Young, Barnaby E, Wei, Wycliffe E, Fong, Siew-Wai, Mak, Tze-Minn, Anderson, Danielle E, Chan, Yi-Hao, Pung, Rachael, Heng, Cheryl SY, Ang, Li Wei, Zheng, Adrian Kang Eng et al (show 16 more authors)
(2021)
Association of SARS-CoV-2 clades with clinical, inflammatory and virologic outcomes: An observational study.
EBIOMEDICINE, 66.
103319-.
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Association of SARS-CoV-2 clades with clinical, inflammatory and virologic outcomes An observational study.pdf - Published version Download (1MB) | Preview |
Abstract
<h4>Background</h4>Host determinants of severe coronavirus disease 2019 include advanced age, comorbidities and male sex. Virologic factors may also be important in determining clinical outcome and transmission rates, but limited patient-level data is available.<h4>Methods</h4>We conducted an observational cohort study at seven public hospitals in Singapore. Clinical and laboratory data were collected and compared between individuals infected with different SARS-CoV-2 clades. Firth's logistic regression was used to examine the association between SARS-CoV-2 clade and development of hypoxia, and quasi-Poisson regression to compare transmission rates. Plasma samples were tested for immune mediator levels and the kinetics of viral replication in cell culture were compared.<h4>Findings</h4>319 patients with PCR-confirmed SARS-CoV-2 infection had clinical and virologic data available for analysis. 29 (9%) were infected with clade S, 90 (28%) with clade L/V, 96 (30%) with clade G (containing D614G variant), and 104 (33%) with other clades 'O' were assigned to lineage B.6. After adjusting for age and other covariates, infections with clade S (adjusted odds ratio (aOR) 0·030 (95% confidence intervals (CI): 0·0002-0·29)) or clade O (B·6) (aOR 0·26 (95% CI 0·064-0·93)) were associated with lower odds of developing hypoxia requiring supplemental oxygen compared with clade L/V. Patients infected with clade L/V had more pronounced systemic inflammation with higher concentrations of pro-inflammatory cytokines, chemokines and growth factors. No significant difference in the severity of clade G infections was observed (aOR 0·95 (95% CI: 0·35-2·52). Though viral loads were significantly higher, there was no evidence of increased transmissibility of clade G, and replicative fitness in cell culture was similar for all clades.<h4>Interpretation</h4>Infection with clades L/V was associated with increased severity and more systemic release of pro-inflammatory cytokines. Infection with clade G was not associated with changes in severity, and despite higher viral loads there was no evidence of increased transmissibility.
| Item Type: | Article |
|---|---|
| Additional Information: | Source info: EBIOM-D-20-03663 |
| Uncontrolled Keywords: | COVID-19, SARS-CoV-2, Clade, D614G, Severity, Transmission |
| Divisions: | Faculty of Health and Life Sciences Faculty of Health and Life Sciences > Institute of Infection, Veterinary and Ecological Sciences |
| Depositing User: | Symplectic Admin |
| Date Deposited: | 14 May 2021 13:37 |
| Last Modified: | 18 Jan 2023 22:47 |
| DOI: | 10.1016/j.ebiom.2021.103319 |
| Open Access URL: | https://www.thelancet.com/journals/ebiom/article/P... |
| Related URLs: | |
| URI: | https://livrepository.liverpool.ac.uk/id/eprint/3122715 |
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