{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T15:57:40Z","timestamp":1753891060220,"version":"3.41.2"},"reference-count":43,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,3,10]],"date-time":"2022-03-10T00:00:00Z","timestamp":1646870400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>The clinical outcomes of the Beta (B.1.351) variant of concern (VOC) of the SARS-CoV-2 virus remain poorly understood. In early 2021, northeastern France experienced an outbreak of Beta that was not observed elsewhere. This outbreak slightly preceded and then overlapped with a second outbreak of the better understood VOC Alpha (B.1.1.7) in the region. This situation allowed us to contemporaneously compare Alpha and Beta in terms of the characteristics, management, and outcomes of critically ill patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A multicenter prospective cohort study was conducted on all consecutive adult patients who had laboratory confirmed SARS CoV-2 infection, underwent variant screening, and were admitted to one of four intensive care units (ICU) for acute respiratory failure between January 9th and May 15th, 2021. Primary outcome was 60-day mortality. Differences between Alpha and Beta in terms of other outcomes, patient variables, management, and vaccination characteristics were also explored by univariate analysis. The factors that associated with 60-day death in Alpha- and Beta-infected patients were examined with logistic regression analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In total, 333 patients (median age, 63 years; 68% male) were enrolled. Of these, 174 and 159 had Alpha and Beta, respectively. The two groups did not differ significantly in terms of 60-day mortality (19 vs. 23%), 28-day mortality (17 vs. 20%), need for mechanical ventilation (60 vs. 61%), mechanical ventilation duration (14 vs. 15 days), other management variables, patient demographic variables, comorbidities, or clinical variables on ICU admission. The vast majority of patients were unvaccinated (94%). The remaining 18 patients had received a partial vaccine course and 2 were fully vaccinated. The vaccinated patients were equally likely to have Alpha and Beta.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Beta did not differ from Alpha in terms of patient characteristics, management, or outcomes in critically ill patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Trial Registration<\/jats:title><jats:p><jats:ext-link>ClinicalTrials.gov<\/jats:ext-link>, identifier: NCT04906850.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fmed.2022.828402","type":"journal-article","created":{"date-parts":[[2022,3,10]],"date-time":"2022-03-10T10:32:34Z","timestamp":1646908354000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":6,"title":["Comparison of SARS-CoV-2 Variants of Concern Alpha (B.1.1.7) vs. Beta (B.1.351) in Critically Ill Patients: A Multicenter Cohort Study"],"prefix":"10.3389","volume":"9","author":[{"given":"Guillaume","family":"Louis","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thibaut","family":"Belveyre","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christophe","family":"Goetz","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S\u00e9bastien","family":"Gibot","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul","family":"Dunand","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marie","family":"Conrad","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rostane","family":"Gaci","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S\u00e9bastien","family":"Gette","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nadia","family":"Ouamara","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pascale","family":"Perez","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cyril","family":"Cadoz","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yoann","family":"Picard","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nouchan","family":"Mellati","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2022,3,10]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"497","DOI":"10.1016\/S0140-6736(20)30183-5","article-title":"Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China","volume":"395","author":"Huang","year":"2020","journal-title":"Lancet."},{"key":"B2","unstructured":"2021"},{"key":"B3","doi-asserted-by":"publisher","first-page":"2126","DOI":"10.1016\/S0140-6736(21)02758-6","article-title":"Omicron SARS-CoV-2 variant: a new chapter in the COVID-19 pandemic","volume":"398","author":"Karim","year":"2021","journal-title":"Lancet."},{"key":"B4","doi-asserted-by":"publisher","first-page":"119","DOI":"10.1016\/j.jinf.2021.04.023","article-title":"The 501YV2 SARS-CoV-2 variant has an intermediate viral load between the 501YV1 and the historical variants in nasopharyngeal samples from newly diagnosed COVID-19 patients","volume":"83","author":"Teyssou","year":"2021","journal-title":"J Infect."},{"key":"B5","doi-asserted-by":"publisher","first-page":"n579","DOI":"10.1136\/bmj.n579","article-title":"Risk of mortality in patients infected with SARS-CoV-2 variant of concern 202012\/1: matched cohort study","volume":"372","author":"Challen","year":"2021","journal-title":"BMJ."},{"key":"B6","doi-asserted-by":"publisher","first-page":"e1216","DOI":"10.1101\/2021.03.09.21253184","article-title":"Difference in mortality among individuals admitted to hospital with COVID-19 during the first and second waves in South Africa: a cohort study","volume":"9","author":"Jassat","year":"2021","journal-title":"Lancet Glob Health."},{"key":"B7","doi-asserted-by":"publisher","first-page":"35","DOI":"10.1016\/S1473-3099(21)00475-8","article-title":"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","volume":"22","author":"Twohig","year":"2021","journal-title":"Lancet Infect Dis."},{"key":"B8","doi-asserted-by":"publisher","first-page":"142","DOI":"10.1038\/s41586-021-03471-w","article-title":"Escape of SARS-CoV-2 501YV2 from neutralization by convalescent plasma","volume":"593","author":"Cele","year":"2021","journal-title":"Nature"},{"key":"B9","doi-asserted-by":"publisher","first-page":"e1337","DOI":"10.1093\/cid\/ciab308","article-title":"Sera neutralizing activities against severe acute respiratory syndrome coronavirus 2 and multiple variants 6 months after hospitalization for coronavirus disease 2019","volume":"73","author":"Betton","year":"2021","journal-title":"Clin Infect Dis."},{"key":"B10","doi-asserted-by":"publisher","first-page":"2100333","DOI":"10.2807\/1560-7917.ES.2021.26.13.2100333","volume":"26","year":"2021","journal-title":"Euro Surveill."},{"key":"B11","unstructured":"COVID-19: Epidemiological Update. March 11, 2021."},{"key":"B12","unstructured":"COVID-19: Epidemiological Update in Grand Est. March 11, 2021."},{"key":"B13","unstructured":"Tracking of Variants. March 1, 2021."},{"key":"B14","doi-asserted-by":"publisher","first-page":"100890","DOI":"10.1016\/j.accpm.2021.100890","article-title":"Preliminary data on severe SARS-CoV-2 infection caused by the 501YV2 variant","volume":"40","author":"Louis","year":"2021","journal-title":"Anaesth Crit Care Pain Med."},{"key":"B15","unstructured":"Position of the Ethics Commission of the French Intensive Care Society: Criteria for Admission Management in Intensive Care in the Context of a Pandemic."},{"key":"B16","doi-asserted-by":"publisher","first-page":"124","DOI":"10.1016\/j.cmi.2021.09.007","article-title":"Monitoring the SARS-CoV-2 pandemic: screening algorithm with single nucleotide polymorphism detection for the rapid identification of established and emerging variants","volume":"28","author":"Mertens","year":"2022","journal-title":"Clin Microbiol Infect."},{"key":"B17","doi-asserted-by":"publisher","first-page":"173","DOI":"10.1016\/S2213-2600(18)30345-X","article-title":"Acute respiratory failure in immunocompromised adults","volume":"7","author":"Azoulay","year":"2019","journal-title":"Lancet Respir Med."},{"key":"B18","doi-asserted-by":"publisher","first-page":"2089","DOI":"10.1111\/j.1523-1755.2005.00365.x","article-title":"Definition and classification of chronic kidney disease: a position statement from Kidney Disease: Improving Global Outcomes (KDIGO)","volume":"67","author":"Levey","year":"2005","journal-title":"Kidney Int."},{"key":"B19","unstructured":"DGS-Urgent N\u00b0 2021-75. Investigation of Vaccine Failures Against Covid-19."},{"key":"B20","unstructured":"COVID-19 and Your Health.2020"},{"key":"B21","doi-asserted-by":"publisher","first-page":"69","DOI":"10.1186\/s13613-019-0540-9","article-title":"Formal guidelines: management of acute respiratory distress syndrome","volume":"9","author":"Papazian","year":"2019","journal-title":"Ann Intensive Care."},{"key":"B22","doi-asserted-by":"publisher","first-page":"693","DOI":"10.1056\/NEJMoa2021436","volume":"384","year":"2020","journal-title":"N Engl J Med."},{"key":"B23","doi-asserted-by":"publisher","first-page":"100931","DOI":"10.1016\/j.accpm.2021.100931","article-title":"French multicentre observational study on SARS-CoV-2 infections intensive care initial management: the FRENCH CORONA study","volume":"40","author":"Roger","year":"2021","journal-title":"Anaesth Crit Care Pain Med."},{"key":"B24","doi-asserted-by":"publisher","first-page":"60","DOI":"10.1007\/s00134-020-06294-x","article-title":"Clinical characteristics and day-90 outcomes of 4244 critically ill adults with COVID-19: a prospective cohort study","volume":"47","year":"2020","journal-title":"Intensive Care Med."},{"key":"B25","doi-asserted-by":"publisher","first-page":"1944","DOI":"10.3390\/microorganisms9091944","article-title":"Clinical course and outcome of patients with SARS-CoV-2 Alpha variant infection compared to patients with SARS-CoV-2 Wild-Type infection admitted to the ICU","volume":"9","author":"Garcia Borrega","year":"2021","journal-title":"Microorganisms."},{"key":"B26","doi-asserted-by":"publisher","first-page":"2100348","DOI":"10.2807\/1560-7917.ES.2021.26.16.2100348","article-title":"Characteristics of SARS-CoV-2 variants of concern B.1.1.7, B.1.351 or P.1: data from seven EU\/EEA countries, weeks 38\/2020 to 10\/2021","volume":"26","author":"Funk","year":"2021","journal-title":"Euro Surveill."},{"key":"B27","doi-asserted-by":"publisher","first-page":"775224","DOI":"10.3389\/fpubh.2021.775224","article-title":"The disease severity and clinical outcomes of the SARS-CoV-2 variants of concern","volume":"9","author":"Lin","year":"2021","journal-title":"Front Public Health."},{"key":"B28","doi-asserted-by":"publisher","first-page":"A613","DOI":"10.1016\/j.chest.2020.08.577","article-title":"Validation of sofa score in critically ill patients with COVID-19","volume":"158","author":"Martinez","year":"2020","journal-title":"Chest."},{"key":"B29","doi-asserted-by":"publisher","first-page":"1469","DOI":"10.1001\/jama.2021.1545","article-title":"Discriminant accuracy of the SOFA Score for determining the probable mortality of patients with COVID-19 Pneumonia requiring mechanical ventilation","volume":"325","author":"Raschke","year":"2021","journal-title":"JAMA."},{"key":"B30","doi-asserted-by":"publisher","first-page":"686","DOI":"10.1007\/s11606-016-3936-3","article-title":"The association between hospital capacity strain and inpatient outcomes in highly developed countries: a systematic review","volume":"32","author":"Eriksson","year":"2017","journal-title":"J Gen Intern Med."},{"key":"B31","doi-asserted-by":"publisher","first-page":"e2034266","DOI":"10.1001\/jamanetworkopen.2020.34266","article-title":"Association of intensive care unit patient load and demand with mortality rates in US department of veterans affairs hospitals during the COVID-19 pandemic","volume":"4","author":"Bravata","year":"2021","journal-title":"JAMA Netw Open."},{"key":"B32","doi-asserted-by":"publisher","first-page":"77","DOI":"10.1186\/s13613-021-00861-1","article-title":"Characteristics, management, and prognosis of elderly patients with COVID-19 admitted in the ICU during the first wave: insights from the COVID-ICU study : Prognosis of COVID-19 elderly critically ill patients in the ICU","volume":"11","author":"Dres","year":"2021","journal-title":"Ann Intensive Care."},{"key":"B33","doi-asserted-by":"publisher","first-page":"300","DOI":"10.1186\/s13054-021-03730-2","article-title":"Elevated HbA1c remains a predominant finding in severe COVID-19 and may be associated with increased mortality in patients requiring mechanical ventilation","volume":"25","author":"Klein","year":"2021","journal-title":"Crit Care."},{"key":"B34","unstructured":"France: COVID-19 Vaccine Numbers by Dose."},{"key":"B35","doi-asserted-by":"publisher","first-page":"100065","DOI":"10.1016\/j.lana.2021.100065","article-title":"Vaccination reduces need for emergency care in breakthrough COVID-19 infections: a multicenter cohort study","volume":"4","author":"Bahl","year":"2021","journal-title":"Lancet Reg Health Am."},{"key":"B36","doi-asserted-by":"publisher","first-page":"5077","DOI":"10.1016\/j.cell.2021.09.010","article-title":"COVID-19 vaccines: keeping pace with SARS-CoV-2 variants","volume":"184","author":"Cevik","year":"2021","journal-title":"Cell."},{"key":"B37","doi-asserted-by":"publisher","first-page":"626","DOI":"10.1038\/s41577-021-00592-1","article-title":"Progress of the COVID-19 vaccine effort: viruses, vaccines and variants versus efficacy, effectiveness and escape","volume":"21","author":"Tregoning","year":"2021","journal-title":"Nat Rev Immunol."},{"key":"B38","doi-asserted-by":"publisher","first-page":"187","DOI":"10.1056\/NEJMc2104974","article-title":"Effectiveness of the BNT162b2 Covid-19 vaccine against the B.1.1.7 and B.1.351 variants","volume":"385","author":"Abu-Raddad","year":"2021","journal-title":"N Engl J Med."},{"key":"B39","doi-asserted-by":"publisher","first-page":"1885","DOI":"10.1056\/NEJMoa2102214","article-title":"Efficacy of the ChAdOx1 nCoV-19 Covid-19 vaccine against the B.1.351 variant","volume":"384","author":"Madhi","year":"2021","journal-title":"N Engl J Med."},{"key":"B40","unstructured":"Vaccination against Covid-19: continuation of specific measures in Moselle"},{"key":"B41","doi-asserted-by":"publisher","first-page":"1945","DOI":"10.1093\/cid\/ciab129","article-title":"Severe reinfection with South African SARS-CoV-2 variant 501Y.V2: a case report","volume":"73","author":"Zucman","year":"2021","journal-title":"Clin Infect Dis."},{"key":"B42","doi-asserted-by":"publisher","first-page":"2100423","DOI":"10.2807\/1560-7917.ES.2021.26.18.2100423","article-title":"Case series of four re-infections with a SARS-CoV-2 B.1.351 variant, Luxembourg, February 2021","volume":"26","author":"Staub","year":"2021","journal-title":"Euro Surveill."},{"key":"B43","doi-asserted-by":"publisher","first-page":"1550","DOI":"10.3201\/eid1009.040058","article-title":"Viral loads in clinical specimens and SARS Manifestations","volume":"10","author":"Hung","year":"2004","journal-title":"Emerg Infect Dis."}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2022.828402\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,3,10]],"date-time":"2022-03-10T10:32:38Z","timestamp":1646908358000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2022.828402\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,3,10]]},"references-count":43,"alternative-id":["10.3389\/fmed.2022.828402"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2022.828402","relation":{},"ISSN":["2296-858X"],"issn-type":[{"type":"electronic","value":"2296-858X"}],"subject":[],"published":{"date-parts":[[2022,3,10]]},"article-number":"828402"}}