Clinical and whole genome characterization of SARS-CoV-2 in India.

Radhakrishna Muttineni,Sunitha Pakalapati,Raja Rao M,Anand K Kondapi,Rama R Amara,Pankaj Singh Dholaniya,Kalyani Putty,Nagamani Kammili,Ravi Kumar Puli,Steven E Bosinger,Shekar K,Mallikarjuna Reddy Doodipala,Thrilok Chander Bingi,Saritha S,Amit A Upadhyay

doi:10.1371/journal.pone.0246173

Abstract

We report clinical profile of hundred and nine patients with SARS CoV-2 infection, and whole genome sequences (WGS) of seven virus isolates from the first reported cases in India, with various international travel histories. Comorbidities such as diabetes, hypertension, and cardiovascular disease were frequently associated with severity of the disease. WBC and neutrophil counts showed an increase, while lymphocyte counts decreased in patients with severe infection suggesting a possible neutrophil mediated organ damage, while immune activity may be diminished with decrease in lymphocytes leading to disease severity. Increase in SGOT, SGPT and blood urea suggests the functional deficiencies of liver, heart, and kidney in patients who succumbed to the disease when compared to the group of recovered patients. The WGS analysis showed that these isolates were classified into two clades: I/A3i, and A2a (four according to GISAID: O, L, GR, and GH). Further, WGS phylogeny and travel history together indicate possible transmission from Middle East and Europe. Three S protein variants: Wuhan reference, D614G, and Y28H were identified predicted to possess different binding affinities to host ACE2.

Highlights

The primary objective of the current study is to present clinical profile of hundred and nine SARS-CoV-2 patients admitted to a COVID-19 referral Gandhi hospital, Hyderabad, Telangana State, India of which fifty-seven patients recovered and fifty-two patients succumbed to the illness
Clinical specimens for SARS-CoV-2 diagnostic testing were obtained in accordance with World Health Organization (WHO) guidelines [13]
Shortness of breath, altered sensorium, haemoptysis, acute kidney injury (AKI), chronic kidney disease (CKD), aphasia, chest pain, dysphagia, oral ulcers, hypoxia, metabolic encephalopathy, renal failure, tracheostomy care, and sudden syncope were admitted to intensive care unit (ICU)

Summary

Objectives

The primary objective of the current study is to present clinical profile of hundred and nine SARS-CoV-2 patients admitted to a COVID-19 referral Gandhi hospital, Hyderabad, Telangana State, India of which fifty-seven patients recovered and fifty-two patients succumbed to the illness

Methods

Results

Conclusion