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Changes in symptomatology, reinfection, and transmissibility associated with the SARS-CoV-2 variant B.1.1.7: an ecological study
Mark S Graham,
Carole H Sudre,
Anna May,
Michela Antonelli,
Benjamin Murray,
Thomas Varsavsky,
Kerstin Kläser,
Liane S Canas,
Erika Molteni,
Marc Modat,
David A Drew,
Long H Nguyen,
Lorenzo Polidori,
Somesh Selvachandran,
Christina Hu,
Joan Capdevila,
Alexander Hammers,
Andrew T Chan,
Jonathan Wolf,
Tim D Spector,
Claire J Steves,
Sebastien Ourselin,
Cherian Koshy,
Amy Ash,
Emma Wise,
Nathan Moore,
Matilde Mori,
Nick Cortes,
Jessica Lynch,
Stephen Kidd,
Derek J Fairley,
Tanya Curran,
James P McKenna,
Helen Adams,
Christophe Fraser,
Tanya Golubchik,
David Bonsall,
Mohammed O Hassan-Ibrahim,
Cassandra S Malone,
Benjamin J Cogger,
Michelle Wantoch,
Nicola Reynolds,
Ben Warne,
Joshua Maksimovic,
Karla Spellman,
Kathryn McCluggage,
Michaela John,
Robert Beer,
Safiah Afifi,
Sian Morgan,
Angela Marchbank,
Anna Price,
Christine Kitchen,
Huw Gulliver,
Ian Merrick,
Joel Southgate,
Martyn Guest,
Robert Munn,
Trudy Workman,
Thomas R Connor,
William Fuller,
Catherine Bresner,
Luke B Snell,
Amita Patel,
Themoula Charalampous,
Gaia Nebbia,
Rahul Batra,
Jonathan Edgeworth,
Samuel C Robson,
Angela H Beckett,
David M Aanensen,
Anthony P Underwood,
Corin A Yeats,
Khalil Abudahab,
Ben EW Taylor,
Mirko Menegazzo,
Gemma Clark,
Wendy Smith,
Manjinder Khakh,
Vicki M Fleming,
Michelle M Lister,
Hannah C Howson-Wells,
Louise Berry,
Tim Boswell,
Amelia Joseph,
Iona Willingham,
Carl Jones,
Christopher Holmes,
Paul Bird,
Thomas Helmer,
Karlie Fallon,
Julian Tang,
Veena Raviprakash,
Sharon Campbell,
Nicola Sheriff,
Victoria Blakey,
Lesley-Anne Williams,
Matthew W Loose,
Nadine Holmes,
Christopher Moore,
Matthew Carlile,
Victoria Wright,
Fei Sang,
Johnny Debebe,
Francesc Coll,
Adrian W Signell,
Gilberto Betancor,
Harry D Wilson,
Sahar Eldirdiri,
Anita Kenyon,
Thomas Davis,
Oliver G Pybus,
Louis du Plessis,
Alex E Zarebski,
Jayna Raghwani,
Moritz UG Kraemer,
Sarah Francois,
Stephen W Attwood,
Tetyana I Vasylyeva,
Marina Escalera Zamudio,
Bernardo Gutierrez,
M. Estee Torok,
William L Hamilton,
Ian G Goodfellow,
Grant Hall,
Aminu S Jahun,
Yasmin Chaudhry,
Myra Hosmillo,
Malte L Pinckert,
Iliana Georgana,
Samuel Moses,
Hannah Lowe,
Luke Bedford,
Jonathan Moore,
Susanne Stonehouse,
Chloe L Fisher,
Ali R Awan,
John BoYes,
Judith Breuer,
Kathryn Ann Harris,
Julianne Rose Brown,
Divya Shah,
Laura Atkinson,
Jack CD Lee,
Nathaniel Storey,
Flavia Flaviani,
Adela Alcolea-Medina,
Rebecca Williams,
Gabrielle Vernet,
Michael R Chapman,
Lisa J Levett,
Judith Heaney,
Wendy Chatterton,
Monika Pusok,
Li Xu-McCrae,
Darren L Smith,
Matthew Bashton,
Gregory R Young,
Alison Holmes,
Paul Anthony Randell,
Alison Cox,
Pinglawathee Madona,
Frances Bolt,
James Price,
Siddharth Mookerjee,
Manon Ragonnet-Cronin,
Fabricia F. Nascimento,
David Jorgensen,
Igor Siveroni,
Rob Johnson,
Olivia Boyd,
Lily Geidelberg,
Erik M Volz,
Aileen Rowan,
Graham P Taylor,
Katherine L Smollett,
Nicholas J Loman,
Joshua Quick,
Claire McMurray,
Joanne Stockton,
Sam Nicholls,
Will Rowe,
Radoslaw Poplawski,
Alan McNally,
Rocio T Martinez Nunez,
Jenifer Mason,
Trevor I Robinson,
Elaine O'Toole,
Joanne Watts,
Cassie Breen,
Angela Cowell,
Graciela Sluga,
Nicholas W Machin,
Shazaad S Y Ahmad,
Ryan P George,
Fenella Halstead,
Venkat Sivaprakasam,
Wendy Hogsden,
Chris J Illingworth,
Chris Jackson,
Emma C Thomson,
James G Shepherd,
Patawee Asamaphan,
Marc O Niebel,
Kathy K Li,
Rajiv N Shah,
Natasha G Jesudason,
Lily Tong,
Alice Broos,
Daniel Mair,
Jenna Nichols,
Stephen N Carmichael,
Kyriaki Nomikou,
Elihu Aranday-Cortes,
Natasha Johnson,
Igor Starinskij,
Ana da Silva Filipe,
David L Robertson,
Richard J Orton,
Joseph Hughes,
Sreenu Vattipally,
Joshua B Singer,
Seema Nickbakhsh,
Antony D Hale,
Louissa R Macfarlane-Smith,
Katherine L Harper,
Holli Carden,
Yusri Taha,
Brendan AI Payne,
Shirelle Burton-Fanning,
Sheila Waugh,
Jennifer Collins,
Gary Eltringham,
Steven Rushton,
Sarah O'Brien,
Amanda Bradley,
Alasdair Maclean,
Guy Mollett,
Rachel Blacow,
Kate E Templeton,
Martin P McHugh,
Rebecca Dewar,
Elizabeth Wastenge,
Samir Dervisevic,
Rachael Stanley,
Emma J Meader,
Lindsay Coupland,
Louise Smith,
Clive Graham,
Edward Barton,
Debra Padgett,
Garren Scott,
Emma Swindells,
Jane Greenaway,
Andrew Nelson,
Clare M McCann,
Wen C Yew,
Monique Andersson,
Timothy Peto,
Anita Justice,
David Eyre,
Derrick Crook,
Tim J Sloan,
Nichola Duckworth,
Sarah Walsh,
Anoop J Chauhan,
Sharon Glaysher,
Kelly Bicknell,
Sarah Wyllie,
Scott Elliott,
Allyson Lloyd,
Robert Impey,
Nick Levene,
Lynn Monaghan,
Declan T Bradley,
Tim Wyatt,
Elias Allara,
Clare Pearson,
Husam Osman,
Andrew Bosworth,
Esther Robinson,
Peter Muir,
Ian B Vipond,
Richard Hopes,
Hannah M Pymont,
Stephanie Hutchings,
Martin D Curran,
Surendra Parmar,
Angie Lackenby,
Tamyo Mbisa,
Steven Platt,
Shahjahan Miah,
David Bibby,
Carmen Manso,
Jonathan Hubb,
Meera Chand,
Gavin Dabrera,
Mary Ramsay,
Daniel Bradshaw,
Alicia Thornton,
Richard Myers,
Ulf Schaefer,
Natalie Groves,
Eileen Gallagher,
David Lee,
David Williams,
Nicholas Ellaby,
Ian Harrison,
Hassan Hartman,
Nikos Manesis,
Vineet Patel,
Chloe Bishop,
Vicki Chalker,
Juan Ledesma,
Katherine A Twohig,
Matthew T.G. Holden,
Sharif Shaaban,
Alec Birchley,
Alexander Adams,
Alisha Davies,
Amy Gaskin,
Amy Plimmer,
Bree Gatica-Wilcox,
Caoimhe McKerr,
Catherine Moore,
Chris Williams,
David Heyburn,
Elen De Lacy,
Ember Hilvers,
Fatima Downing,
Giri Shankar,
Hannah Jones,
Hibo Asad,
Jason Coombes,
Joanne Watkins,
Johnathan M Evans,
Laia Fina,
Laura Gifford,
Lauren Gilbert,
Lee Graham,
Malorie Perry,
Mari Morgan,
Matthew Bull,
Michelle Cronin,
Nicole Pacchiarini,
Noel Craine,
Rachel Jones,
Robin Howe,
Sally Corden,
Sara Rey,
Sara Kumziene-SummerhaYes,
Sarah Taylor,
Simon Cottrell,
Sophie Jones,
Sue Edwards,
Justin O'Grady,
Andrew J Page,
Alison E Mather,
David J Baker,
Steven Rudder,
Alp Aydin,
Gemma L Kay,
Alexander J Trotter,
Nabil-Fareed Alikhan,
Leonardo de Oliveira Martins,
Thanh Le-Viet,
Lizzie Meadows,
Anna Casey,
Liz Ratcliffe,
David A Simpson,
Zoltan Molnar,
Thomas Thompson,
Erwan Acheson,
Jane AH Masoli,
Bridget A Knight,
Sian Ellard,
Cressida Auckland,
Christopher R Jones,
Tabitha W Mahungu,
Dianne Irish-Tavares,
Tanzina Haque,
Jennifer Hart,
Eric Witele,
Melisa Louise Fenton,
Ashok Dadrah,
Amanda Symmonds,
Tranprit Saluja,
Yann Bourgeois,
Garry P Scarlett,
Katie F Loveson,
Salman Goudarzi,
Christopher Fearn,
Kate Cook,
Hannah Dent,
Hannah Paul,
David G Partridge,
Mohammad Raza,
Cariad Evans,
Kate Johnson,
Steven Liggett,
Paul Baker,
Stephen Bonner,
Sarah Essex,
Ronan A Lyons,
Kordo Saeed,
Adhyana I.K Mahanama,
Buddhini Samaraweera,
Siona Silveira,
Emanuela Pelosi,
Eleri Wilson-Davies,
Rachel J Williams,
Mark Kristiansen,
Sunando Roy,
Charlotte A Williams,
Marius Cotic,
Nadua Bayzid,
Adam P Westhorpe,
John A Hartley,
Riaz Jannoo,
Helen L Lowe,
Angeliki Karamani,
Leah Ensell,
Jacqui A Prieto,
Sarah Jeremiah,
Dimitris Grammatopoulos,
Sarojini Pandey,
Lisa Berry,
Katie Jones,
Alex Richter,
Andrew Beggs,
Angus Best,
Benita Percival,
Jeremy Mirza,
Oliver Megram,
Megan Mayhew,
Liam Crawford,
Fiona Ashcroft,
Emma Moles-Garcia,
Nicola Cumley,
Colin P Smith,
Giselda Bucca,
Andrew R Hesketh,
Beth Blane,
Sophia T Girgis,
Danielle Leek,
Sushmita Sridhar,
Sally Forrest,
Claire Cormie,
Harmeet K Gill,
Joana Dias,
Ellen E Higginson,
Mailis Maes,
Jamie Young,
Leanne M Kermack,
Ravi Kumar Gupta,
Catherine Ludden,
Sharon J Peacock,
Sophie Palmer,
Carol M Churcher,
Nazreen F Hadjirin,
Alessandro M Carabelli,
Ellena Brooks,
Kim S Smith,
Katerina Galai,
Georgina M McManus,
Chris Ruis,
Rose K Davidson,
Andrew Rambaut,
Thomas Williams,
Carlos E Balcazar,
Michael D Gallagher,
Áine O'Toole,
Stefan Rooke,
Verity Hill,
Kathleen A Williamson,
Thomas D Stanton,
Stephen L Michell,
Claire M Bewshea,
Ben Temperton,
Michelle L Michelsen,
Joanna Warwick-Dugdale,
Robin Manley,
Audrey Farbos,
James W Harrison,
Christine M Sambles,
David J Studholme,
Aaron R Jeffries,
Alistair C Darby,
Julian A Hiscox,
Steve Paterson,
Miren Iturriza-Gomara,
Kathryn A Jackson,
Anita O Lucaci,
Edith E Vamos,
Margaret Hughes,
Lucille Rainbow,
Richard Eccles,
Charlotte Nelson,
Mark Whitehead,
Lance Turtle,
Sam T Haldenby,
Richard Gregory,
Matthew Gemmell,
Claudia Wierzbicki,
Hermione J Webster,
Thushan I de Silva,
Nikki Smith,
Adrienn Angyal,
Benjamin B Lindsey,
Danielle C Groves,
Luke R Green,
Dennis Wang,
Timothy M Freeman,
Matthew D Parker,
Alexander J Keeley,
Paul J Parsons,
Rachel M Tucker,
Rebecca Brown,
Matthew Wyles,
Max Whiteley,
Peijun Zhang,
Marta Gallis,
Stavroula F Louka,
Chrystala Constantinidou,
Meera Unnikrishnan,
Sascha Ott,
Jeffrey K.J. Cheng,
Hannah E. Bridgewater,
Lucy R. Frost,
Grace Taylor-Joyce,
Richard Stark,
Laura Baxter,
Mohammad T. Alam,
Paul E Brown,
Dinesh Aggarwal,
Alberto C Cerda,
Tammy V Merrill,
Rebekah E Wilson,
Patrick C McClure,
Joseph G Chappell,
Theocharis Tsoleridis,
Jonathan Ball,
David Buck,
John A Todd,
Angie Green,
Amy Trebes,
George MacIntyre-Cockett,
Mariateresa de Cesare,
Alex Alderton,
Roberto Amato,
Cristina V Ariani,
Mathew A Beale,
Charlotte Beaver,
Katherine L Bellis,
Emma Betteridge,
James Bonfield,
John Danesh,
Matthew J Dorman,
Eleanor Drury,
Ben W Farr,
Luke Foulser,
Sonia Goncalves,
Scott Goodwin,
Marina Gourtovaia,
Ewan M Harrison,
David K Jackson,
Dorota Jamrozy,
Ian Johnston,
Leanne Kane,
Sally Kay,
Jon-Paul Keatley,
Dominic Kwiatkowski,
Cordelia F Langford,
Mara Lawniczak,
Laura Letchford,
Rich Livett,
Stephanie Lo,
Inigo Martincorena,
Samantha McGuigan,
Rachel Nelson,
Steve Palmer,
Naomi R Park,
Minal Patel,
Liam Prestwood,
Christoph Puethe,
Michael A Quail,
Shavanthi Rajatileka,
Carol Scott,
Lesley Shirley,
John Sillitoe,
Michael H Spencer Chapman,
Scott AJ Thurston,
Gerry Tonkin-Hill,
Danni Weldon,
Diana Rajan,
Iraad F Bronner,
Louise Aigrain,
Nicholas M Redshaw,
Stefanie V Lensing,
Robert Davies,
Andrew Whitwham,
Jennifier Liddle,
Kevin Lewis,
Jaime M Tovar-Corona,
Steven Leonard,
Jillian Durham,
Andrew R Bassett,
Shane McCarthy,
Robin J Moll,
Keith James,
Karen Oliver,
Alex Makunin,
Jeff Barrett,
Rory N Gunson,
Ronan Lyons 
The Lancet Public Health, Volume: 6, Issue: 5, Pages: e335 - e345
Swansea University Author:
Ronan Lyons
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DOI (Published version): 10.1016/s2468-2667(21)00055-4
Abstract
BackgroundThe SARS-CoV-2 variant B.1.1.7 was first identified in December, 2020, in England. We aimed to investigate whether increases in the proportion of infections with this variant are associated with differences in symptoms or disease course, reinfection rates, or transmissibility.MethodsWe did...
| Published in: | The Lancet Public Health |
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| ISSN: | 2468-2667 |
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Elsevier BV
2021
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<?xml version="1.0" encoding="utf-8"?><rfc1807 xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xmlns:xsd="http://www.w3.org/2001/XMLSchema"><bib-version>v2</bib-version><id>66442</id><entry>2024-05-15</entry><title>Changes in symptomatology, reinfection, and transmissibility associated with the SARS-CoV-2 variant B.1.1.7: an ecological study</title><swanseaauthors><author><sid>83efcf2a9dfcf8b55586999d3d152ac6</sid><ORCID>0000-0001-5225-000X</ORCID><firstname>Ronan</firstname><surname>Lyons</surname><name>Ronan Lyons</name><active>true</active><ethesisStudent>false</ethesisStudent></author></swanseaauthors><date>2024-05-15</date><deptcode>MEDS</deptcode><abstract>BackgroundThe SARS-CoV-2 variant B.1.1.7 was first identified in December, 2020, in England. We aimed to investigate whether increases in the proportion of infections with this variant are associated with differences in symptoms or disease course, reinfection rates, or transmissibility.MethodsWe did an ecological study to examine the association between the regional proportion of infections with the SARS-CoV-2 B.1.1.7 variant and reported symptoms, disease course, rates of reinfection, and transmissibility. Data on types and duration of symptoms were obtained from longitudinal reports from users of the COVID Symptom Study app who reported a positive test for COVID-19 between Sept 28 and Dec 27, 2020 (during which the prevalence of B.1.1.7 increased most notably in parts of the UK). From this dataset, we also estimated the frequency of possible reinfection, defined as the presence of two reported positive tests separated by more than 90 days with a period of reporting no symptoms for more than 7 days before the second positive test. The proportion of SARS-CoV-2 infections with the B.1.1.7 variant across the UK was estimated with use of genomic data from the COVID-19 Genomics UK Consortium and data from Public Health England on spike-gene target failure (a non-specific indicator of the B.1.1.7 variant) in community cases in England. We used linear regression to examine the association between reported symptoms and proportion of B.1.1.7. We assessed the Spearman correlation between the proportion of B.1.1.7 cases and number of reinfections over time, and between the number of positive tests and reinfections. We estimated incidence for B.1.1.7 and previous variants, and compared the effective reproduction number, Rt, for the two incidence estimates.FindingsFrom Sept 28 to Dec 27, 2020, positive COVID-19 tests were reported by 36 920 COVID Symptom Study app users whose region was known and who reported as healthy on app sign-up. We found no changes in reported symptoms or disease duration associated with B.1.1.7. For the same period, possible reinfections were identified in 249 (0·7% [95% CI 0·6–0·8]) of 36 509 app users who reported a positive swab test before Oct 1, 2020, but there was no evidence that the frequency of reinfections was higher for the B.1.1.7 variant than for pre-existing variants. Reinfection occurrences were more positively correlated with the overall regional rise in cases (Spearman correlation 0·56–0·69 for South East, London, and East of England) than with the regional increase in the proportion of infections with the B.1.1.7 variant (Spearman correlation 0·38–0·56 in the same regions), suggesting B.1.1.7 does not substantially alter the risk of reinfection. We found a multiplicative increase in the Rt of B.1.1.7 by a factor of 1·35 (95% CI 1·02–1·69) relative to pre-existing variants. However, Rt fell below 1 during regional and national lockdowns, even in regions with high proportions of infections with the B.1.1.7 variant.InterpretationThe lack of change in symptoms identified in this study indicates that existing testing and surveillance infrastructure do not need to change specifically for the B.1.1.7 variant. In addition, given that there was no apparent increase in the reinfection rate, vaccines are likely to remain effective against the B.1.1.7 variant.</abstract><type>Journal Article</type><journal>The Lancet Public Health</journal><volume>6</volume><journalNumber>5</journalNumber><paginationStart>e335</paginationStart><paginationEnd>e345</paginationEnd><publisher>Elsevier BV</publisher><placeOfPublication/><isbnPrint/><isbnElectronic/><issnPrint>2468-2667</issnPrint><issnElectronic/><keywords/><publishedDay>1</publishedDay><publishedMonth>5</publishedMonth><publishedYear>2021</publishedYear><publishedDate>2021-05-01</publishedDate><doi>10.1016/s2468-2667(21)00055-4</doi><url/><notes/><college>COLLEGE NANME</college><department>Medical School</department><CollegeCode>COLLEGE CODE</CollegeCode><DepartmentCode>MEDS</DepartmentCode><institution>Swansea University</institution><apcterm/><funders>Zoe Global, Department of Health (UK), Wellcome Trust, Engineering and Physical Sciences Research Council (UK), National Institute for Health Research (UK), Medical Research Council (UK), Alzheimer's Society.</funders><projectreference/><lastEdited>2024-06-24T14:13:30.3075317</lastEdited><Created>2024-05-15T11:39:40.6575732</Created><path><level id="1">Faculty of Medicine, Health and Life Sciences</level><level id="2">Swansea University Medical School - Health Data Science</level></path><authors><author><firstname>Mark S</firstname><surname>Graham</surname><order>1</order></author><author><firstname>Carole H</firstname><surname>Sudre</surname><order>2</order></author><author><firstname>Anna</firstname><surname>May</surname><order>3</order></author><author><firstname>Michela</firstname><surname>Antonelli</surname><order>4</order></author><author><firstname>Benjamin</firstname><surname>Murray</surname><order>5</order></author><author><firstname>Thomas</firstname><surname>Varsavsky</surname><order>6</order></author><author><firstname>Kerstin</firstname><surname>Kläser</surname><order>7</order></author><author><firstname>Liane S</firstname><surname>Canas</surname><order>8</order></author><author><firstname>Erika</firstname><surname>Molteni</surname><order>9</order></author><author><firstname>Marc</firstname><surname>Modat</surname><order>10</order></author><author><firstname>David A</firstname><surname>Drew</surname><order>11</order></author><author><firstname>Long H</firstname><surname>Nguyen</surname><order>12</order></author><author><firstname>Lorenzo</firstname><surname>Polidori</surname><order>13</order></author><author><firstname>Somesh</firstname><surname>Selvachandran</surname><order>14</order></author><author><firstname>Christina</firstname><surname>Hu</surname><order>15</order></author><author><firstname>Joan</firstname><surname>Capdevila</surname><order>16</order></author><author><firstname>Alexander</firstname><surname>Hammers</surname><order>17</order></author><author><firstname>Andrew T</firstname><surname>Chan</surname><order>18</order></author><author><firstname>Jonathan</firstname><surname>Wolf</surname><order>19</order></author><author><firstname>Tim D</firstname><surname>Spector</surname><order>20</order></author><author><firstname>Claire J</firstname><surname>Steves</surname><order>21</order></author><author><firstname>Sebastien</firstname><surname>Ourselin</surname><order>22</order></author><author><firstname>Cherian</firstname><surname>Koshy</surname><order>23</order></author><author><firstname>Amy</firstname><surname>Ash</surname><order>24</order></author><author><firstname>Emma</firstname><surname>Wise</surname><order>25</order></author><author><firstname>Nathan</firstname><surname>Moore</surname><order>26</order></author><author><firstname>Matilde</firstname><surname>Mori</surname><order>27</order></author><author><firstname>Nick</firstname><surname>Cortes</surname><order>28</order></author><author><firstname>Jessica</firstname><surname>Lynch</surname><order>29</order></author><author><firstname>Stephen</firstname><surname>Kidd</surname><order>30</order></author><author><firstname>Derek J</firstname><surname>Fairley</surname><order>31</order></author><author><firstname>Tanya</firstname><surname>Curran</surname><order>32</order></author><author><firstname>James P</firstname><surname>McKenna</surname><order>33</order></author><author><firstname>Helen</firstname><surname>Adams</surname><order>34</order></author><author><firstname>Christophe</firstname><surname>Fraser</surname><order>35</order></author><author><firstname>Tanya</firstname><surname>Golubchik</surname><order>36</order></author><author><firstname>David</firstname><surname>Bonsall</surname><order>37</order></author><author><firstname>Mohammed O</firstname><surname>Hassan-Ibrahim</surname><order>38</order></author><author><firstname>Cassandra S</firstname><surname>Malone</surname><order>39</order></author><author><firstname>Benjamin J</firstname><surname>Cogger</surname><order>40</order></author><author><firstname>Michelle</firstname><surname>Wantoch</surname><order>41</order></author><author><firstname>Nicola</firstname><surname>Reynolds</surname><order>42</order></author><author><firstname>Ben</firstname><surname>Warne</surname><order>43</order></author><author><firstname>Joshua</firstname><surname>Maksimovic</surname><order>44</order></author><author><firstname>Karla</firstname><surname>Spellman</surname><order>45</order></author><author><firstname>Kathryn</firstname><surname>McCluggage</surname><order>46</order></author><author><firstname>Michaela</firstname><surname>John</surname><order>47</order></author><author><firstname>Robert</firstname><surname>Beer</surname><order>48</order></author><author><firstname>Safiah</firstname><surname>Afifi</surname><order>49</order></author><author><firstname>Sian</firstname><surname>Morgan</surname><order>50</order></author><author><firstname>Angela</firstname><surname>Marchbank</surname><order>51</order></author><author><firstname>Anna</firstname><surname>Price</surname><order>52</order></author><author><firstname>Christine</firstname><surname>Kitchen</surname><order>53</order></author><author><firstname>Huw</firstname><surname>Gulliver</surname><order>54</order></author><author><firstname>Ian</firstname><surname>Merrick</surname><order>55</order></author><author><firstname>Joel</firstname><surname>Southgate</surname><order>56</order></author><author><firstname>Martyn</firstname><surname>Guest</surname><order>57</order></author><author><firstname>Robert</firstname><surname>Munn</surname><order>58</order></author><author><firstname>Trudy</firstname><surname>Workman</surname><order>59</order></author><author><firstname>Thomas R</firstname><surname>Connor</surname><order>60</order></author><author><firstname>William</firstname><surname>Fuller</surname><order>61</order></author><author><firstname>Catherine</firstname><surname>Bresner</surname><order>62</order></author><author><firstname>Luke B</firstname><surname>Snell</surname><order>63</order></author><author><firstname>Amita</firstname><surname>Patel</surname><order>64</order></author><author><firstname>Themoula</firstname><surname>Charalampous</surname><order>65</order></author><author><firstname>Gaia</firstname><surname>Nebbia</surname><order>66</order></author><author><firstname>Rahul</firstname><surname>Batra</surname><order>67</order></author><author><firstname>Jonathan</firstname><surname>Edgeworth</surname><order>68</order></author><author><firstname>Samuel C</firstname><surname>Robson</surname><order>69</order></author><author><firstname>Angela H</firstname><surname>Beckett</surname><order>70</order></author><author><firstname>David M</firstname><surname>Aanensen</surname><order>71</order></author><author><firstname>Anthony P</firstname><surname>Underwood</surname><order>72</order></author><author><firstname>Corin A</firstname><surname>Yeats</surname><order>73</order></author><author><firstname>Khalil</firstname><surname>Abudahab</surname><order>74</order></author><author><firstname>Ben EW</firstname><surname>Taylor</surname><order>75</order></author><author><firstname>Mirko</firstname><surname>Menegazzo</surname><order>76</order></author><author><firstname>Gemma</firstname><surname>Clark</surname><order>77</order></author><author><firstname>Wendy</firstname><surname>Smith</surname><order>78</order></author><author><firstname>Manjinder</firstname><surname>Khakh</surname><order>79</order></author><author><firstname>Vicki M</firstname><surname>Fleming</surname><order>80</order></author><author><firstname>Michelle M</firstname><surname>Lister</surname><order>81</order></author><author><firstname>Hannah C</firstname><surname>Howson-Wells</surname><order>82</order></author><author><firstname>Louise</firstname><surname>Berry</surname><order>83</order></author><author><firstname>Tim</firstname><surname>Boswell</surname><order>84</order></author><author><firstname>Amelia</firstname><surname>Joseph</surname><order>85</order></author><author><firstname>Iona</firstname><surname>Willingham</surname><order>86</order></author><author><firstname>Carl</firstname><surname>Jones</surname><order>87</order></author><author><firstname>Christopher</firstname><surname>Holmes</surname><order>88</order></author><author><firstname>Paul</firstname><surname>Bird</surname><order>89</order></author><author><firstname>Thomas</firstname><surname>Helmer</surname><order>90</order></author><author><firstname>Karlie</firstname><surname>Fallon</surname><order>91</order></author><author><firstname>Julian</firstname><surname>Tang</surname><order>92</order></author><author><firstname>Veena</firstname><surname>Raviprakash</surname><order>93</order></author><author><firstname>Sharon</firstname><surname>Campbell</surname><order>94</order></author><author><firstname>Nicola</firstname><surname>Sheriff</surname><order>95</order></author><author><firstname>Victoria</firstname><surname>Blakey</surname><order>96</order></author><author><firstname>Lesley-Anne</firstname><surname>Williams</surname><order>97</order></author><author><firstname>Matthew W</firstname><surname>Loose</surname><order>98</order></author><author><firstname>Nadine</firstname><surname>Holmes</surname><order>99</order></author><author><firstname>Christopher</firstname><surname>Moore</surname><order>100</order></author><author><firstname>Matthew</firstname><surname>Carlile</surname><order>101</order></author><author><firstname>Victoria</firstname><surname>Wright</surname><order>102</order></author><author><firstname>Fei</firstname><surname>Sang</surname><order>103</order></author><author><firstname>Johnny</firstname><surname>Debebe</surname><order>104</order></author><author><firstname>Francesc</firstname><surname>Coll</surname><order>105</order></author><author><firstname>Adrian W</firstname><surname>Signell</surname><order>106</order></author><author><firstname>Gilberto</firstname><surname>Betancor</surname><order>107</order></author><author><firstname>Harry D</firstname><surname>Wilson</surname><order>108</order></author><author><firstname>Sahar</firstname><surname>Eldirdiri</surname><order>109</order></author><author><firstname>Anita</firstname><surname>Kenyon</surname><order>110</order></author><author><firstname>Thomas</firstname><surname>Davis</surname><order>111</order></author><author><firstname>Oliver G</firstname><surname>Pybus</surname><order>112</order></author><author><firstname>Louis du</firstname><surname>Plessis</surname><order>113</order></author><author><firstname>Alex E</firstname><surname>Zarebski</surname><order>114</order></author><author><firstname>Jayna</firstname><surname>Raghwani</surname><order>115</order></author><author><firstname>Moritz UG</firstname><surname>Kraemer</surname><order>116</order></author><author><firstname>Sarah</firstname><surname>Francois</surname><order>117</order></author><author><firstname>Stephen W</firstname><surname>Attwood</surname><order>118</order></author><author><firstname>Tetyana I</firstname><surname>Vasylyeva</surname><order>119</order></author><author><firstname>Marina Escalera</firstname><surname>Zamudio</surname><order>120</order></author><author><firstname>Bernardo</firstname><surname>Gutierrez</surname><order>121</order></author><author><firstname>M. Estee</firstname><surname>Torok</surname><order>122</order></author><author><firstname>William L</firstname><surname>Hamilton</surname><order>123</order></author><author><firstname>Ian G</firstname><surname>Goodfellow</surname><order>124</order></author><author><firstname>Grant</firstname><surname>Hall</surname><order>125</order></author><author><firstname>Aminu S</firstname><surname>Jahun</surname><order>126</order></author><author><firstname>Yasmin</firstname><surname>Chaudhry</surname><order>127</order></author><author><firstname>Myra</firstname><surname>Hosmillo</surname><order>128</order></author><author><firstname>Malte L</firstname><surname>Pinckert</surname><order>129</order></author><author><firstname>Iliana</firstname><surname>Georgana</surname><order>130</order></author><author><firstname>Samuel</firstname><surname>Moses</surname><order>131</order></author><author><firstname>Hannah</firstname><surname>Lowe</surname><order>132</order></author><author><firstname>Luke</firstname><surname>Bedford</surname><order>133</order></author><author><firstname>Jonathan</firstname><surname>Moore</surname><order>134</order></author><author><firstname>Susanne</firstname><surname>Stonehouse</surname><order>135</order></author><author><firstname>Chloe L</firstname><surname>Fisher</surname><order>136</order></author><author><firstname>Ali R</firstname><surname>Awan</surname><order>137</order></author><author><firstname>John</firstname><surname>BoYes</surname><order>138</order></author><author><firstname>Judith</firstname><surname>Breuer</surname><order>139</order></author><author><firstname>Kathryn Ann</firstname><surname>Harris</surname><order>140</order></author><author><firstname>Julianne Rose</firstname><surname>Brown</surname><order>141</order></author><author><firstname>Divya</firstname><surname>Shah</surname><order>142</order></author><author><firstname>Laura</firstname><surname>Atkinson</surname><order>143</order></author><author><firstname>Jack CD</firstname><surname>Lee</surname><order>144</order></author><author><firstname>Nathaniel</firstname><surname>Storey</surname><order>145</order></author><author><firstname>Flavia</firstname><surname>Flaviani</surname><order>146</order></author><author><firstname>Adela</firstname><surname>Alcolea-Medina</surname><order>147</order></author><author><firstname>Rebecca</firstname><surname>Williams</surname><order>148</order></author><author><firstname>Gabrielle</firstname><surname>Vernet</surname><order>149</order></author><author><firstname>Michael R</firstname><surname>Chapman</surname><order>150</order></author><author><firstname>Lisa J</firstname><surname>Levett</surname><order>151</order></author><author><firstname>Judith</firstname><surname>Heaney</surname><order>152</order></author><author><firstname>Wendy</firstname><surname>Chatterton</surname><order>153</order></author><author><firstname>Monika</firstname><surname>Pusok</surname><order>154</order></author><author><firstname>Li</firstname><surname>Xu-McCrae</surname><order>155</order></author><author><firstname>Darren L</firstname><surname>Smith</surname><order>156</order></author><author><firstname>Matthew</firstname><surname>Bashton</surname><order>157</order></author><author><firstname>Gregory R</firstname><surname>Young</surname><order>158</order></author><author><firstname>Alison</firstname><surname>Holmes</surname><order>159</order></author><author><firstname>Paul Anthony</firstname><surname>Randell</surname><order>160</order></author><author><firstname>Alison</firstname><surname>Cox</surname><order>161</order></author><author><firstname>Pinglawathee</firstname><surname>Madona</surname><order>162</order></author><author><firstname>Frances</firstname><surname>Bolt</surname><order>163</order></author><author><firstname>James</firstname><surname>Price</surname><order>164</order></author><author><firstname>Siddharth</firstname><surname>Mookerjee</surname><order>165</order></author><author><firstname>Manon</firstname><surname>Ragonnet-Cronin</surname><order>166</order></author><author><firstname>Fabricia F.</firstname><surname>Nascimento</surname><order>167</order></author><author><firstname>David</firstname><surname>Jorgensen</surname><order>168</order></author><author><firstname>Igor</firstname><surname>Siveroni</surname><order>169</order></author><author><firstname>Rob</firstname><surname>Johnson</surname><order>170</order></author><author><firstname>Olivia</firstname><surname>Boyd</surname><order>171</order></author><author><firstname>Lily</firstname><surname>Geidelberg</surname><order>172</order></author><author><firstname>Erik M</firstname><surname>Volz</surname><order>173</order></author><author><firstname>Aileen</firstname><surname>Rowan</surname><order>174</order></author><author><firstname>Graham P</firstname><surname>Taylor</surname><order>175</order></author><author><firstname>Katherine L</firstname><surname>Smollett</surname><order>176</order></author><author><firstname>Nicholas J</firstname><surname>Loman</surname><order>177</order></author><author><firstname>Joshua</firstname><surname>Quick</surname><order>178</order></author><author><firstname>Claire</firstname><surname>McMurray</surname><order>179</order></author><author><firstname>Joanne</firstname><surname>Stockton</surname><order>180</order></author><author><firstname>Sam</firstname><surname>Nicholls</surname><order>181</order></author><author><firstname>Will</firstname><surname>Rowe</surname><order>182</order></author><author><firstname>Radoslaw</firstname><surname>Poplawski</surname><order>183</order></author><author><firstname>Alan</firstname><surname>McNally</surname><order>184</order></author><author><firstname>Rocio T Martinez</firstname><surname>Nunez</surname><order>185</order></author><author><firstname>Jenifer</firstname><surname>Mason</surname><order>186</order></author><author><firstname>Trevor I</firstname><surname>Robinson</surname><order>187</order></author><author><firstname>Elaine</firstname><surname>O'Toole</surname><order>188</order></author><author><firstname>Joanne</firstname><surname>Watts</surname><order>189</order></author><author><firstname>Cassie</firstname><surname>Breen</surname><order>190</order></author><author><firstname>Angela</firstname><surname>Cowell</surname><order>191</order></author><author><firstname>Graciela</firstname><surname>Sluga</surname><order>192</order></author><author><firstname>Nicholas W</firstname><surname>Machin</surname><order>193</order></author><author><firstname>Shazaad S Y</firstname><surname>Ahmad</surname><order>194</order></author><author><firstname>Ryan P</firstname><surname>George</surname><order>195</order></author><author><firstname>Fenella</firstname><surname>Halstead</surname><order>196</order></author><author><firstname>Venkat</firstname><surname>Sivaprakasam</surname><order>197</order></author><author><firstname>Wendy</firstname><surname>Hogsden</surname><order>198</order></author><author><firstname>Chris J</firstname><surname>Illingworth</surname><order>199</order></author><author><firstname>Chris</firstname><surname>Jackson</surname><order>200</order></author><author><firstname>Emma C</firstname><surname>Thomson</surname><order>201</order></author><author><firstname>James G</firstname><surname>Shepherd</surname><order>202</order></author><author><firstname>Patawee</firstname><surname>Asamaphan</surname><order>203</order></author><author><firstname>Marc O</firstname><surname>Niebel</surname><order>204</order></author><author><firstname>Kathy K</firstname><surname>Li</surname><order>205</order></author><author><firstname>Rajiv N</firstname><surname>Shah</surname><order>206</order></author><author><firstname>Natasha G</firstname><surname>Jesudason</surname><order>207</order></author><author><firstname>Lily</firstname><surname>Tong</surname><order>208</order></author><author><firstname>Alice</firstname><surname>Broos</surname><order>209</order></author><author><firstname>Daniel</firstname><surname>Mair</surname><order>210</order></author><author><firstname>Jenna</firstname><surname>Nichols</surname><order>211</order></author><author><firstname>Stephen N</firstname><surname>Carmichael</surname><order>212</order></author><author><firstname>Kyriaki</firstname><surname>Nomikou</surname><order>213</order></author><author><firstname>Elihu</firstname><surname>Aranday-Cortes</surname><order>214</order></author><author><firstname>Natasha</firstname><surname>Johnson</surname><order>215</order></author><author><firstname>Igor</firstname><surname>Starinskij</surname><order>216</order></author><author><firstname>Ana da Silva</firstname><surname>Filipe</surname><order>217</order></author><author><firstname>David L</firstname><surname>Robertson</surname><order>218</order></author><author><firstname>Richard J</firstname><surname>Orton</surname><order>219</order></author><author><firstname>Joseph</firstname><surname>Hughes</surname><order>220</order></author><author><firstname>Sreenu</firstname><surname>Vattipally</surname><order>221</order></author><author><firstname>Joshua B</firstname><surname>Singer</surname><order>222</order></author><author><firstname>Seema</firstname><surname>Nickbakhsh</surname><order>223</order></author><author><firstname>Antony D</firstname><surname>Hale</surname><order>224</order></author><author><firstname>Louissa R</firstname><surname>Macfarlane-Smith</surname><order>225</order></author><author><firstname>Katherine L</firstname><surname>Harper</surname><order>226</order></author><author><firstname>Holli</firstname><surname>Carden</surname><order>227</order></author><author><firstname>Yusri</firstname><surname>Taha</surname><order>228</order></author><author><firstname>Brendan AI</firstname><surname>Payne</surname><order>229</order></author><author><firstname>Shirelle</firstname><surname>Burton-Fanning</surname><order>230</order></author><author><firstname>Sheila</firstname><surname>Waugh</surname><order>231</order></author><author><firstname>Jennifer</firstname><surname>Collins</surname><order>232</order></author><author><firstname>Gary</firstname><surname>Eltringham</surname><order>233</order></author><author><firstname>Steven</firstname><surname>Rushton</surname><order>234</order></author><author><firstname>Sarah</firstname><surname>O'Brien</surname><order>235</order></author><author><firstname>Amanda</firstname><surname>Bradley</surname><order>236</order></author><author><firstname>Alasdair</firstname><surname>Maclean</surname><order>237</order></author><author><firstname>Guy</firstname><surname>Mollett</surname><order>238</order></author><author><firstname>Rachel</firstname><surname>Blacow</surname><order>239</order></author><author><firstname>Kate E</firstname><surname>Templeton</surname><order>240</order></author><author><firstname>Martin P</firstname><surname>McHugh</surname><order>241</order></author><author><firstname>Rebecca</firstname><surname>Dewar</surname><order>242</order></author><author><firstname>Elizabeth</firstname><surname>Wastenge</surname><order>243</order></author><author><firstname>Samir</firstname><surname>Dervisevic</surname><order>244</order></author><author><firstname>Rachael</firstname><surname>Stanley</surname><order>245</order></author><author><firstname>Emma J</firstname><surname>Meader</surname><order>246</order></author><author><firstname>Lindsay</firstname><surname>Coupland</surname><order>247</order></author><author><firstname>Louise</firstname><surname>Smith</surname><order>248</order></author><author><firstname>Clive</firstname><surname>Graham</surname><order>249</order></author><author><firstname>Edward</firstname><surname>Barton</surname><order>250</order></author><author><firstname>Debra</firstname><surname>Padgett</surname><order>251</order></author><author><firstname>Garren</firstname><surname>Scott</surname><order>252</order></author><author><firstname>Emma</firstname><surname>Swindells</surname><order>253</order></author><author><firstname>Jane</firstname><surname>Greenaway</surname><order>254</order></author><author><firstname>Andrew</firstname><surname>Nelson</surname><order>255</order></author><author><firstname>Clare M</firstname><surname>McCann</surname><order>256</order></author><author><firstname>Wen C</firstname><surname>Yew</surname><order>257</order></author><author><firstname>Monique</firstname><surname>Andersson</surname><order>258</order></author><author><firstname>Timothy</firstname><surname>Peto</surname><order>259</order></author><author><firstname>Anita</firstname><surname>Justice</surname><order>260</order></author><author><firstname>David</firstname><surname>Eyre</surname><order>261</order></author><author><firstname>Derrick</firstname><surname>Crook</surname><order>262</order></author><author><firstname>Tim J</firstname><surname>Sloan</surname><order>263</order></author><author><firstname>Nichola</firstname><surname>Duckworth</surname><order>264</order></author><author><firstname>Sarah</firstname><surname>Walsh</surname><order>265</order></author><author><firstname>Anoop J</firstname><surname>Chauhan</surname><order>266</order></author><author><firstname>Sharon</firstname><surname>Glaysher</surname><order>267</order></author><author><firstname>Kelly</firstname><surname>Bicknell</surname><order>268</order></author><author><firstname>Sarah</firstname><surname>Wyllie</surname><order>269</order></author><author><firstname>Scott</firstname><surname>Elliott</surname><order>270</order></author><author><firstname>Allyson</firstname><surname>Lloyd</surname><order>271</order></author><author><firstname>Robert</firstname><surname>Impey</surname><order>272</order></author><author><firstname>Nick</firstname><surname>Levene</surname><order>273</order></author><author><firstname>Lynn</firstname><surname>Monaghan</surname><order>274</order></author><author><firstname>Declan T</firstname><surname>Bradley</surname><order>275</order></author><author><firstname>Tim</firstname><surname>Wyatt</surname><order>276</order></author><author><firstname>Elias</firstname><surname>Allara</surname><order>277</order></author><author><firstname>Clare</firstname><surname>Pearson</surname><order>278</order></author><author><firstname>Husam</firstname><surname>Osman</surname><order>279</order></author><author><firstname>Andrew</firstname><surname>Bosworth</surname><order>280</order></author><author><firstname>Esther</firstname><surname>Robinson</surname><order>281</order></author><author><firstname>Peter</firstname><surname>Muir</surname><order>282</order></author><author><firstname>Ian B</firstname><surname>Vipond</surname><order>283</order></author><author><firstname>Richard</firstname><surname>Hopes</surname><order>284</order></author><author><firstname>Hannah M</firstname><surname>Pymont</surname><order>285</order></author><author><firstname>Stephanie</firstname><surname>Hutchings</surname><order>286</order></author><author><firstname>Martin D</firstname><surname>Curran</surname><order>287</order></author><author><firstname>Surendra</firstname><surname>Parmar</surname><order>288</order></author><author><firstname>Angie</firstname><surname>Lackenby</surname><order>289</order></author><author><firstname>Tamyo</firstname><surname>Mbisa</surname><order>290</order></author><author><firstname>Steven</firstname><surname>Platt</surname><order>291</order></author><author><firstname>Shahjahan</firstname><surname>Miah</surname><order>292</order></author><author><firstname>David</firstname><surname>Bibby</surname><order>293</order></author><author><firstname>Carmen</firstname><surname>Manso</surname><order>294</order></author><author><firstname>Jonathan</firstname><surname>Hubb</surname><order>295</order></author><author><firstname>Meera</firstname><surname>Chand</surname><order>296</order></author><author><firstname>Gavin</firstname><surname>Dabrera</surname><order>297</order></author><author><firstname>Mary</firstname><surname>Ramsay</surname><order>298</order></author><author><firstname>Daniel</firstname><surname>Bradshaw</surname><order>299</order></author><author><firstname>Alicia</firstname><surname>Thornton</surname><order>300</order></author><author><firstname>Richard</firstname><surname>Myers</surname><order>301</order></author><author><firstname>Ulf</firstname><surname>Schaefer</surname><order>302</order></author><author><firstname>Natalie</firstname><surname>Groves</surname><order>303</order></author><author><firstname>Eileen</firstname><surname>Gallagher</surname><order>304</order></author><author><firstname>David</firstname><surname>Lee</surname><order>305</order></author><author><firstname>David</firstname><surname>Williams</surname><order>306</order></author><author><firstname>Nicholas</firstname><surname>Ellaby</surname><order>307</order></author><author><firstname>Ian</firstname><surname>Harrison</surname><order>308</order></author><author><firstname>Hassan</firstname><surname>Hartman</surname><order>309</order></author><author><firstname>Nikos</firstname><surname>Manesis</surname><order>310</order></author><author><firstname>Vineet</firstname><surname>Patel</surname><order>311</order></author><author><firstname>Chloe</firstname><surname>Bishop</surname><order>312</order></author><author><firstname>Vicki</firstname><surname>Chalker</surname><order>313</order></author><author><firstname>Juan</firstname><surname>Ledesma</surname><order>314</order></author><author><firstname>Katherine A</firstname><surname>Twohig</surname><order>315</order></author><author><firstname>Matthew T.G.</firstname><surname>Holden</surname><order>316</order></author><author><firstname>Sharif</firstname><surname>Shaaban</surname><order>317</order></author><author><firstname>Alec</firstname><surname>Birchley</surname><order>318</order></author><author><firstname>Alexander</firstname><surname>Adams</surname><order>319</order></author><author><firstname>Alisha</firstname><surname>Davies</surname><order>320</order></author><author><firstname>Amy</firstname><surname>Gaskin</surname><order>321</order></author><author><firstname>Amy</firstname><surname>Plimmer</surname><order>322</order></author><author><firstname>Bree</firstname><surname>Gatica-Wilcox</surname><order>323</order></author><author><firstname>Caoimhe</firstname><surname>McKerr</surname><order>324</order></author><author><firstname>Catherine</firstname><surname>Moore</surname><order>325</order></author><author><firstname>Chris</firstname><surname>Williams</surname><order>326</order></author><author><firstname>David</firstname><surname>Heyburn</surname><order>327</order></author><author><firstname>Elen De</firstname><surname>Lacy</surname><order>328</order></author><author><firstname>Ember</firstname><surname>Hilvers</surname><order>329</order></author><author><firstname>Fatima</firstname><surname>Downing</surname><order>330</order></author><author><firstname>Giri</firstname><surname>Shankar</surname><order>331</order></author><author><firstname>Hannah</firstname><surname>Jones</surname><order>332</order></author><author><firstname>Hibo</firstname><surname>Asad</surname><order>333</order></author><author><firstname>Jason</firstname><surname>Coombes</surname><order>334</order></author><author><firstname>Joanne</firstname><surname>Watkins</surname><order>335</order></author><author><firstname>Johnathan M</firstname><surname>Evans</surname><order>336</order></author><author><firstname>Laia</firstname><surname>Fina</surname><order>337</order></author><author><firstname>Laura</firstname><surname>Gifford</surname><order>338</order></author><author><firstname>Lauren</firstname><surname>Gilbert</surname><order>339</order></author><author><firstname>Lee</firstname><surname>Graham</surname><order>340</order></author><author><firstname>Malorie</firstname><surname>Perry</surname><order>341</order></author><author><firstname>Mari</firstname><surname>Morgan</surname><order>342</order></author><author><firstname>Matthew</firstname><surname>Bull</surname><order>343</order></author><author><firstname>Michelle</firstname><surname>Cronin</surname><order>344</order></author><author><firstname>Nicole</firstname><surname>Pacchiarini</surname><order>345</order></author><author><firstname>Noel</firstname><surname>Craine</surname><order>346</order></author><author><firstname>Rachel</firstname><surname>Jones</surname><order>347</order></author><author><firstname>Robin</firstname><surname>Howe</surname><order>348</order></author><author><firstname>Sally</firstname><surname>Corden</surname><order>349</order></author><author><firstname>Sara</firstname><surname>Rey</surname><order>350</order></author><author><firstname>Sara</firstname><surname>Kumziene-SummerhaYes</surname><order>351</order></author><author><firstname>Sarah</firstname><surname>Taylor</surname><order>352</order></author><author><firstname>Simon</firstname><surname>Cottrell</surname><order>353</order></author><author><firstname>Sophie</firstname><surname>Jones</surname><order>354</order></author><author><firstname>Sue</firstname><surname>Edwards</surname><order>355</order></author><author><firstname>Justin</firstname><surname>O'Grady</surname><order>356</order></author><author><firstname>Andrew J</firstname><surname>Page</surname><order>357</order></author><author><firstname>Alison E</firstname><surname>Mather</surname><order>358</order></author><author><firstname>David J</firstname><surname>Baker</surname><order>359</order></author><author><firstname>Steven</firstname><surname>Rudder</surname><order>360</order></author><author><firstname>Alp</firstname><surname>Aydin</surname><order>361</order></author><author><firstname>Gemma L</firstname><surname>Kay</surname><order>362</order></author><author><firstname>Alexander J</firstname><surname>Trotter</surname><order>363</order></author><author><firstname>Nabil-Fareed</firstname><surname>Alikhan</surname><order>364</order></author><author><firstname>Leonardo de Oliveira</firstname><surname>Martins</surname><order>365</order></author><author><firstname>Thanh</firstname><surname>Le-Viet</surname><order>366</order></author><author><firstname>Lizzie</firstname><surname>Meadows</surname><order>367</order></author><author><firstname>Anna</firstname><surname>Casey</surname><order>368</order></author><author><firstname>Liz</firstname><surname>Ratcliffe</surname><order>369</order></author><author><firstname>David A</firstname><surname>Simpson</surname><order>370</order></author><author><firstname>Zoltan</firstname><surname>Molnar</surname><order>371</order></author><author><firstname>Thomas</firstname><surname>Thompson</surname><order>372</order></author><author><firstname>Erwan</firstname><surname>Acheson</surname><order>373</order></author><author><firstname>Jane AH</firstname><surname>Masoli</surname><order>374</order></author><author><firstname>Bridget A</firstname><surname>Knight</surname><order>375</order></author><author><firstname>Sian</firstname><surname>Ellard</surname><order>376</order></author><author><firstname>Cressida</firstname><surname>Auckland</surname><order>377</order></author><author><firstname>Christopher R</firstname><surname>Jones</surname><order>378</order></author><author><firstname>Tabitha W</firstname><surname>Mahungu</surname><order>379</order></author><author><firstname>Dianne</firstname><surname>Irish-Tavares</surname><order>380</order></author><author><firstname>Tanzina</firstname><surname>Haque</surname><order>381</order></author><author><firstname>Jennifer</firstname><surname>Hart</surname><order>382</order></author><author><firstname>Eric</firstname><surname>Witele</surname><order>383</order></author><author><firstname>Melisa Louise</firstname><surname>Fenton</surname><order>384</order></author><author><firstname>Ashok</firstname><surname>Dadrah</surname><order>385</order></author><author><firstname>Amanda</firstname><surname>Symmonds</surname><order>386</order></author><author><firstname>Tranprit</firstname><surname>Saluja</surname><order>387</order></author><author><firstname>Yann</firstname><surname>Bourgeois</surname><order>388</order></author><author><firstname>Garry P</firstname><surname>Scarlett</surname><order>389</order></author><author><firstname>Katie F</firstname><surname>Loveson</surname><order>390</order></author><author><firstname>Salman</firstname><surname>Goudarzi</surname><order>391</order></author><author><firstname>Christopher</firstname><surname>Fearn</surname><order>392</order></author><author><firstname>Kate</firstname><surname>Cook</surname><order>393</order></author><author><firstname>Hannah</firstname><surname>Dent</surname><order>394</order></author><author><firstname>Hannah</firstname><surname>Paul</surname><order>395</order></author><author><firstname>David G</firstname><surname>Partridge</surname><order>396</order></author><author><firstname>Mohammad</firstname><surname>Raza</surname><order>397</order></author><author><firstname>Cariad</firstname><surname>Evans</surname><order>398</order></author><author><firstname>Kate</firstname><surname>Johnson</surname><order>399</order></author><author><firstname>Steven</firstname><surname>Liggett</surname><order>400</order></author><author><firstname>Paul</firstname><surname>Baker</surname><order>401</order></author><author><firstname>Stephen</firstname><surname>Bonner</surname><order>402</order></author><author><firstname>Sarah</firstname><surname>Essex</surname><order>403</order></author><author><firstname>Ronan A</firstname><surname>Lyons</surname><order>404</order></author><author><firstname>Kordo</firstname><surname>Saeed</surname><order>405</order></author><author><firstname>Adhyana I.K</firstname><surname>Mahanama</surname><order>406</order></author><author><firstname>Buddhini</firstname><surname>Samaraweera</surname><order>407</order></author><author><firstname>Siona</firstname><surname>Silveira</surname><order>408</order></author><author><firstname>Emanuela</firstname><surname>Pelosi</surname><order>409</order></author><author><firstname>Eleri</firstname><surname>Wilson-Davies</surname><order>410</order></author><author><firstname>Rachel J</firstname><surname>Williams</surname><order>411</order></author><author><firstname>Mark</firstname><surname>Kristiansen</surname><order>412</order></author><author><firstname>Sunando</firstname><surname>Roy</surname><order>413</order></author><author><firstname>Charlotte A</firstname><surname>Williams</surname><order>414</order></author><author><firstname>Marius</firstname><surname>Cotic</surname><order>415</order></author><author><firstname>Nadua</firstname><surname>Bayzid</surname><order>416</order></author><author><firstname>Adam P</firstname><surname>Westhorpe</surname><order>417</order></author><author><firstname>John A</firstname><surname>Hartley</surname><order>418</order></author><author><firstname>Riaz</firstname><surname>Jannoo</surname><order>419</order></author><author><firstname>Helen L</firstname><surname>Lowe</surname><order>420</order></author><author><firstname>Angeliki</firstname><surname>Karamani</surname><order>421</order></author><author><firstname>Leah</firstname><surname>Ensell</surname><order>422</order></author><author><firstname>Jacqui A</firstname><surname>Prieto</surname><order>423</order></author><author><firstname>Sarah</firstname><surname>Jeremiah</surname><order>424</order></author><author><firstname>Dimitris</firstname><surname>Grammatopoulos</surname><order>425</order></author><author><firstname>Sarojini</firstname><surname>Pandey</surname><order>426</order></author><author><firstname>Lisa</firstname><surname>Berry</surname><order>427</order></author><author><firstname>Katie</firstname><surname>Jones</surname><order>428</order></author><author><firstname>Alex</firstname><surname>Richter</surname><order>429</order></author><author><firstname>Andrew</firstname><surname>Beggs</surname><order>430</order></author><author><firstname>Angus</firstname><surname>Best</surname><order>431</order></author><author><firstname>Benita</firstname><surname>Percival</surname><order>432</order></author><author><firstname>Jeremy</firstname><surname>Mirza</surname><order>433</order></author><author><firstname>Oliver</firstname><surname>Megram</surname><order>434</order></author><author><firstname>Megan</firstname><surname>Mayhew</surname><order>435</order></author><author><firstname>Liam</firstname><surname>Crawford</surname><order>436</order></author><author><firstname>Fiona</firstname><surname>Ashcroft</surname><order>437</order></author><author><firstname>Emma</firstname><surname>Moles-Garcia</surname><order>438</order></author><author><firstname>Nicola</firstname><surname>Cumley</surname><order>439</order></author><author><firstname>Colin P</firstname><surname>Smith</surname><order>440</order></author><author><firstname>Giselda</firstname><surname>Bucca</surname><order>441</order></author><author><firstname>Andrew R</firstname><surname>Hesketh</surname><order>442</order></author><author><firstname>Beth</firstname><surname>Blane</surname><order>443</order></author><author><firstname>Sophia T</firstname><surname>Girgis</surname><order>444</order></author><author><firstname>Danielle</firstname><surname>Leek</surname><order>445</order></author><author><firstname>Sushmita</firstname><surname>Sridhar</surname><order>446</order></author><author><firstname>Sally</firstname><surname>Forrest</surname><order>447</order></author><author><firstname>Claire</firstname><surname>Cormie</surname><order>448</order></author><author><firstname>Harmeet K</firstname><surname>Gill</surname><order>449</order></author><author><firstname>Joana</firstname><surname>Dias</surname><order>450</order></author><author><firstname>Ellen E</firstname><surname>Higginson</surname><order>451</order></author><author><firstname>Mailis</firstname><surname>Maes</surname><order>452</order></author><author><firstname>Jamie</firstname><surname>Young</surname><order>453</order></author><author><firstname>Leanne M</firstname><surname>Kermack</surname><order>454</order></author><author><firstname>Ravi Kumar</firstname><surname>Gupta</surname><order>455</order></author><author><firstname>Catherine</firstname><surname>Ludden</surname><order>456</order></author><author><firstname>Sharon J</firstname><surname>Peacock</surname><order>457</order></author><author><firstname>Sophie</firstname><surname>Palmer</surname><order>458</order></author><author><firstname>Carol M</firstname><surname>Churcher</surname><order>459</order></author><author><firstname>Nazreen F</firstname><surname>Hadjirin</surname><order>460</order></author><author><firstname>Alessandro M</firstname><surname>Carabelli</surname><order>461</order></author><author><firstname>Ellena</firstname><surname>Brooks</surname><order>462</order></author><author><firstname>Kim S</firstname><surname>Smith</surname><order>463</order></author><author><firstname>Katerina</firstname><surname>Galai</surname><order>464</order></author><author><firstname>Georgina M</firstname><surname>McManus</surname><order>465</order></author><author><firstname>Chris</firstname><surname>Ruis</surname><order>466</order></author><author><firstname>Rose K</firstname><surname>Davidson</surname><order>467</order></author><author><firstname>Andrew</firstname><surname>Rambaut</surname><order>468</order></author><author><firstname>Thomas</firstname><surname>Williams</surname><order>469</order></author><author><firstname>Carlos E</firstname><surname>Balcazar</surname><order>470</order></author><author><firstname>Michael D</firstname><surname>Gallagher</surname><order>471</order></author><author><firstname>Áine</firstname><surname>O'Toole</surname><order>472</order></author><author><firstname>Stefan</firstname><surname>Rooke</surname><order>473</order></author><author><firstname>Verity</firstname><surname>Hill</surname><order>474</order></author><author><firstname>Kathleen A</firstname><surname>Williamson</surname><order>475</order></author><author><firstname>Thomas D</firstname><surname>Stanton</surname><order>476</order></author><author><firstname>Stephen L</firstname><surname>Michell</surname><order>477</order></author><author><firstname>Claire M</firstname><surname>Bewshea</surname><order>478</order></author><author><firstname>Ben</firstname><surname>Temperton</surname><order>479</order></author><author><firstname>Michelle L</firstname><surname>Michelsen</surname><order>480</order></author><author><firstname>Joanna</firstname><surname>Warwick-Dugdale</surname><order>481</order></author><author><firstname>Robin</firstname><surname>Manley</surname><order>482</order></author><author><firstname>Audrey</firstname><surname>Farbos</surname><order>483</order></author><author><firstname>James W</firstname><surname>Harrison</surname><order>484</order></author><author><firstname>Christine M</firstname><surname>Sambles</surname><order>485</order></author><author><firstname>David J</firstname><surname>Studholme</surname><order>486</order></author><author><firstname>Aaron R</firstname><surname>Jeffries</surname><order>487</order></author><author><firstname>Alistair C</firstname><surname>Darby</surname><order>488</order></author><author><firstname>Julian A</firstname><surname>Hiscox</surname><order>489</order></author><author><firstname>Steve</firstname><surname>Paterson</surname><order>490</order></author><author><firstname>Miren</firstname><surname>Iturriza-Gomara</surname><order>491</order></author><author><firstname>Kathryn A</firstname><surname>Jackson</surname><order>492</order></author><author><firstname>Anita O</firstname><surname>Lucaci</surname><order>493</order></author><author><firstname>Edith E</firstname><surname>Vamos</surname><order>494</order></author><author><firstname>Margaret</firstname><surname>Hughes</surname><order>495</order></author><author><firstname>Lucille</firstname><surname>Rainbow</surname><order>496</order></author><author><firstname>Richard</firstname><surname>Eccles</surname><order>497</order></author><author><firstname>Charlotte</firstname><surname>Nelson</surname><order>498</order></author><author><firstname>Mark</firstname><surname>Whitehead</surname><order>499</order></author><author><firstname>Lance</firstname><surname>Turtle</surname><order>500</order></author><author><firstname>Sam T</firstname><surname>Haldenby</surname><order>501</order></author><author><firstname>Richard</firstname><surname>Gregory</surname><order>502</order></author><author><firstname>Matthew</firstname><surname>Gemmell</surname><order>503</order></author><author><firstname>Claudia</firstname><surname>Wierzbicki</surname><order>504</order></author><author><firstname>Hermione J</firstname><surname>Webster</surname><order>505</order></author><author><firstname>Thushan I de</firstname><surname>Silva</surname><order>506</order></author><author><firstname>Nikki</firstname><surname>Smith</surname><order>507</order></author><author><firstname>Adrienn</firstname><surname>Angyal</surname><order>508</order></author><author><firstname>Benjamin B</firstname><surname>Lindsey</surname><order>509</order></author><author><firstname>Danielle C</firstname><surname>Groves</surname><order>510</order></author><author><firstname>Luke R</firstname><surname>Green</surname><order>511</order></author><author><firstname>Dennis</firstname><surname>Wang</surname><order>512</order></author><author><firstname>Timothy M</firstname><surname>Freeman</surname><order>513</order></author><author><firstname>Matthew D</firstname><surname>Parker</surname><order>514</order></author><author><firstname>Alexander J</firstname><surname>Keeley</surname><order>515</order></author><author><firstname>Paul J</firstname><surname>Parsons</surname><order>516</order></author><author><firstname>Rachel M</firstname><surname>Tucker</surname><order>517</order></author><author><firstname>Rebecca</firstname><surname>Brown</surname><order>518</order></author><author><firstname>Matthew</firstname><surname>Wyles</surname><order>519</order></author><author><firstname>Max</firstname><surname>Whiteley</surname><order>520</order></author><author><firstname>Peijun</firstname><surname>Zhang</surname><order>521</order></author><author><firstname>Marta</firstname><surname>Gallis</surname><order>522</order></author><author><firstname>Stavroula F</firstname><surname>Louka</surname><order>523</order></author><author><firstname>Chrystala</firstname><surname>Constantinidou</surname><order>524</order></author><author><firstname>Meera</firstname><surname>Unnikrishnan</surname><order>525</order></author><author><firstname>Sascha</firstname><surname>Ott</surname><order>526</order></author><author><firstname>Jeffrey K.J.</firstname><surname>Cheng</surname><order>527</order></author><author><firstname>Hannah E.</firstname><surname>Bridgewater</surname><order>528</order></author><author><firstname>Lucy R.</firstname><surname>Frost</surname><order>529</order></author><author><firstname>Grace</firstname><surname>Taylor-Joyce</surname><order>530</order></author><author><firstname>Richard</firstname><surname>Stark</surname><order>531</order></author><author><firstname>Laura</firstname><surname>Baxter</surname><order>532</order></author><author><firstname>Mohammad T.</firstname><surname>Alam</surname><order>533</order></author><author><firstname>Paul E</firstname><surname>Brown</surname><order>534</order></author><author><firstname>Dinesh</firstname><surname>Aggarwal</surname><order>535</order></author><author><firstname>Alberto C</firstname><surname>Cerda</surname><order>536</order></author><author><firstname>Tammy V</firstname><surname>Merrill</surname><order>537</order></author><author><firstname>Rebekah E</firstname><surname>Wilson</surname><order>538</order></author><author><firstname>Patrick C</firstname><surname>McClure</surname><order>539</order></author><author><firstname>Joseph G</firstname><surname>Chappell</surname><order>540</order></author><author><firstname>Theocharis</firstname><surname>Tsoleridis</surname><order>541</order></author><author><firstname>Jonathan</firstname><surname>Ball</surname><order>542</order></author><author><firstname>David</firstname><surname>Buck</surname><order>543</order></author><author><firstname>John A</firstname><surname>Todd</surname><order>544</order></author><author><firstname>Angie</firstname><surname>Green</surname><order>545</order></author><author><firstname>Amy</firstname><surname>Trebes</surname><order>546</order></author><author><firstname>George</firstname><surname>MacIntyre-Cockett</surname><order>547</order></author><author><firstname>Mariateresa de</firstname><surname>Cesare</surname><order>548</order></author><author><firstname>Alex</firstname><surname>Alderton</surname><order>549</order></author><author><firstname>Roberto</firstname><surname>Amato</surname><order>550</order></author><author><firstname>Cristina V</firstname><surname>Ariani</surname><order>551</order></author><author><firstname>Mathew A</firstname><surname>Beale</surname><order>552</order></author><author><firstname>Charlotte</firstname><surname>Beaver</surname><order>553</order></author><author><firstname>Katherine 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v2 66442 2024-05-15 Changes in symptomatology, reinfection, and transmissibility associated with the SARS-CoV-2 variant B.1.1.7: an ecological study 83efcf2a9dfcf8b55586999d3d152ac6 0000-0001-5225-000X Ronan Lyons Ronan Lyons true false 2024-05-15 MEDS BackgroundThe SARS-CoV-2 variant B.1.1.7 was first identified in December, 2020, in England. We aimed to investigate whether increases in the proportion of infections with this variant are associated with differences in symptoms or disease course, reinfection rates, or transmissibility.MethodsWe did an ecological study to examine the association between the regional proportion of infections with the SARS-CoV-2 B.1.1.7 variant and reported symptoms, disease course, rates of reinfection, and transmissibility. Data on types and duration of symptoms were obtained from longitudinal reports from users of the COVID Symptom Study app who reported a positive test for COVID-19 between Sept 28 and Dec 27, 2020 (during which the prevalence of B.1.1.7 increased most notably in parts of the UK). From this dataset, we also estimated the frequency of possible reinfection, defined as the presence of two reported positive tests separated by more than 90 days with a period of reporting no symptoms for more than 7 days before the second positive test. The proportion of SARS-CoV-2 infections with the B.1.1.7 variant across the UK was estimated with use of genomic data from the COVID-19 Genomics UK Consortium and data from Public Health England on spike-gene target failure (a non-specific indicator of the B.1.1.7 variant) in community cases in England. We used linear regression to examine the association between reported symptoms and proportion of B.1.1.7. We assessed the Spearman correlation between the proportion of B.1.1.7 cases and number of reinfections over time, and between the number of positive tests and reinfections. We estimated incidence for B.1.1.7 and previous variants, and compared the effective reproduction number, Rt, for the two incidence estimates.FindingsFrom Sept 28 to Dec 27, 2020, positive COVID-19 tests were reported by 36 920 COVID Symptom Study app users whose region was known and who reported as healthy on app sign-up. We found no changes in reported symptoms or disease duration associated with B.1.1.7. For the same period, possible reinfections were identified in 249 (0·7% [95% CI 0·6–0·8]) of 36 509 app users who reported a positive swab test before Oct 1, 2020, but there was no evidence that the frequency of reinfections was higher for the B.1.1.7 variant than for pre-existing variants. Reinfection occurrences were more positively correlated with the overall regional rise in cases (Spearman correlation 0·56–0·69 for South East, London, and East of England) than with the regional increase in the proportion of infections with the B.1.1.7 variant (Spearman correlation 0·38–0·56 in the same regions), suggesting B.1.1.7 does not substantially alter the risk of reinfection. We found a multiplicative increase in the Rt of B.1.1.7 by a factor of 1·35 (95% CI 1·02–1·69) relative to pre-existing variants. However, Rt fell below 1 during regional and national lockdowns, even in regions with high proportions of infections with the B.1.1.7 variant.InterpretationThe lack of change in symptoms identified in this study indicates that existing testing and surveillance infrastructure do not need to change specifically for the B.1.1.7 variant. In addition, given that there was no apparent increase in the reinfection rate, vaccines are likely to remain effective against the B.1.1.7 variant. Journal Article The Lancet Public Health 6 5 e335 e345 Elsevier BV 2468-2667 1 5 2021 2021-05-01 10.1016/s2468-2667(21)00055-4 COLLEGE NANME Medical School COLLEGE CODE MEDS Swansea University Zoe Global, Department of Health (UK), Wellcome Trust, Engineering and Physical Sciences Research Council (UK), National Institute for Health Research (UK), Medical Research Council (UK), Alzheimer's Society. 2024-06-24T14:13:30.3075317 2024-05-15T11:39:40.6575732 Faculty of Medicine, Health and Life Sciences Swansea University Medical School - Health Data Science Mark S Graham 1 Carole H Sudre 2 Anna May 3 Michela Antonelli 4 Benjamin Murray 5 Thomas Varsavsky 6 Kerstin Kläser 7 Liane S Canas 8 Erika Molteni 9 Marc Modat 10 David A Drew 11 Long H Nguyen 12 Lorenzo Polidori 13 Somesh Selvachandran 14 Christina Hu 15 Joan Capdevila 16 Alexander Hammers 17 Andrew T Chan 18 Jonathan Wolf 19 Tim D Spector 20 Claire J Steves 21 Sebastien Ourselin 22 Cherian Koshy 23 Amy Ash 24 Emma Wise 25 Nathan Moore 26 Matilde Mori 27 Nick Cortes 28 Jessica Lynch 29 Stephen Kidd 30 Derek J Fairley 31 Tanya Curran 32 James P McKenna 33 Helen Adams 34 Christophe Fraser 35 Tanya Golubchik 36 David Bonsall 37 Mohammed O Hassan-Ibrahim 38 Cassandra S Malone 39 Benjamin J Cogger 40 Michelle Wantoch 41 Nicola Reynolds 42 Ben Warne 43 Joshua Maksimovic 44 Karla Spellman 45 Kathryn McCluggage 46 Michaela John 47 Robert Beer 48 Safiah Afifi 49 Sian Morgan 50 Angela Marchbank 51 Anna Price 52 Christine Kitchen 53 Huw Gulliver 54 Ian Merrick 55 Joel Southgate 56 Martyn Guest 57 Robert Munn 58 Trudy Workman 59 Thomas R Connor 60 William Fuller 61 Catherine Bresner 62 Luke B Snell 63 Amita Patel 64 Themoula Charalampous 65 Gaia Nebbia 66 Rahul Batra 67 Jonathan Edgeworth 68 Samuel C Robson 69 Angela H Beckett 70 David M Aanensen 71 Anthony P Underwood 72 Corin A Yeats 73 Khalil Abudahab 74 Ben EW Taylor 75 Mirko Menegazzo 76 Gemma Clark 77 Wendy Smith 78 Manjinder Khakh 79 Vicki M Fleming 80 Michelle M Lister 81 Hannah C Howson-Wells 82 Louise Berry 83 Tim Boswell 84 Amelia Joseph 85 Iona Willingham 86 Carl Jones 87 Christopher Holmes 88 Paul Bird 89 Thomas Helmer 90 Karlie Fallon 91 Julian Tang 92 Veena Raviprakash 93 Sharon Campbell 94 Nicola Sheriff 95 Victoria Blakey 96 Lesley-Anne Williams 97 Matthew W Loose 98 Nadine Holmes 99 Christopher Moore 100 Matthew Carlile 101 Victoria Wright 102 Fei Sang 103 Johnny Debebe 104 Francesc Coll 105 Adrian W Signell 106 Gilberto Betancor 107 Harry D Wilson 108 Sahar Eldirdiri 109 Anita Kenyon 110 Thomas Davis 111 Oliver G Pybus 112 Louis du Plessis 113 Alex E Zarebski 114 Jayna Raghwani 115 Moritz UG Kraemer 116 Sarah Francois 117 Stephen W Attwood 118 Tetyana I Vasylyeva 119 Marina Escalera Zamudio 120 Bernardo Gutierrez 121 M. Estee Torok 122 William L Hamilton 123 Ian G Goodfellow 124 Grant Hall 125 Aminu S Jahun 126 Yasmin Chaudhry 127 Myra Hosmillo 128 Malte L Pinckert 129 Iliana Georgana 130 Samuel Moses 131 Hannah Lowe 132 Luke Bedford 133 Jonathan Moore 134 Susanne Stonehouse 135 Chloe L Fisher 136 Ali R Awan 137 John BoYes 138 Judith Breuer 139 Kathryn Ann Harris 140 Julianne Rose Brown 141 Divya Shah 142 Laura Atkinson 143 Jack CD Lee 144 Nathaniel Storey 145 Flavia Flaviani 146 Adela Alcolea-Medina 147 Rebecca Williams 148 Gabrielle Vernet 149 Michael R Chapman 150 Lisa J Levett 151 Judith Heaney 152 Wendy Chatterton 153 Monika Pusok 154 Li Xu-McCrae 155 Darren L Smith 156 Matthew Bashton 157 Gregory R Young 158 Alison Holmes 159 Paul Anthony Randell 160 Alison Cox 161 Pinglawathee Madona 162 Frances Bolt 163 James Price 164 Siddharth Mookerjee 165 Manon Ragonnet-Cronin 166 Fabricia F. Nascimento 167 David Jorgensen 168 Igor Siveroni 169 Rob Johnson 170 Olivia Boyd 171 Lily Geidelberg 172 Erik M Volz 173 Aileen Rowan 174 Graham P Taylor 175 Katherine L Smollett 176 Nicholas J Loman 177 Joshua Quick 178 Claire McMurray 179 Joanne Stockton 180 Sam Nicholls 181 Will Rowe 182 Radoslaw Poplawski 183 Alan McNally 184 Rocio T Martinez Nunez 185 Jenifer Mason 186 Trevor I Robinson 187 Elaine O'Toole 188 Joanne Watts 189 Cassie Breen 190 Angela Cowell 191 Graciela Sluga 192 Nicholas W Machin 193 Shazaad S Y Ahmad 194 Ryan P George 195 Fenella Halstead 196 Venkat Sivaprakasam 197 Wendy Hogsden 198 Chris J Illingworth 199 Chris Jackson 200 Emma C Thomson 201 James G Shepherd 202 Patawee Asamaphan 203 Marc O Niebel 204 Kathy K Li 205 Rajiv N Shah 206 Natasha G Jesudason 207 Lily Tong 208 Alice Broos 209 Daniel Mair 210 Jenna Nichols 211 Stephen N Carmichael 212 Kyriaki Nomikou 213 Elihu Aranday-Cortes 214 Natasha Johnson 215 Igor Starinskij 216 Ana da Silva Filipe 217 David L Robertson 218 Richard J Orton 219 Joseph Hughes 220 Sreenu Vattipally 221 Joshua B Singer 222 Seema Nickbakhsh 223 Antony D Hale 224 Louissa R Macfarlane-Smith 225 Katherine L Harper 226 Holli Carden 227 Yusri Taha 228 Brendan AI Payne 229 Shirelle Burton-Fanning 230 Sheila Waugh 231 Jennifer Collins 232 Gary Eltringham 233 Steven Rushton 234 Sarah O'Brien 235 Amanda Bradley 236 Alasdair Maclean 237 Guy Mollett 238 Rachel Blacow 239 Kate E Templeton 240 Martin P McHugh 241 Rebecca Dewar 242 Elizabeth Wastenge 243 Samir Dervisevic 244 Rachael Stanley 245 Emma J Meader 246 Lindsay Coupland 247 Louise Smith 248 Clive Graham 249 Edward Barton 250 Debra Padgett 251 Garren Scott 252 Emma Swindells 253 Jane Greenaway 254 Andrew Nelson 255 Clare M McCann 256 Wen C Yew 257 Monique Andersson 258 Timothy Peto 259 Anita Justice 260 David Eyre 261 Derrick Crook 262 Tim J Sloan 263 Nichola Duckworth 264 Sarah Walsh 265 Anoop J Chauhan 266 Sharon Glaysher 267 Kelly Bicknell 268 Sarah Wyllie 269 Scott Elliott 270 Allyson Lloyd 271 Robert Impey 272 Nick Levene 273 Lynn Monaghan 274 Declan T Bradley 275 Tim Wyatt 276 Elias Allara 277 Clare Pearson 278 Husam Osman 279 Andrew Bosworth 280 Esther Robinson 281 Peter Muir 282 Ian B Vipond 283 Richard Hopes 284 Hannah M Pymont 285 Stephanie Hutchings 286 Martin D Curran 287 Surendra Parmar 288 Angie Lackenby 289 Tamyo Mbisa 290 Steven Platt 291 Shahjahan Miah 292 David Bibby 293 Carmen Manso 294 Jonathan Hubb 295 Meera Chand 296 Gavin Dabrera 297 Mary Ramsay 298 Daniel Bradshaw 299 Alicia Thornton 300 Richard Myers 301 Ulf Schaefer 302 Natalie Groves 303 Eileen Gallagher 304 David Lee 305 David Williams 306 Nicholas Ellaby 307 Ian Harrison 308 Hassan Hartman 309 Nikos Manesis 310 Vineet Patel 311 Chloe Bishop 312 Vicki Chalker 313 Juan Ledesma 314 Katherine A Twohig 315 Matthew T.G. Holden 316 Sharif Shaaban 317 Alec Birchley 318 Alexander Adams 319 Alisha Davies 320 Amy Gaskin 321 Amy Plimmer 322 Bree Gatica-Wilcox 323 Caoimhe McKerr 324 Catherine Moore 325 Chris Williams 326 David Heyburn 327 Elen De Lacy 328 Ember Hilvers 329 Fatima Downing 330 Giri Shankar 331 Hannah Jones 332 Hibo Asad 333 Jason Coombes 334 Joanne Watkins 335 Johnathan M Evans 336 Laia Fina 337 Laura Gifford 338 Lauren Gilbert 339 Lee Graham 340 Malorie Perry 341 Mari Morgan 342 Matthew Bull 343 Michelle Cronin 344 Nicole Pacchiarini 345 Noel Craine 346 Rachel Jones 347 Robin Howe 348 Sally Corden 349 Sara Rey 350 Sara Kumziene-SummerhaYes 351 Sarah Taylor 352 Simon Cottrell 353 Sophie Jones 354 Sue Edwards 355 Justin O'Grady 356 Andrew J Page 357 Alison E Mather 358 David J Baker 359 Steven Rudder 360 Alp Aydin 361 Gemma L Kay 362 Alexander J Trotter 363 Nabil-Fareed Alikhan 364 Leonardo de Oliveira Martins 365 Thanh Le-Viet 366 Lizzie Meadows 367 Anna Casey 368 Liz Ratcliffe 369 David A Simpson 370 Zoltan Molnar 371 Thomas Thompson 372 Erwan Acheson 373 Jane AH Masoli 374 Bridget A Knight 375 Sian Ellard 376 Cressida Auckland 377 Christopher R Jones 378 Tabitha W Mahungu 379 Dianne Irish-Tavares 380 Tanzina Haque 381 Jennifer Hart 382 Eric Witele 383 Melisa Louise Fenton 384 Ashok Dadrah 385 Amanda Symmonds 386 Tranprit Saluja 387 Yann Bourgeois 388 Garry P Scarlett 389 Katie F Loveson 390 Salman Goudarzi 391 Christopher Fearn 392 Kate Cook 393 Hannah Dent 394 Hannah Paul 395 David G Partridge 396 Mohammad Raza 397 Cariad Evans 398 Kate Johnson 399 Steven Liggett 400 Paul Baker 401 Stephen Bonner 402 Sarah Essex 403 Ronan A Lyons 404 Kordo Saeed 405 Adhyana I.K Mahanama 406 Buddhini Samaraweera 407 Siona Silveira 408 Emanuela Pelosi 409 Eleri Wilson-Davies 410 Rachel J Williams 411 Mark Kristiansen 412 Sunando Roy 413 Charlotte A Williams 414 Marius Cotic 415 Nadua Bayzid 416 Adam P Westhorpe 417 John A Hartley 418 Riaz Jannoo 419 Helen L Lowe 420 Angeliki Karamani 421 Leah Ensell 422 Jacqui A Prieto 423 Sarah Jeremiah 424 Dimitris Grammatopoulos 425 Sarojini Pandey 426 Lisa Berry 427 Katie Jones 428 Alex Richter 429 Andrew Beggs 430 Angus Best 431 Benita Percival 432 Jeremy Mirza 433 Oliver Megram 434 Megan Mayhew 435 Liam Crawford 436 Fiona Ashcroft 437 Emma Moles-Garcia 438 Nicola Cumley 439 Colin P Smith 440 Giselda Bucca 441 Andrew R Hesketh 442 Beth Blane 443 Sophia T Girgis 444 Danielle Leek 445 Sushmita Sridhar 446 Sally Forrest 447 Claire Cormie 448 Harmeet K Gill 449 Joana Dias 450 Ellen E Higginson 451 Mailis Maes 452 Jamie Young 453 Leanne M Kermack 454 Ravi Kumar Gupta 455 Catherine Ludden 456 Sharon J Peacock 457 Sophie Palmer 458 Carol M Churcher 459 Nazreen F Hadjirin 460 Alessandro M Carabelli 461 Ellena Brooks 462 Kim S Smith 463 Katerina Galai 464 Georgina M McManus 465 Chris Ruis 466 Rose K Davidson 467 Andrew Rambaut 468 Thomas Williams 469 Carlos E Balcazar 470 Michael D Gallagher 471 Áine O'Toole 472 Stefan Rooke 473 Verity Hill 474 Kathleen A Williamson 475 Thomas D Stanton 476 Stephen L Michell 477 Claire M Bewshea 478 Ben Temperton 479 Michelle L Michelsen 480 Joanna Warwick-Dugdale 481 Robin Manley 482 Audrey Farbos 483 James W Harrison 484 Christine M Sambles 485 David J Studholme 486 Aaron R Jeffries 487 Alistair C Darby 488 Julian A Hiscox 489 Steve Paterson 490 Miren Iturriza-Gomara 491 Kathryn A Jackson 492 Anita O Lucaci 493 Edith E Vamos 494 Margaret Hughes 495 Lucille Rainbow 496 Richard Eccles 497 Charlotte Nelson 498 Mark Whitehead 499 Lance Turtle 500 Sam T Haldenby 501 Richard Gregory 502 Matthew Gemmell 503 Claudia Wierzbicki 504 Hermione J Webster 505 Thushan I de Silva 506 Nikki Smith 507 Adrienn Angyal 508 Benjamin B Lindsey 509 Danielle C Groves 510 Luke R Green 511 Dennis Wang 512 Timothy M Freeman 513 Matthew D Parker 514 Alexander J Keeley 515 Paul J Parsons 516 Rachel M Tucker 517 Rebecca Brown 518 Matthew Wyles 519 Max Whiteley 520 Peijun Zhang 521 Marta Gallis 522 Stavroula F Louka 523 Chrystala Constantinidou 524 Meera Unnikrishnan 525 Sascha Ott 526 Jeffrey K.J. Cheng 527 Hannah E. Bridgewater 528 Lucy R. Frost 529 Grace Taylor-Joyce 530 Richard Stark 531 Laura Baxter 532 Mohammad T. Alam 533 Paul E Brown 534 Dinesh Aggarwal 535 Alberto C Cerda 536 Tammy V Merrill 537 Rebekah E Wilson 538 Patrick C McClure 539 Joseph G Chappell 540 Theocharis Tsoleridis 541 Jonathan Ball 542 David Buck 543 John A Todd 544 Angie Green 545 Amy Trebes 546 George MacIntyre-Cockett 547 Mariateresa de Cesare 548 Alex Alderton 549 Roberto Amato 550 Cristina V Ariani 551 Mathew A Beale 552 Charlotte Beaver 553 Katherine L Bellis 554 Emma Betteridge 555 James Bonfield 556 John Danesh 557 Matthew J Dorman 558 Eleanor Drury 559 Ben W Farr 560 Luke Foulser 561 Sonia Goncalves 562 Scott Goodwin 563 Marina Gourtovaia 564 Ewan M Harrison 565 David K Jackson 566 Dorota Jamrozy 567 Ian Johnston 568 Leanne Kane 569 Sally Kay 570 Jon-Paul Keatley 571 Dominic Kwiatkowski 572 Cordelia F Langford 573 Mara Lawniczak 574 Laura Letchford 575 Rich Livett 576 Stephanie Lo 577 Inigo Martincorena 578 Samantha McGuigan 579 Rachel Nelson 580 Steve Palmer 581 Naomi R Park 582 Minal Patel 583 Liam Prestwood 584 Christoph Puethe 585 Michael A Quail 586 Shavanthi Rajatileka 587 Carol Scott 588 Lesley Shirley 589 John Sillitoe 590 Michael H Spencer Chapman 591 Scott AJ Thurston 592 Gerry Tonkin-Hill 593 Danni Weldon 594 Diana Rajan 595 Iraad F Bronner 596 Louise Aigrain 597 Nicholas M Redshaw 598 Stefanie V Lensing 599 Robert Davies 600 Andrew Whitwham 601 Jennifier Liddle 602 Kevin Lewis 603 Jaime M Tovar-Corona 604 Steven Leonard 605 Jillian Durham 606 Andrew R Bassett 607 Shane McCarthy 608 Robin J Moll 609 Keith James 610 Karen Oliver 611 Alex Makunin 612 Jeff Barrett 613 Rory N Gunson 614 Ronan Lyons 0000-0001-5225-000X 615 66442__30380__518ed58500014f57b76ead7c537a8a70.pdf 66442.pdf 2024-05-15T11:41:38.0016880 Output 1025617 application/pdf Version of Record true This is an Open Access article under the CC BY 4·0 license. true eng https://creativecommons.org/licenses/by/4.0/ |
| title |
Changes in symptomatology, reinfection, and transmissibility associated with the SARS-CoV-2 variant B.1.1.7: an ecological study |
| spellingShingle |
Changes in symptomatology, reinfection, and transmissibility associated with the SARS-CoV-2 variant B.1.1.7: an ecological study Ronan Lyons |
| title_short |
Changes in symptomatology, reinfection, and transmissibility associated with the SARS-CoV-2 variant B.1.1.7: an ecological study |
| title_full |
Changes in symptomatology, reinfection, and transmissibility associated with the SARS-CoV-2 variant B.1.1.7: an ecological study |
| title_fullStr |
Changes in symptomatology, reinfection, and transmissibility associated with the SARS-CoV-2 variant B.1.1.7: an ecological study |
| title_full_unstemmed |
Changes in symptomatology, reinfection, and transmissibility associated with the SARS-CoV-2 variant B.1.1.7: an ecological study |
| title_sort |
Changes in symptomatology, reinfection, and transmissibility associated with the SARS-CoV-2 variant B.1.1.7: an ecological study |
| author_id_str_mv |
83efcf2a9dfcf8b55586999d3d152ac6 |
| author_id_fullname_str_mv |
83efcf2a9dfcf8b55586999d3d152ac6_***_Ronan Lyons |
| author |
Ronan Lyons |
| author2 |
Mark S Graham Carole H Sudre Anna May Michela Antonelli Benjamin Murray Thomas Varsavsky Kerstin Kläser Liane S Canas Erika Molteni Marc Modat David A Drew Long H Nguyen Lorenzo Polidori Somesh Selvachandran Christina Hu Joan Capdevila Alexander Hammers Andrew T Chan Jonathan Wolf Tim D Spector Claire J Steves Sebastien Ourselin Cherian Koshy Amy Ash Emma Wise Nathan Moore Matilde Mori Nick Cortes Jessica Lynch Stephen Kidd Derek J Fairley Tanya Curran James P McKenna Helen Adams Christophe Fraser Tanya Golubchik David Bonsall Mohammed O Hassan-Ibrahim Cassandra S Malone Benjamin J Cogger Michelle Wantoch Nicola Reynolds Ben Warne Joshua Maksimovic Karla Spellman Kathryn McCluggage Michaela John Robert Beer Safiah Afifi Sian Morgan Angela Marchbank Anna Price Christine Kitchen Huw Gulliver Ian Merrick Joel Southgate Martyn Guest Robert Munn Trudy Workman Thomas R Connor William Fuller Catherine Bresner Luke B Snell Amita Patel Themoula Charalampous Gaia Nebbia Rahul Batra Jonathan Edgeworth Samuel C Robson Angela H Beckett David M Aanensen Anthony P Underwood Corin A Yeats Khalil Abudahab Ben EW Taylor Mirko Menegazzo Gemma Clark Wendy Smith Manjinder Khakh Vicki M Fleming Michelle M Lister Hannah C Howson-Wells Louise Berry Tim Boswell Amelia Joseph Iona Willingham Carl Jones Christopher Holmes Paul Bird Thomas Helmer Karlie Fallon Julian Tang Veena Raviprakash Sharon Campbell Nicola Sheriff Victoria Blakey Lesley-Anne Williams Matthew W Loose Nadine Holmes Christopher Moore Matthew Carlile Victoria Wright Fei Sang Johnny Debebe Francesc Coll Adrian W Signell Gilberto Betancor Harry D Wilson Sahar Eldirdiri Anita Kenyon Thomas Davis Oliver G Pybus Louis du Plessis Alex E Zarebski Jayna Raghwani Moritz UG Kraemer Sarah Francois Stephen W Attwood Tetyana I Vasylyeva Marina Escalera Zamudio Bernardo Gutierrez M. Estee Torok William L Hamilton Ian G Goodfellow Grant Hall Aminu S Jahun Yasmin Chaudhry Myra Hosmillo Malte L Pinckert Iliana Georgana Samuel Moses Hannah Lowe Luke Bedford Jonathan Moore Susanne Stonehouse Chloe L Fisher Ali R Awan John BoYes Judith Breuer Kathryn Ann Harris Julianne Rose Brown Divya Shah Laura Atkinson Jack CD Lee Nathaniel Storey Flavia Flaviani Adela Alcolea-Medina Rebecca Williams Gabrielle Vernet Michael R Chapman Lisa J Levett Judith Heaney Wendy Chatterton Monika Pusok Li Xu-McCrae Darren L Smith Matthew Bashton Gregory R Young Alison Holmes Paul Anthony Randell Alison Cox Pinglawathee Madona Frances Bolt James Price Siddharth Mookerjee Manon Ragonnet-Cronin Fabricia F. Nascimento David Jorgensen Igor Siveroni Rob Johnson Olivia Boyd Lily Geidelberg Erik M Volz Aileen Rowan Graham P Taylor Katherine L Smollett Nicholas J Loman Joshua Quick Claire McMurray Joanne Stockton Sam Nicholls Will Rowe Radoslaw Poplawski Alan McNally Rocio T Martinez Nunez Jenifer Mason Trevor I Robinson Elaine O'Toole Joanne Watts Cassie Breen Angela Cowell Graciela Sluga Nicholas W Machin Shazaad S Y Ahmad Ryan P George Fenella Halstead Venkat Sivaprakasam Wendy Hogsden Chris J Illingworth Chris Jackson Emma C Thomson James G Shepherd Patawee Asamaphan Marc O Niebel Kathy K Li Rajiv N Shah Natasha G Jesudason Lily Tong Alice Broos Daniel Mair Jenna Nichols Stephen N Carmichael Kyriaki Nomikou Elihu Aranday-Cortes Natasha Johnson Igor Starinskij Ana da Silva Filipe David L Robertson Richard J Orton Joseph Hughes Sreenu Vattipally Joshua B Singer Seema Nickbakhsh Antony D Hale Louissa R Macfarlane-Smith Katherine L Harper Holli Carden Yusri Taha Brendan AI Payne Shirelle Burton-Fanning Sheila Waugh Jennifer Collins Gary Eltringham Steven Rushton Sarah O'Brien Amanda Bradley Alasdair Maclean Guy Mollett Rachel Blacow Kate E Templeton Martin P McHugh Rebecca Dewar Elizabeth Wastenge Samir Dervisevic Rachael Stanley Emma J Meader Lindsay Coupland Louise Smith Clive Graham Edward Barton Debra Padgett Garren Scott Emma Swindells Jane Greenaway Andrew Nelson Clare M McCann Wen C Yew Monique Andersson Timothy Peto Anita Justice David Eyre Derrick Crook Tim J Sloan Nichola Duckworth Sarah Walsh Anoop J Chauhan Sharon Glaysher Kelly Bicknell Sarah Wyllie Scott Elliott Allyson Lloyd Robert Impey Nick Levene Lynn Monaghan Declan T Bradley Tim Wyatt Elias Allara Clare Pearson Husam Osman Andrew Bosworth Esther Robinson Peter Muir Ian B Vipond Richard Hopes Hannah M Pymont Stephanie Hutchings Martin D Curran Surendra Parmar Angie Lackenby Tamyo Mbisa Steven Platt Shahjahan Miah David Bibby Carmen Manso Jonathan Hubb Meera Chand Gavin Dabrera Mary Ramsay Daniel Bradshaw Alicia Thornton Richard Myers Ulf Schaefer Natalie Groves Eileen Gallagher David Lee David Williams Nicholas Ellaby Ian Harrison Hassan Hartman Nikos Manesis Vineet Patel Chloe Bishop Vicki Chalker Juan Ledesma Katherine A Twohig Matthew T.G. Holden Sharif Shaaban Alec Birchley Alexander Adams Alisha Davies Amy Gaskin Amy Plimmer Bree Gatica-Wilcox Caoimhe McKerr Catherine Moore Chris Williams David Heyburn Elen De Lacy Ember Hilvers Fatima Downing Giri Shankar Hannah Jones Hibo Asad Jason Coombes Joanne Watkins Johnathan M Evans Laia Fina Laura Gifford Lauren Gilbert Lee Graham Malorie Perry Mari Morgan Matthew Bull Michelle Cronin Nicole Pacchiarini Noel Craine Rachel Jones Robin Howe Sally Corden Sara Rey Sara Kumziene-SummerhaYes Sarah Taylor Simon Cottrell Sophie Jones Sue Edwards Justin O'Grady Andrew J Page Alison E Mather David J Baker Steven Rudder Alp Aydin Gemma L Kay Alexander J Trotter Nabil-Fareed Alikhan Leonardo de Oliveira Martins Thanh Le-Viet Lizzie Meadows Anna Casey Liz Ratcliffe David A Simpson Zoltan Molnar Thomas Thompson Erwan Acheson Jane AH Masoli Bridget A Knight Sian Ellard Cressida Auckland Christopher R Jones Tabitha W Mahungu Dianne Irish-Tavares Tanzina Haque Jennifer Hart Eric Witele Melisa Louise Fenton Ashok Dadrah Amanda Symmonds Tranprit Saluja Yann Bourgeois Garry P Scarlett Katie F Loveson Salman Goudarzi Christopher Fearn Kate Cook Hannah Dent Hannah Paul David G Partridge Mohammad Raza Cariad Evans Kate Johnson Steven Liggett Paul Baker Stephen Bonner Sarah Essex Ronan A Lyons Kordo Saeed Adhyana I.K Mahanama Buddhini Samaraweera Siona Silveira Emanuela Pelosi Eleri Wilson-Davies Rachel J Williams Mark Kristiansen Sunando Roy Charlotte A Williams Marius Cotic Nadua Bayzid Adam P Westhorpe John A Hartley Riaz Jannoo Helen L Lowe Angeliki Karamani Leah Ensell Jacqui A Prieto Sarah Jeremiah Dimitris Grammatopoulos Sarojini Pandey Lisa Berry Katie Jones Alex Richter Andrew Beggs Angus Best Benita Percival Jeremy Mirza Oliver Megram Megan Mayhew Liam Crawford Fiona Ashcroft Emma Moles-Garcia Nicola Cumley Colin P Smith Giselda Bucca Andrew R Hesketh Beth Blane Sophia T Girgis Danielle Leek Sushmita Sridhar Sally Forrest Claire Cormie Harmeet K Gill Joana Dias Ellen E Higginson Mailis Maes Jamie Young Leanne M Kermack Ravi Kumar Gupta Catherine Ludden Sharon J Peacock Sophie Palmer Carol M Churcher Nazreen F Hadjirin Alessandro M Carabelli Ellena Brooks Kim S Smith Katerina Galai Georgina M McManus Chris Ruis Rose K Davidson Andrew Rambaut Thomas Williams Carlos E Balcazar Michael D Gallagher Áine O'Toole Stefan Rooke Verity Hill Kathleen A Williamson Thomas D Stanton Stephen L Michell Claire M Bewshea Ben Temperton Michelle L Michelsen Joanna Warwick-Dugdale Robin Manley Audrey Farbos James W Harrison Christine M Sambles David J Studholme Aaron R Jeffries Alistair C Darby Julian A Hiscox Steve Paterson Miren Iturriza-Gomara Kathryn A Jackson Anita O Lucaci Edith E Vamos Margaret Hughes Lucille Rainbow Richard Eccles Charlotte Nelson Mark Whitehead Lance Turtle Sam T Haldenby Richard Gregory Matthew Gemmell Claudia Wierzbicki Hermione J Webster Thushan I de Silva Nikki Smith Adrienn Angyal Benjamin B Lindsey Danielle C Groves Luke R Green Dennis Wang Timothy M Freeman Matthew D Parker Alexander J Keeley Paul J Parsons Rachel M Tucker Rebecca Brown Matthew Wyles Max Whiteley Peijun Zhang Marta Gallis Stavroula F Louka Chrystala Constantinidou Meera Unnikrishnan Sascha Ott Jeffrey K.J. Cheng Hannah E. Bridgewater Lucy R. Frost Grace Taylor-Joyce Richard Stark Laura Baxter Mohammad T. Alam Paul E Brown Dinesh Aggarwal Alberto C Cerda Tammy V Merrill Rebekah E Wilson Patrick C McClure Joseph G Chappell Theocharis Tsoleridis Jonathan Ball David Buck John A Todd Angie Green Amy Trebes George MacIntyre-Cockett Mariateresa de Cesare Alex Alderton Roberto Amato Cristina V Ariani Mathew A Beale Charlotte Beaver Katherine L Bellis Emma Betteridge James Bonfield John Danesh Matthew J Dorman Eleanor Drury Ben W Farr Luke Foulser Sonia Goncalves Scott Goodwin Marina Gourtovaia Ewan M Harrison David K Jackson Dorota Jamrozy Ian Johnston Leanne Kane Sally Kay Jon-Paul Keatley Dominic Kwiatkowski Cordelia F Langford Mara Lawniczak Laura Letchford Rich Livett Stephanie Lo Inigo Martincorena Samantha McGuigan Rachel Nelson Steve Palmer Naomi R Park Minal Patel Liam Prestwood Christoph Puethe Michael A Quail Shavanthi Rajatileka Carol Scott Lesley Shirley John Sillitoe Michael H Spencer Chapman Scott AJ Thurston Gerry Tonkin-Hill Danni Weldon Diana Rajan Iraad F Bronner Louise Aigrain Nicholas M Redshaw Stefanie V Lensing Robert Davies Andrew Whitwham Jennifier Liddle Kevin Lewis Jaime M Tovar-Corona Steven Leonard Jillian Durham Andrew R Bassett Shane McCarthy Robin J Moll Keith James Karen Oliver Alex Makunin Jeff Barrett Rory N Gunson Ronan Lyons |
| format |
Journal article |
| container_title |
The Lancet Public Health |
| container_volume |
6 |
| container_issue |
5 |
| container_start_page |
e335 |
| publishDate |
2021 |
| institution |
Swansea University |
| issn |
2468-2667 |
| doi_str_mv |
10.1016/s2468-2667(21)00055-4 |
| publisher |
Elsevier BV |
| college_str |
Faculty of Medicine, Health and Life Sciences |
| hierarchytype |
|
| hierarchy_top_id |
facultyofmedicinehealthandlifesciences |
| hierarchy_top_title |
Faculty of Medicine, Health and Life Sciences |
| hierarchy_parent_id |
facultyofmedicinehealthandlifesciences |
| hierarchy_parent_title |
Faculty of Medicine, Health and Life Sciences |
| department_str |
Swansea University Medical School - Health Data Science{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}Swansea University Medical School - Health Data Science |
| document_store_str |
1 |
| active_str |
0 |
| description |
BackgroundThe SARS-CoV-2 variant B.1.1.7 was first identified in December, 2020, in England. We aimed to investigate whether increases in the proportion of infections with this variant are associated with differences in symptoms or disease course, reinfection rates, or transmissibility.MethodsWe did an ecological study to examine the association between the regional proportion of infections with the SARS-CoV-2 B.1.1.7 variant and reported symptoms, disease course, rates of reinfection, and transmissibility. Data on types and duration of symptoms were obtained from longitudinal reports from users of the COVID Symptom Study app who reported a positive test for COVID-19 between Sept 28 and Dec 27, 2020 (during which the prevalence of B.1.1.7 increased most notably in parts of the UK). From this dataset, we also estimated the frequency of possible reinfection, defined as the presence of two reported positive tests separated by more than 90 days with a period of reporting no symptoms for more than 7 days before the second positive test. The proportion of SARS-CoV-2 infections with the B.1.1.7 variant across the UK was estimated with use of genomic data from the COVID-19 Genomics UK Consortium and data from Public Health England on spike-gene target failure (a non-specific indicator of the B.1.1.7 variant) in community cases in England. We used linear regression to examine the association between reported symptoms and proportion of B.1.1.7. We assessed the Spearman correlation between the proportion of B.1.1.7 cases and number of reinfections over time, and between the number of positive tests and reinfections. We estimated incidence for B.1.1.7 and previous variants, and compared the effective reproduction number, Rt, for the two incidence estimates.FindingsFrom Sept 28 to Dec 27, 2020, positive COVID-19 tests were reported by 36 920 COVID Symptom Study app users whose region was known and who reported as healthy on app sign-up. We found no changes in reported symptoms or disease duration associated with B.1.1.7. For the same period, possible reinfections were identified in 249 (0·7% [95% CI 0·6–0·8]) of 36 509 app users who reported a positive swab test before Oct 1, 2020, but there was no evidence that the frequency of reinfections was higher for the B.1.1.7 variant than for pre-existing variants. Reinfection occurrences were more positively correlated with the overall regional rise in cases (Spearman correlation 0·56–0·69 for South East, London, and East of England) than with the regional increase in the proportion of infections with the B.1.1.7 variant (Spearman correlation 0·38–0·56 in the same regions), suggesting B.1.1.7 does not substantially alter the risk of reinfection. We found a multiplicative increase in the Rt of B.1.1.7 by a factor of 1·35 (95% CI 1·02–1·69) relative to pre-existing variants. However, Rt fell below 1 during regional and national lockdowns, even in regions with high proportions of infections with the B.1.1.7 variant.InterpretationThe lack of change in symptoms identified in this study indicates that existing testing and surveillance infrastructure do not need to change specifically for the B.1.1.7 variant. In addition, given that there was no apparent increase in the reinfection rate, vaccines are likely to remain effective against the B.1.1.7 variant. |
| published_date |
2021-05-01T14:13:31Z |
| _version_ |
1802748362229809152 |
| score |
11.036837 |