study included data from around 2.2 million positive cases in the UK from September 1, 2020 to February 14, 2021.

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An analysis published in the British Medical Journal last week showed similar results. Researchers from the University of Exeter even found a 64 percent higher risk of death from an infection with B.1.1.7 compared to other corona variants. The scientists had analyzed the deaths of almost 110,000 infected people over the age of 30 who had come to corona test centers.

Based on these studies, Janssens considers the rapid spread to be “worrying”. He assumes that people between the ages of 50 and 70 will become seriously ill and that the situation will worsen again after Easter if the numbers continue to rise significantly. Virologist Christian Drosten had already warned of this.

Stefan Kluge, head of the intensive care clinic at the University Medical Center Hamburg-Eppendorf (UKE), sees the situation a little differently than Janssens. “The question of whether the variants affect the disease progression of Covid-19 patients in intensive care units cannot be answered with certainty by an intensive care physician at the moment,” says Kluge of the Tagesspiegel.

Tobias Welte, head of the Covid intensive care unit and post-Covid outpatient clinic at the Hannover Medical School, goes even further. From his point of view, according to current knowledge, Covid 19 disease does not differ between different variants of the virus.

Despite the increasing spread of B.1.1.7, he cannot see an increase in the number of cases in intensive care units. “In Germany, too, mortality is falling significantly, although B 1.1.7 continues to spread,” Welte told Tagesspiegel. For him, this already reflects the vaccination effect on people over 80 years of age.

Severity of the course also depends on age

For Welte, one consequence of the vaccination effect is that the rate of new infections in older people is stable or even falling and the virus is currently spreading, especially in the age group between 15 and 50. “These are the people who are not vaccinated,” says Welte. However, the rate of seriously ill people who are younger than 50 years of age is not increasing in relative terms.

According to Stefan Kluge from the UKE in Hamburg, this shows that the severity of the course also depends on age. This becomes even clearer with a view to the serious disease progression in children. “I cannot report any increase in intensive care cases among children. When there were cases, children often had serious previous illnesses, ”says Kluge.

Apart from age, the number of serious illnesses can always be an effect of the lockdown, said Kluge.

Precisely for this reason, Welte from the Hanover Medical School is even completely questioning the two studies from England. Because: From his point of view, they did not take into account factors such as the extent and stringency of lockdown measures and the effect of the vaccination.

In Great Britain, for example, there was practically no lockdown in force around Christmas time, which is why the variant could spread more easily. The vaccination effect only started later. Then, at the beginning of the year, when the UK imposed a tough lockdown, the death rate fell rapidly, although B.1.1.7 continued to spread.

Due to the vaccination effect, the infection rates and death rates in Great Britain are now far below the figures in Germany, despite the dominance of B.1.1.7. According to Welte, this could also be due to the measures in Germany. “One can argue about whether we really had a hard lockdown in Germany and, above all, whether it was adhered to,” said Welte. “Regulations are of little use in a pandemic if they are not followed.”





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