巴西南部一家医院的新冠病毒 2 型毒株及新冠肺炎患者的临床概况
SARS-CoV-2 strains and clinical profiles of COVID-19 patients in a Southern Brazil hospital.
作者信息
Fam Bibiana S de Oliveira, Cadore Nathan Araujo, Sbruzzi Renan, Feira Marilea Furtado, Giudicelli Giovanna Câmara, de Almeida Luiz G P, Gerber Alexandra L, Guimarães Ana Paula de C, Vasconcelos Ana Tereza Ribeiro, Pereira Alexandre C, Pereira Lygia V, Hünemeier Tábita, Camey Suzi Alves, Vianna Fernanda S Luiz
机构信息
Laboratory of Genomic Medicine, Center of Experimental Research, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Brazil.
Laboratory of Immunobiology and Immunogenetics, Graduate Program in Genetics and Molecular Biology, Department of Genetics, Institute of Biosciences, Federal University of Rio Grande do Sul, Porto Alegre, Brazil.
出版信息
Front Immunol. 2024 Dec 18;15:1444620. doi: 10.3389/fimmu.2024.1444620. eCollection 2024.
INTRODUCTION
The COVID-19 pandemic had a widespread global impact and presented numerous challenges. The emergence of SARS-CoV-2 variants has changed transmission rates and immune evasion, possibly impacting the severity. This study aims to investigate the impact of variants on clinical outcomes in southern Brazil.
METHODS
In total, samples from 277 patients, hospitalized and non-hospitalized, were collected between March 2020 and March 2021, before the vaccine was made widely available to the general population in Brazil. Whole genome sequencing of SARS-CoV-2 was performed and bioinformatics and biostatistics analyses were implemented on molecular and clinical data, respectively.
RESULTS
The study identified significant demographic and clinical differences. The hospitalized group exhibited a higher proportion of males (51.9%) and an increased prevalence of comorbidities, including hypertension (66.0%), obesity (42.6%), and chronic kidney disease (23.6%). Patients were identified with twelve SARS-CoV-2 strains, predominantly B.1.1.28 and B.1.1.33 in the early 2020 first wave, and P.1 overlapping in the late 2020 and early 2021 second wave of COVID-19. Significant differences in hospitalization rates were found among patients infected with the different SARS-CoV-2 lineages: B.1.1.33 (46.0%), B.1.1.28 (65.9%), and P.1 (97.9%). Severity markers, such as pneumonia (62.5%, p=0.002), acute respiratory distress syndrome (ARDS, 72.9%, p<0.001), and oxygen support >6 L/min O (64.6%, p<0.001), were more frequent in patients from the second wave. These findings highlight the impact of different variants on the clinical evolution and prognosis of COVID-19, especially when comparing the first and second waves of the pandemic.
CONCLUSIONS
The study underscores the association between SARS-CoV-2 strains and COVID-19 severity by integrating clinical and viral data for public health responses during different pandemic phases, highlighting the importance of adapting pandemic strategies as the pandemic evolves.
引言
新冠疫情在全球产生了广泛影响，并带来了诸多挑战。严重急性呼吸综合征冠状病毒2（SARS-CoV-2）变体的出现改变了传播率和免疫逃逸情况，可能影响疾病严重程度。本研究旨在调查变体对巴西南部临床结局的影响。
方法
在2020年3月至2021年3月期间，即巴西普通人群广泛接种疫苗之前，共收集了277例住院和非住院患者的样本。对SARS-CoV-2进行全基因组测序，并分别对分子数据和临床数据进行生物信息学和生物统计学分析。
结果
该研究发现了显著的人口统计学和临床差异。住院组男性比例较高（51.9%），合并症患病率增加，包括高血压（66.0%）、肥胖（42.6%）和慢性肾脏病（23.6%）。共鉴定出12种SARS-CoV-2毒株，在2020年第一波疫情早期主要为B.1.1.28和B.1.1.33，在2020年末和2021年初的第二波新冠疫情中P.1毒株出现重叠。感染不同SARS-CoV-2谱系的患者住院率存在显著差异：B.1.1.33（46.0%）、B.1.1.28（65.9%）和P.1（97.9%）。在第二波疫情患者中，肺炎（62.5%，p = 0.002）、急性呼吸窘迫综合征（ARDS，72.9%，p < 0.001）以及氧支持>6L/min O（64.6%，p < 0.001）等严重程度指标更为常见。这些发现突出了不同变体对新冠临床演变和预后的影响，尤其是在比较疫情的第一波和第二波时。
结论
该研究通过整合不同疫情阶段临床和病毒数据，强调了SARS-CoV-2毒株与新冠严重程度之间的关联，凸显了随着疫情演变调整疫情应对策略的重要性。
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