ABSTRACT
Objective To analyze the molecular epidemiological characteristics of the Corona virus disease 2019 (COVID‑19) cases in Shijiazhuang, which can reveal the origin of the outbreak and provide a scientific basis for COVID‑19 prevention and control. Methods From January 2 to January 8, 2021, a total of 404 samples from 170 COVID‑19 cases were collected from the Shijiazhuang Fifth Hospital. The consensus sequence of 2019 novel Coronavirus(2019‑nCoV) was obtained through multiplex polymerase chain reaction‑based sequencing. The sequences of 170 COVID‑19 cases were analyzed by the PANGOLIN, and the data were statistically analyzed by T‑test. Results Among the 404 COVID‑19 samples, a total of 356 samples obtained high quality genome sequences (>95%, 100×sequencing depth). The whole genome sequences of 170 COVID‑19 cases were obtained by eliminating repeated samples. All 170 sequences were recognized as lineage B1.1 using PANGOLIN. The number of single nucleotide polymorphism arrange from 18-22 and most of the single nucleotide polymorphism were synonymous variants. All of 170 genomes could be classified into 48 sub‑groups and most of the genomes were classified into 2 sub‑groups (66 and 31, respectively). Conclusions All cases in this study are likely originated from one imported case. The viruses have spread in the community for a long time and have mutated during the community transmission.
ABSTRACT
Background: Under the increasingly severe situation of COVID-19 pandemic, Hebei Province has received a large number of individuals returned from abroad.Therefore, on the occasion of returning to work, production and school, it is imperative to effectively strengthen SARS-CoV-2 screening and management of overseas imported cases and to take actions to cut off the transmission channels to prevent the spread of SARS-CoV-2 from this group.Objective: To study the clinical characteristics of overseas imported and local COVID-19 cases in Hebei Province, to provide a reference for developing targeted programs to prevent the recurrence of the pandemic.Methods: 28 patients with COVID-19(7 overseas imported and 21 local )who were admitted to Shijiazhuang Fifth Hospital from January 21 to April 5, 2020 were selected.The epidemiological characteristics, clinical manifestations, laboratory and imaging examinations of them were summarized and analyzed.Results (1)The imported group included 5 men and 2 women, mostly were young adults〔4(57.1%)were 19-29 years〕, with an average age of (23.6±11.1) years.The local group included 14 men and 7 women, mostly were middle-aged and elderly adults〔19(90.5%)aged 30-72 years〕, with an average age of(43.6±19.7) years, mainly were infected with COVID-19 after family gatherings.(2)Among the imported cases, 1 had fever, 1 had diarrhea, and 5 had no clinical symptoms;6(85.7%)had common type COVID-19, 1(14.3%)had severe type, no mild and critically severe types.Among the local cases, 15 had fever, 9 had cough, 5 had sore throat, 3 had fatigue, 2 had muscle pain, and 1 had diarrhea;1(4.8%) had mild type COVID-19, 15(71.4%)had common type, 4(19.0%)had severe type, and 1(4.8%)had critically severe type.(3)The imported cases showed lower average cycle threshold(Ct) value of SARS-CoV-2 N gene(t=14.430, P<0.001) than the local cases.Moreover, the average Ct value of SARS-CoV-2 N gene and ORF1ab gene was also lower in the imported cases(t=17.856, P<0.001).The prevalence of reduced CD4+ T lymphocytes was above 50.0% in both groups compared with the normal reference range value.The prevalence of reduced lymphocyte count and CD3+ T lymphocytes, and elevated C-reactive protein, aspartate aminotransferase, alanine aminotransferase and lactate dehydrogenase was higher than 40.0% in the imported cases.The prevalence of elevated C-reactive protein and lactate dehydrogenase was higher than 40.0% in the local cases.(4)The lung CT examination of two groups indicated that the lesions were mainly distributed in bilateral lung lobes, followed by unilateral unilobe, and then unilateral multiple lobes.Ground-glass opacity was the main image finding in the imported group, while ground-glass opacity and consolidation opacity were the main image findings in the local group.Conclusion: In Hebei Province, the imported COVID-19 cases showed milder symptoms, lower Ct values of SARS-CoV-2 N gene and ORF1ab gene and higher SARS-CoV-2 viral nucleic acids from nasopharyngeal swabs, which indicate that the virus from imported cases may be more contagious.Therefore, it is necessary to strengthen isolation, screening and early diagnosis of imported cases, so as to prevent the spread of disease as much as possible. Copyright © 2020 by the Chinese General Practice.