Renal and hepatic injury associated with COVID-19 infection; A prospective cohort analysis of renal and hepatic injury in patients infected with COVID-19 (preprint)

The current study evaluated the rate of progression of acute kidney and hepatic injury and its associated mortality rate in patients infected with COVID-19. For this study, a total of 397 COVID-19 positive adult patients were prospectively recruited. Routine medical examination, liver function tests (LFT) and renal function test (RFT) were performed at the time of hospitalization and this procedure was repeated for every two days until the hospital stay of the patient or till the death of the patient. The upper values (data obtained from the recovered patients or died patients during course of the disease) of LFT and RFT were compared to that of baseline values (recorded at the time of hospitalization) of recovered or died patients. The baseline values of both LFT and RFT values were not significantly varied between recovered 88.41% ( n =351) and died patients 11.59% ( n =46) at the time of hospitalization. However, the baseline values of total serum bilirubin were significantly (P = 0.001) higher in died patients at the time of hospitalization as compared to the recovered patients. Moreover, majority (52.17%) of the died patients progressed to stage III and stage IV acute kidney injury prior to death. Furthermore, both LFT and RFT were abnormally elevated as compared to their baseline values among the died patients.  COVID-19 patients possess high risk for the development of acute kidney and liver injuries, which can substantially enhance the mortality rate.

The Evolution of Severe Acute Respiratory Syndrome Coronavirus-2 during Pandemic and Adaptation to the Host.

Severe Acute Respiratory Syndrome Coronavirus-2 is a zoonotic virus with a possible origin in bats and potential transmission to humans through an intermediate host. When zoonotic viruses jump to a new host, they undergo both mutational and natural selective pressures that result in non-synonymous and synonymous adaptive changes, necessary for efficient replication and rapid spread of diseases in new host species. The nucleotide composition and codon usage pattern of SARS-CoV-2 indicate the presence of a highly conserved, gene-specific codon usage bias. The codon usage pattern of SARS-CoV-2 is mostly antagonistic to human and bat codon usage. SARS-CoV-2 codon usage bias is mainly shaped by the natural selection, while mutational pressure plays a minor role. The time-series analysis of SARS-CoV-2 genome indicates that the virus is slowly evolving. Virus isolates from later stages of the outbreak have more biased codon usage and nucleotide composition than virus isolates from early stages of the outbreak.