{"title":"COVID-19 严重程度和临床结果与病毒变种的相关性：一项前瞻性多中心医院网络研究。","authors":"Komal Wadhwa, Shilpa Malik, Srinigila Balaji, Ramachandran Thiruvengadam, Murali Dharan Bashyam, Prasanta Kumar Bhattacharya, Bijayini Behera, Pankaj Bhardwaj, Nidhan K Biswas, Asim Das, Anindya Dey, Dhiraj Dhotre, Mary Dias, Pankaj Dubey, Shreelekha Dutta, Ravisekhar Gadepalli, Mudita Gosain, Kalal Iravaty Goud, Neeraj Kumar Gupta, Nitesh Gupta, Pradipta Jana, Deepak Jena, Elizabeth John, Arunkumar Karunanidhi, S Muhammad Salim Khan, Sahil Khattar, Abhilash Prabhakar Kundavaram Paul, Shakti Kumar, Arindam Maitra, Nikhil Modi, Mahesh Moorthy, Savitha Nagaraj, Dasaradhi Palakodeti, Anil Kumar Pandey, Aparna Pandey, Sunil Kumar Raghav, Suresh Ramasubban, Sreevatsan Raghavan, S Harikrishnan, S Krishnamoorthy, Selvaraj Selvamurugan, Raman Sardana, Yogesh Shouche, Akanksha Singh, Arvind Kumar Singh, V Ramasubramaniyan, Monika Yadav, Danish Zahoor, Suneetha Narreddy, Shinjini Bhatnagar, Nitya Wadhwa, Bhabatosh Das, Pramod Kumar Garg","doi":"10.4103/ijmr.ijmr_1041_23","DOIUrl":null,"url":null,"abstract":"<p><strong>Background objectives: </strong>The clinical course of COVID-19 and its prognosis are influenced by both viral and host factors. The objectives of this study were to develop a nationwide platform to investigate the molecular epidemiology of SARS-CoV-2 (Severe acute respiratory syndrome Corona virus 2) and correlate the severity and clinical outcomes of COVID-19 with virus variants.</p><p><strong>Methods: </strong>A nationwide, longitudinal, prospective cohort study was conducted from September 2021 to December 2022 at 14 hospitals across the country that were linked to a viral sequencing laboratory under the Indian SARS-CoV-2 Genomics Consortium. All participants (18 yr and above) who attended the hospital with a suspicion of SARS-CoV-2 infection and tested positive by the reverse transcription-PCR method were included. The participant population consisted of both hospitalized as well as outpatients. Their clinical course and outcomes were studied prospectively. Nasopharyngeal samples collected were subjected to whole genome sequencing to detect SARS-CoV-2 variants.</p><p><strong>Results: </strong>Of the 4972 participants enrolled, 3397 provided samples for viral sequencing and 2723 samples were successfully sequenced. From this, the evolution of virus variants of concern including Omicron subvariants which emerged over time was observed and the same reported here. The mean age of the study participants was 41 yr and overall 49.3 per cent were female. The common symptoms were fever and cough and 32.5 per cent had comorbidities. Infection with the Delta variant evidently increased the risk of severe COVID-19 (adjusted odds ratio: 2.53, 95% confidence interval: 1.52, 4.2), while Omicron was milder independent of vaccination status. The independent risk factors for mortality were age >65 yr, presence of comorbidities and no vaccination.</p><p><strong>Interpretation conclusions: </strong>The authors believe that this is a first-of-its-kind study in the country that provides real-time data of virus evolution from a pan-India network of hospitals closely linked to the genome sequencing laboratories. The severity of COVID-19 could be correlated with virus variants with Omicron being the milder variant.</p>","PeriodicalId":13349,"journal":{"name":"Indian Journal of Medical Research","volume":null,"pages":null},"PeriodicalIF":2.7000,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10954099/pdf/","citationCount":"0","resultStr":"{\"title\":\"Correlation of severity & clinical outcomes of COVID-19 with virus variants: A prospective, multicentre hospital network study.\",\"authors\":\"Komal Wadhwa, Shilpa Malik, Srinigila Balaji, Ramachandran Thiruvengadam, Murali Dharan Bashyam, Prasanta Kumar Bhattacharya, Bijayini Behera, Pankaj Bhardwaj, Nidhan K Biswas, Asim Das, Anindya Dey, Dhiraj Dhotre, Mary Dias, Pankaj Dubey, Shreelekha Dutta, Ravisekhar Gadepalli, Mudita Gosain, Kalal Iravaty Goud, Neeraj Kumar Gupta, Nitesh Gupta, Pradipta Jana, Deepak Jena, Elizabeth John, Arunkumar Karunanidhi, S Muhammad Salim Khan, Sahil Khattar, Abhilash Prabhakar Kundavaram Paul, Shakti Kumar, Arindam Maitra, Nikhil Modi, Mahesh Moorthy, Savitha Nagaraj, Dasaradhi Palakodeti, Anil Kumar Pandey, Aparna Pandey, Sunil Kumar Raghav, Suresh Ramasubban, Sreevatsan Raghavan, S Harikrishnan, S Krishnamoorthy, Selvaraj Selvamurugan, Raman Sardana, Yogesh Shouche, Akanksha Singh, Arvind Kumar Singh, V Ramasubramaniyan, Monika Yadav, Danish Zahoor, Suneetha Narreddy, Shinjini Bhatnagar, Nitya Wadhwa, Bhabatosh Das, Pramod Kumar Garg\",\"doi\":\"10.4103/ijmr.ijmr_1041_23\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background objectives: </strong>The clinical course of COVID-19 and its prognosis are influenced by both viral and host factors. The objectives of this study were to develop a nationwide platform to investigate the molecular epidemiology of SARS-CoV-2 (Severe acute respiratory syndrome Corona virus 2) and correlate the severity and clinical outcomes of COVID-19 with virus variants.</p><p><strong>Methods: </strong>A nationwide, longitudinal, prospective cohort study was conducted from September 2021 to December 2022 at 14 hospitals across the country that were linked to a viral sequencing laboratory under the Indian SARS-CoV-2 Genomics Consortium. All participants (18 yr and above) who attended the hospital with a suspicion of SARS-CoV-2 infection and tested positive by the reverse transcription-PCR method were included. The participant population consisted of both hospitalized as well as outpatients. Their clinical course and outcomes were studied prospectively. Nasopharyngeal samples collected were subjected to whole genome sequencing to detect SARS-CoV-2 variants.</p><p><strong>Results: </strong>Of the 4972 participants enrolled, 3397 provided samples for viral sequencing and 2723 samples were successfully sequenced. From this, the evolution of virus variants of concern including Omicron subvariants which emerged over time was observed and the same reported here. The mean age of the study participants was 41 yr and overall 49.3 per cent were female. The common symptoms were fever and cough and 32.5 per cent had comorbidities. Infection with the Delta variant evidently increased the risk of severe COVID-19 (adjusted odds ratio: 2.53, 95% confidence interval: 1.52, 4.2), while Omicron was milder independent of vaccination status. The independent risk factors for mortality were age >65 yr, presence of comorbidities and no vaccination.</p><p><strong>Interpretation conclusions: </strong>The authors believe that this is a first-of-its-kind study in the country that provides real-time data of virus evolution from a pan-India network of hospitals closely linked to the genome sequencing laboratories. The severity of COVID-19 could be correlated with virus variants with Omicron being the milder variant.</p>\",\"PeriodicalId\":13349,\"journal\":{\"name\":\"Indian Journal of Medical Research\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":2.7000,\"publicationDate\":\"2024-01-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10954099/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Indian Journal of Medical Research\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.4103/ijmr.ijmr_1041_23\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/3/4 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q3\",\"JCRName\":\"IMMUNOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Indian Journal of Medical Research","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.4103/ijmr.ijmr_1041_23","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/3/4 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"IMMUNOLOGY","Score":null,"Total":0}
Correlation of severity & clinical outcomes of COVID-19 with virus variants: A prospective, multicentre hospital network study.
Background objectives: The clinical course of COVID-19 and its prognosis are influenced by both viral and host factors. The objectives of this study were to develop a nationwide platform to investigate the molecular epidemiology of SARS-CoV-2 (Severe acute respiratory syndrome Corona virus 2) and correlate the severity and clinical outcomes of COVID-19 with virus variants.
Methods: A nationwide, longitudinal, prospective cohort study was conducted from September 2021 to December 2022 at 14 hospitals across the country that were linked to a viral sequencing laboratory under the Indian SARS-CoV-2 Genomics Consortium. All participants (18 yr and above) who attended the hospital with a suspicion of SARS-CoV-2 infection and tested positive by the reverse transcription-PCR method were included. The participant population consisted of both hospitalized as well as outpatients. Their clinical course and outcomes were studied prospectively. Nasopharyngeal samples collected were subjected to whole genome sequencing to detect SARS-CoV-2 variants.
Results: Of the 4972 participants enrolled, 3397 provided samples for viral sequencing and 2723 samples were successfully sequenced. From this, the evolution of virus variants of concern including Omicron subvariants which emerged over time was observed and the same reported here. The mean age of the study participants was 41 yr and overall 49.3 per cent were female. The common symptoms were fever and cough and 32.5 per cent had comorbidities. Infection with the Delta variant evidently increased the risk of severe COVID-19 (adjusted odds ratio: 2.53, 95% confidence interval: 1.52, 4.2), while Omicron was milder independent of vaccination status. The independent risk factors for mortality were age >65 yr, presence of comorbidities and no vaccination.
Interpretation conclusions: The authors believe that this is a first-of-its-kind study in the country that provides real-time data of virus evolution from a pan-India network of hospitals closely linked to the genome sequencing laboratories. The severity of COVID-19 could be correlated with virus variants with Omicron being the milder variant.
期刊介绍：
The Indian Journal of Medical Research (IJMR) [ISSN 0971-5916] is one of the oldest medical Journals not only in India, but probably in Asia, as it started in the year 1913. The Journal was started as a quarterly (4 issues/year) in 1913 and made bimonthly (6 issues/year) in 1958. It became monthly (12 issues/year) in the year 1964.
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