key: cord-1034461-dy9s1c90 authors: Yu, Zhikang; Wu, Heming; Huang, Qingyan; Zhong, Zhixiong title: Clinical and biochemical indexes of 11 COVID‐19 patients and the genome sequence analysis of the tested SARS‐CoV‐2 date: 2021-11-05 journal: J Clin Lab Anal DOI: 10.1002/jcla.24088 sha: a85e201fa8df7f914d9467e6442d1ea2fc95f36e doc_id: 1034461 cord_uid: dy9s1c90 BACKGROUND: At present, SARS‐CoV‐2 epidemic in the world rapidly spread. It is a serious global public health emergency. METHODS: In this study, we described the clinical characteristics of 11 COVID‐19 patients hospitalized in the Meizhou People's Hospital, and viral genome sequences of SARS‐CoV‐2 from these patients were analyzed. RESULTS: Of the 11 patients, six cases developed fever, 9 cases developed a cough, and two cases developed headache and chills. Four patients (36.4%) had underlying diseases. Pneumonia is the most common complication. The laboratory test results showed that there were no adult patients with increased lymphocyte/lymphocyte percentage (LYM/LYM%). Most patients had normal total protein (TP) and albumin (ALB), but only two patients had decreased. Most patients had increased or normal levels of erythrocyte sedimentation rate (ESR), C reactive protein (CRP), activated partial thromboplastin time (APTT), fibrinogen (FIB), creatine kinase isoenzymes (CK‐MB), and lactate dehydrogenase (LDH). Neutrophil (NEU) (r = 0.664, p = 0.026), CK‐MB (r = 0.655, p = 0.029) and blood urea nitrogen (BUN) (r = 0.682, p = 0.021) were significantly associated with SARS‐CoV‐2 virus cycle threshold (Ct) value. Multiple sequence alignment (MSA) shows that two different SNPs were identified at positions 8781 and 28144, and have a complete linkage genetic form of 8781C‐28144T and 8781T‐28144C. CONCLUSIONS: The reports of the 11 COVID‐19 patients in our hospital will provide useful information for the diagnosis, treatment, and drug development of SARS‐CoV‐2. In December 2019, pneumonia caused by a novel coronavirus (2019-nCoV) was broken out. In China, it first appeared in Wuhan city, Hubei Province. The novel coronavirus spread rapidly from person to person and spread, with confirmed cases appearing in a number of countries. On January 30, 2020, a statement was issued by the World Health Organization (WHO), declaring it is a global public health emergency. 1 The disease was later named coronavirus dis- CoV-2 and SARS-CoV is about 80%, and that between SARS-CoV and MERS-CoV is about 55%. 11 The virulence of SARS-CoV-2 is relatively weak compared with MERS-CoV and SARS-CoV, 12 the virus spreads by human-to-human transmission and people are generally susceptible. 13 Since February 2020, SARS-CoV-2 is spreading around the world, causing a huge social and economic burden to various countries, and is being attracted the attention of the world. The clinical symptoms of COVID-19 patients overlap significantly with common acute respiratory illnesses, including fever, cough, and fatigue. Common laboratory abnormalities include decreased lymphocyte (LYM)/lymphocyte percentage (LYM%) and hypoxemia. The initial chest radiograph showed multiple ground-glass opacity in both lungs. 14 In addition, asymptomatic cases result in delayed or even missed diagnosis inevitable and makes other persons to SARS-CoV-2 infection. Therefore, analysis of the clinical characteristics of confirmed COVID-19 patients is helpful to provide valuable information for the diagnosis and subsequent treatment of this disease. On the contrary, the viral genome sequences analysis is helpful for understanding of the mechanism of viral infection and the potential treatment options selection, and laying a foundation for the research and development of subsequent vaccines and drugs. 11, [15] [16] [17] In this study, we described the clinical characteristics of 11 Clinical information, including complete blood counts, blood biochemistry was collected at the earliest time possible after admission. The main information including initial symptoms (fever, cough, headache, myalgia, chill, vomiting, and diarrhea), underlying diseases, complications (pneumonia, ARDS, liver, kidney, and heart function), and therapeutic drugs (antiviral agents, corticosteroid, and immunoglobulin) were collected. We collected the first results of complete blood counts and blood biochemistry of each patient upon admission. SPSS statistical software version 21.0 was used for data analysis. The Spearman rank correlation coefficient and Pearson's Correlation were used for correlation analysis between two groups with variables. A value of p < 0.05 was considered statistically significant. Eleven COVID-19 inpatients in Meizhou People's Hospital and confirmed to be infected with SARS-CoV-2 by Meizhou Center for Disease Control and Prevention (CDC) from January to May 2020. Of the 11 patients, 6 cases developed fever, 10 cases developed a cough, and 2 cases developed headache and chills. There were five patients with fever and cough at the same time, five patients with a cough only, and one patient with fever only. Four patients (36.4%) had underlying diseases, including hypertension, diabetes, coronary heart disease, and fatty liver. Pneumonia was the most common complication. In addition, one case (Case 4) developed acute respiratory distress (ARDS) and respiratory failure. All patients were treated with anti-viral therapy (Arbidol, Lopnave/litonwe, Prezista, Ribavirin, and Interferon), and one patient was treated with noninvasive mechanical ventilation. Cases 4 and 6 were treated with corticosteroids. Cases 1, 2, 3, 4, 5, 6, 7, 8, and 9 were treated with immunoglobulin (Table 1) . Complete blood count and blood biochemistry were performed at the earliest time of admission for each patient. The laboratory test results showed that LYM/LYM% were decreased or normal among adults, there were no adult patients with increased LYM/LYM%. correlated to the Ct value. 22 We hope that the reports of these 11 cases in our hospital will provide useful information for the diagnosis and treatment of COVID-19. We In view of the characteristics of SARS-CoV-2, such as long incubation period, strong infectivity, and general susceptibility of the population, there are currently no specific drug/drugs that can better treat the COVID-19 caused by SARS-CoV-2. Therefore, it is great significance to search for potential drug/drugs with an inhibitory ef- In this study, the clinical characteristics of 11 COVID-19 patients and the genome sequence information of the tested SARS-CoV-2 were described. The relationship between blood biochemical markers and viral load was analyzed. Two SNPs were identified, one of which is responsible for the serine/leucine variation of the viral ORF8 coding protein. These two SNPs can divide SARS-CoV-2 into L and S types. The reports of these 11 cases in our hospital will provide useful information for the diagnosis, treatment, and drug development of SARS-CoV-2. -coronavirus-(ncov)-infection-issuspected. 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Diagnosis and treatment protocol for COVID-19 Clinical and biochemical indexes of 11 COVID-19 patients and the genome sequence analysis of the tested SARS-CoV-2 The author would like to thank other colleagues who were not The authors declare that they have no competing interests. The data that support the findings of this study are available from the corresponding author upon reasonable request.