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COVID-19 due to the B.1.617.2 (Delta) variant compared to B.1.1.7 (Alpha) variant of SARS-CoV-2: a prospective observational cohort study

Abstract:
The Delta (B.1.617.2) variant was the predominant UK circulating SARS-CoV-2 strain between May and December 2021. How Delta infection compares with previous variants is unknown. This prospective observational cohort study assessed symptomatic adults participating in the app-based COVID Symptom Study who tested positive for SARS-CoV-2 from May 26 to July 1, 2021 (Delta overwhelmingly the predominant circulating UK variant), compared (1:1, age- and sex-matched) with individuals presenting from December 28, 2020 to May 6, 2021 (Alpha (B.1.1.7) the predominant variant). We assessed illness (symptoms, duration, presentation to hospital) during Alpha- and Delta-predominant timeframes; and transmission, reinfection, and vaccine effectiveness during the Delta-predominant period. 3581 individuals (aged 18 to 100 years) from each timeframe were assessed. The seven most frequent symptoms were common to both variants. Within the first 28 days of illness, some symptoms were more common with Delta versus Alpha infection (including fever, sore throat, and headache) and some vice versa (dyspnoea). Symptom burden in the first week was higher with Delta versus Alpha infection; however, the odds of any given symptom lasting ≥ 7 days was either lower or unchanged. Illness duration ≥ 28 days was lower with Delta versus Alpha infection, though unchanged in unvaccinated individuals. Hospitalisation for COVID-19 was unchanged. The Delta variant appeared more (1.49) transmissible than Alpha. Re-infections were low in all UK regions. Vaccination markedly reduced the risk of Delta infection (by 69-84%). We conclude that COVID-19 from Delta or Alpha infections is similar. The Delta variant is more transmissible than Alpha; however, current vaccines showed good efficacy against disease. This research framework can be useful for future comparisons with new emerging variants.
Publication status:
Published
Peer review status:
Peer reviewed

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Author
ORCID:
0000-0002-5230-6939
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Role:
Author
ORCID:
0000-0001-7773-8140
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Author
ORCID:
0000-0002-4170-1095
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ORCID:
0000-0002-2553-1284
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Author
ORCID:
0000-0001-7363-5574


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Funder identifier:
10.13039/100010269
Grant:
WT213038/Z/18/Z
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Funder identifier:
10.13039/501100000265


Publisher:
Nature Research
Journal:
Scientific Reports More from this journal
Volume:
12
Issue:
1
Pages:
10904-10904
Article number:
10904
Publication date:
2022-06-28
DOI:
EISSN:
2045-2322
ISSN:
2045-2322


Language:
English
Keywords:
Pubs id:
1268918
Local pid:
pubs:1268918
Source identifiers:
W4283732304
Deposit date:
2026-04-27
ARK identifier:
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