Clinical Characteristics of Patients with SARS-CoV-2 N501Y Variants in General Practitioner Clinic in Japan

Mariko Hanafusa,Katsutoshi Ishihara,Jin Kuramochi,Nobutoshi Nawa,Takeo Fujiwara,Makiko Honda

doi:10.3390/jcm10245865

Mariko Hanafusa, Katsutoshi Ishihara + Show 4 more

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https://doi.org/10.3390/jcm10245865

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Abstract

The clinical characteristics of patients with N501Y mutation in SARS-CoV-2 variants (N501YV) is not fully understood, especially in the setting of general practice. In this retrospective cohort study, COVID-19 patients admitted to one general practitioner clinic between 26 March and 26 May 2021 were retrospectively analyzed. The characteristics, clinical symptoms and radiological findings before treatment were compared between N501YV and wild-type 501N. Twenty-eight patients were classified as wild-type 501N and 24 as N501YV. The mean (±standard deviation) age was 37.4 (±16.1) years, with no significant difference between groups. Among clinical symptoms, prevalence of fever of 38 degrees Celsius (°C) or higher was significantly higher in the N501YV group than in the wild-type 501N group (p = 0.001). Multivariate analysis showed that fever of 38 °C or higher remained significantly associated with N501YV (adjust odds ratio [aOR]: 6.07, 95% confidence interval [CI]: 1.68 to 21.94). For radiological findings, the lung involvement area was significantly larger in patients infected with N501YV (p = 0.013). In conclusion, in the N501YV group, fever of 38 °C or higher and extensive pneumonia were more frequently observed compared to the wild-type 501N group. There was no significant difference in terms of other demographics and clinical symptoms.

Highlights

Introduction published maps and institutional affilThe coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), has induced high number of deaths worldwide [1].The emergence of viruses that have acquired genomic mutations makes the SARS-CoV-2 pandemic even more difficult to control [2]
Around the 9th week of 2021, Japan entered the fourth wave of the SARS-CoV-2 pandemic with a rapid replace of predominant strains with the B.1.1.7 lineage of SARS-CoV-2 with a N501Y replacement in the receptor binding domain (RBD) of spike (N501YV)
The purpose of this study was to compare the differences in clinical characteristics and radiological findings of admitted COVID-19 patients, before treatment at a general practitioner in Japan, between N501Y mutation in SARS-CoV-2 variants (N501YV) and wild-type 501N cases

Summary

Introduction

The coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), has induced high number of deaths worldwide [1]. The emergence of viruses that have acquired genomic mutations makes the SARS-CoV-2 pandemic even more difficult to control [2]. The number of new cases per week peaked at approximately 32 per 100,000 population at 19th week of 2021 [3]. The national whole genetic screening of COVID-19 cases at that time showed that the proportion of the B.1.1.7 lineage had reached over 80% [3]. The B1.1.7 lineage was presumed to be structurally more transmissible [4,5], and clinically, an increase in reproduction numbers was reported.

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