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1.616 (n=39), VOC (n=32), and unknown (n=43). B.1.616-related cases were older than VOC-related cases (81years, interquartile range (IQR) 73-88 versus 73years, IQR 67-82, p0.05) and their first RT-PCR tests were rarely positive (6/39, 15% versus 31/32, 97%, p0.05). The B.1.616 variant was independently associated with severe disease (multivariable Cox model HR 4.0, 95%CI 1.5-10.9) and increased lethality (28-day mortality 18/39 (46%) for B.1.616 versus 5/32 (16%) for VOC, p = 0.006). We report a nosocomial outbreak of COVID-19 c