ABSTRACT
Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is the causative agent of the coronavirus disease 2019 (COVID-19) pandemic. In this study, we conducted a comparative analysis of the structural genes of SARS-CoV-2 and other CoVs. We found that the sequence of the E gene was the most evolutionarily conserved across 200 SARS-CoV-2 isolates. The E gene and M gene sequences of SARS-CoV-2 and NC014470 CoV were closely related and fell within the same branch of a phylogenetic tree. The absolute diversity of E gene and M gene sequences of SARS-CoV-2 isolates was similar to that of common CoVs (C-CoVs) infecting other organisms. The absolute diversity of the M gene sequence of the KJ481931 CoV that can infect humans was similar to that of SARS-CoV-2 and C-CoVs infecting other organisms. The M gene sequence of KJ481931 CoV (infecting humans), SARS-CoV-2 and NC014470 CoV (infecting other organisms) were closely related, falling within the same branch of a phylogenetic tree. Patterns of variation and evolutionary characteristics of the N gene and S gene were very similar. These data may be of value for understanding the origins and intermediate hosts of SARS-CoV-2.
ABSTRACT
OBJECTIVE: The aim of this study was to systematically and comprehensively evaluate the diagnostic and prognostic value of myocardial injury biomarkers in COVID-19 patients. METHODS: This is a retrospective cohort study of confirmed COVID-19 patients that were admitted to the Renmin Hospital of Wuhan University from January 30, 2020 to February 15, 2020. RESULTS: Receiver operating characteristic (ROC) curve analysis demonstrated that cTnI-ultra had the highest area under the curve (AUC) at 0.855, with a sensitivity of 67.3% and a specificity of 88.7% for the prediction of in-hospital mortality. Patients with higher troponin I-ultra (cTnI-ultra), creatinine kinase-myocardial band (CK-MB), and N-terminal pro-B-type natriuretic peptide (NT-proBNP) were associated with higher mortality, compared to those who lower levels. The multivariable cox regression indicated that age (hazard ratio (HR) 3.450, 95% confidence interval (CI) 1.627-7.314, P = 0.001), coronary heart disease (HR 1.855, 95% CI 1.006-3.421; P = 0.048), elevated cTnI-ultra (HR 3.083, 95% CI 1.616-5.883, P = 0.001), elevated CK-MB (HR 2.907, 95% CI 1.233-6.854; P = 0.015), and elevated NT-proBNP (HR 5.776, 95% CI 2.272-14.682; P < 0.001) were associated with in-hospital mortality. CONCLUSIONS: cTnI-ultra might be the best predictor of in-hospital mortality among myocardial injury biomarkers. Elevated cTnI-ultra, CK-MB, and NT-proBNP were independent biomarkers of the mortality in COVID-19 patients.
Subject(s)
Coronavirus Infections/complications , Coronavirus Infections/diagnosis , Heart Injuries/complications , Heart Injuries/metabolism , Hospitalization , Pneumonia, Viral/complications , Pneumonia, Viral/diagnosis , Aged , Biomarkers/metabolism , COVID-19 , Cohort Studies , Coronavirus Infections/metabolism , Coronavirus Infections/mortality , Female , Hospital Mortality , Humans , Male , Middle Aged , Pandemics , Pneumonia, Viral/metabolism , Pneumonia, Viral/mortality , ROC Curve , Retrospective StudiesABSTRACT
A novel coronavirus disease, designated as COVID-19, has become a pandemic worldwide. This study aims to estimate the incubation period and serial interval of COVID-19. We collected contact tracing data in a municipality in Hubei province during a full outbreak period. The date of infection and infector-infectee pairs were inferred from the history of travel in Wuhan or exposed to confirmed cases. The incubation periods and serial intervals were estimated using parametric accelerated failure time models, accounting for interval censoring of the exposures. Our estimated median incubation period of COVID-19 is 5.4 days (bootstrapped 95% confidence interval (CI) 4.8-6.0), and the 2.5th and 97.5th percentiles are 1 and 15 days, respectively; while the estimated serial interval of COVID-19 falls within the range of -4 to 13 days with 95% confidence and has a median of 4.6 days (95% CI 3.7-5.5). Ninety-five per cent of symptomatic cases showed symptoms by 13.7 days (95% CI 12.5-14.9). The incubation periods and serial intervals were not significantly different between male and female, and among age groups. Our results suggest a considerable proportion of secondary transmission occurred prior to symptom onset. And the current practice of 14-day quarantine period in many regions is reasonable.