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1.
PLoS One ; 16(12): e0260767, 2021.
Article in English | MEDLINE | ID: covidwho-1581773

ABSTRACT

BACKGROUND: The COVID-19 pandemic has affected health care systems worldwide. Multidisciplinary teams provide specialist palliative home care (SPHC) for patients with incurable, severe, progressive diseases. These patients are at the same time at high risk, if infected, highly constricted by containment measures, and dependent on support. AIM: To explore i) how German SPHC teams were affected by the pandemic during the first wave, ii) which challenges they faced, and iii) which strategies helped to handle the consequences of the COVID-19 pandemic for providing good SPHC. METHOD: Four focus groups (with representatives of 18 SPHC teams) and five guided interviews with stakeholders were conducted and analysed using qualitative content analysis. RESULTS: Seven key categories emerged from the data. A category in the background describes dependence on organizational characteristics (e.g. sponsorship), which varied by regional factors. Information management was a challenge to SPHC teams, as they had to collect, interpret and adapt, and disseminate information. They reported a shift in patient care because of the COVID-19 pandemic, due to restricted home visits, visitation ban in nursing homes, and difficulties for hospital, hospice and nursing home admissions. Measures to reduce risk of infection impeded teamwork. Teams relied upon their local networks in crisis management, but felt often overlooked by local health authorities. Their respective SPHC state associations supported them in information management and exchange. DISCUSSION: The pandemic has severely impacted home care for especially vulnerable seriously ill and dying people. A good network with local health providers and authorities could help to harmonize local regulations and ensure quality care for all patient groups. SPHC teams could play an important role in caring for palliative patients with COVID-19 who are not admitted to a hospital due to preferences or resources.


Subject(s)
COVID-19 , Adaptation, Physiological , Humans , Uncertainty
2.
PLoS Comput Biol ; 17(11): e1009560, 2021 11.
Article in English | MEDLINE | ID: covidwho-1523396

ABSTRACT

Severe acute respiratory coronavirus 2 (SARS-CoV-2), the causative agent of COVID-19, is of zoonotic origin. Evolutionary analyses assessing whether coronaviruses similar to SARS-CoV-2 infected ancestral species of modern-day animal hosts could be useful in identifying additional reservoirs of potentially dangerous coronaviruses. We reasoned that if a clade of species has been repeatedly exposed to a virus, then their proteins relevant for viral entry may exhibit adaptations that affect host susceptibility or response. We perform comparative analyses across the mammalian phylogeny of angiotensin-converting enzyme 2 (ACE2), the cellular receptor for SARS-CoV-2, in order to uncover evidence for selection acting at its binding interface with the SARS-CoV-2 spike protein. We uncover that in rodents there is evidence for adaptive amino acid substitutions at positions comprising the ACE2-spike interaction interface, whereas the variation within ACE2 proteins in primates and some other mammalian clades is not consistent with evolutionary adaptations. We also analyze aminopeptidase N (APN), the receptor for the human coronavirus 229E, a virus that causes the common cold, and find evidence for adaptation in primates. Altogether, our results suggest that the rodent and primate lineages may have had ancient exposures to viruses similar to SARS-CoV-2 and HCoV-229E, respectively.


Subject(s)
COVID-19/genetics , COVID-19/virology , Coronavirus Infections/genetics , Coronavirus Infections/virology , SARS-CoV-2/genetics , Adaptation, Physiological/genetics , Amino Acid Substitution , Angiotensin-Converting Enzyme 2/genetics , Angiotensin-Converting Enzyme 2/physiology , Animals , CD13 Antigens/genetics , CD13 Antigens/physiology , Common Cold/genetics , Common Cold/virology , Computational Biology , Coronavirus 229E, Human/genetics , Coronavirus 229E, Human/physiology , Evolution, Molecular , Genomics , Host Microbial Interactions/genetics , Host Microbial Interactions/physiology , Host Specificity/genetics , Host Specificity/physiology , Humans , Mammals/genetics , Mammals/virology , Phylogeny , Protein Interaction Domains and Motifs/genetics , Receptors, Virus/genetics , Receptors, Virus/physiology , SARS-CoV-2/physiology , Selection, Genetic , Spike Glycoprotein, Coronavirus/genetics , Spike Glycoprotein, Coronavirus/physiology , Virus Internalization
4.
Int J Environ Res Public Health ; 18(19)2021 09 27.
Article in English | MEDLINE | ID: covidwho-1438621

ABSTRACT

As the novel coronavirus (COVID-19) pandemic continues, frontline nurses caring for COVID-19 patients are experiencing severe fatigue and mental stress. This study explored nurses' adaptation process in caring for COVID-19 patients and examined how nurses interact with the phenomenon using a grounded theory approach. The study aimed to develop a substantive theory and provide basic data with which to develop intervention programs that can support nurses caring for COVID-19 patients. Data were collected between 7 August and 31 October 2020, via face-to-face in-depth interviews with 23 nurses who had been caring for COVID-19 patients for six months or more at a nationally designated COVID-19 hospital. Sampling was started purposively and continued theoretically. Data analysis, performed using the method proposed by Strauss and Corbin, resulted in 13 main categories, the core one being "growing as a proficient nurse alongside comrades on the COVID-19 frontline". The study's results identify the nurses' adaptation process in caring for COVID-19 patients and their reactions to the circumstances around it. Ensuring that nurses can systematically cope with emerging infectious diseases requires regularly providing them with basic education on caring for patients with such diseases and strengthening professional education in order to develop nurses specializing in them. This study also recommends that a support system for work and childrearing be developed.


Subject(s)
COVID-19 , Nurses , Adaptation, Physiological , Grounded Theory , Humans , SARS-CoV-2
5.
Physiol Rep ; 9(18): e15044, 2021 09.
Article in English | MEDLINE | ID: covidwho-1436402

ABSTRACT

In humans, exercise-induced thermogenesis is a markedly variable component of total energy expenditure, which had been acutely affected worldwide by COVID-19 pandemic-related lockdowns. We hypothesized that dietary macronutrient composition may affect metabolic adaptation/fuel selection in response to an acute decrease in voluntary activity. Using mice fed short-term high-fat diet (HFD) compared to low-fat diet (LFD)-fed mice, we evaluated whole-body fuel utilization by metabolic cages before and 3 days after omitting a voluntary running wheel in the cage. Short-term (24-48 h) HFD was sufficient to increase energy intake, fat oxidation, and decrease carbohydrate oxidation. Running wheel omission did not change energy intake, but resulted in a significant 50% decrease in total activity and a ~20% in energy expenditure in the active phase (night-time), compared to the period with wheel, irrespective of the dietary composition, resulting in significant weight gain. Yet, while in LFD wheel omission significantly decreased active phase fat oxidation, thereby trending to increase respiratory exchange ratio (RER), in HFD it diminished active phase carbohydrate oxidation. In conclusion, acute decrease in voluntary activity resulted in positive energy balance in mice on both diets, and decreased oxidation of the minor energy (macronutrient) fuel source, demonstrating that dietary macronutrient composition determines fuel utilization choices under conditions of acute changes in energetic demand.


Subject(s)
Diet, Fat-Restricted , Diet, High-Fat , Dietary Fats/administration & dosage , Energy Metabolism , Adaptation, Physiological , Animal Feed , Animal Nutritional Physiological Phenomena , Animals , Dietary Fats/metabolism , Energy Intake , Male , Mice, Inbred C57BL , Nutritional Status , Nutritive Value , Running , Time Factors
6.
PLoS One ; 16(9): e0256695, 2021.
Article in English | MEDLINE | ID: covidwho-1403301

ABSTRACT

The purpose of this study was to examine to what extent the physical match performance of professional soccer players is both position and player specific. First, official match data from the 2019/20 German Bundesliga season was used to search for players that met the inclusion criteria of playing a minimum of four entire matches in at least two different playing positions. Overall, 25 players met the criteria prior to the COVID-19 induced break, playing a minimum of eight matches. Second, the physical match performance of these players was analyzed separately for each position they played. The following four parameters were captured: total distance, high-intensity distance, sprinting distance, and accelerations. Third, the 25 players' physical match performance data was then compared to normative data for each position they played to understand whether players adapted their physical performance (position dependent), or maintained their performance regardless of which position they were assigned to (position independent). When switching the position, the change in physical match performance of the respective players could be explained by 44-58% through the normative positional data. Moreover, there existed large individual differences in the way players adapted or maintained their performance when acting in different positions. Coaches and practitioners should be aware that some professional soccer players will likely incur differences in the composition of physical match performance when switching positions and therefore should pay special consideration for such differences in the training and recovery process of these players.


Subject(s)
Athletic Performance , Physical Functional Performance , Soccer , Adaptation, Physiological , Humans
7.
Public Health Res Pract ; 31(3)2021 09 08.
Article in English | MEDLINE | ID: covidwho-1399673
8.
Genome Biol Evol ; 13(8)2021 08 03.
Article in English | MEDLINE | ID: covidwho-1390355

ABSTRACT

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been posing an unprecedented challenge to global public health. SARS-CoV-2 and several other coronaviruses utilize angiotensin-converting enzyme 2 (ACE2) as their entry receptors. The ACE2 gene has been found to experience episodic positive selection across mammals. However, much remains unknown about how the ACE2 gene evolved in human populations. Here, we use population genetics approaches to investigate the evolution of the ACE2 gene in 26 human populations sampled globally. We find the ACE2 gene exhibits an extremely low nucleotide diversity in the East Asian populations. Strong signals of selective sweep are detected in the East Asian populations, but not in the other human populations. The selective sweep in ACE2 is estimated to begin in East Asian populations ∼23,600 years ago. Our study provides novel insights into the evolution of the ACE2 gene within human populations.


Subject(s)
Angiotensin-Converting Enzyme 2/genetics , Evolution, Molecular , Adaptation, Physiological , DNA, Ancient , Haplotypes , Humans , Selection, Genetic
10.
Int J Environ Res Public Health ; 18(16)2021 08 05.
Article in English | MEDLINE | ID: covidwho-1376804

ABSTRACT

Humans on earth inhabit a wide range of environmental conditions and some environments are more challenging for human survival than others. However, many living beings, including humans, have developed adaptive mechanisms to live in such inhospitable, harsh environments. Among different difficult environments, high-altitude living is especially demanding because of diminished partial pressure of oxygen and resulting chronic hypobaric hypoxia. This results in poor blood oxygenation and reduces aerobic oxidative respiration in the mitochondria, leading to increased reactive oxygen species generation and activation of hypoxia-inducible gene expression. Genetic mechanisms in the adaptation to high altitude is well-studied, but there are only limited studies regarding the role of epigenetic mechanisms. The purpose of this review is to understand the epigenetic mechanisms behind high-altitude adaptive and maladaptive phenotypes. Hypobaric hypoxia is a form of cellular hypoxia, which is similar to the one suffered by critically-ill hypoxemia patients. Thus, understanding the adaptive epigenetic signals operating in in high-altitude adjusted indigenous populations may help in therapeutically modulating signaling pathways in hypoxemia patients by copying the most successful epigenotype. In addition, we have summarized the current information about exosomes in hypoxia research and prospects to use them as diagnostic tools to study the epigenome of high-altitude adapted healthy or maladapted individuals.


Subject(s)
Exosomes , Exposome , Adaptation, Physiological/genetics , Altitude , Epigenesis, Genetic , Exosomes/genetics , Humans , Hypoxia/genetics
11.
Diagn Microbiol Infect Dis ; 101(4): 115520, 2021 Dec.
Article in English | MEDLINE | ID: covidwho-1363963

ABSTRACT

Sample panels of SARS-CoV-2 cases were retrospectively whole-genome sequenced. In three individuals, samples of upper and lower respiratory tract resulted in identical sequences suggesting virus stability including the spike protein cleavage site. In a fourth case, low-level intra-host genomic evolution and a unique 5-nucleotide deletion was observed.


Subject(s)
Adaptation, Physiological/genetics , COVID-19/virology , Respiratory System/virology , SARS-CoV-2/isolation & purification , Whole Genome Sequencing , Genome, Viral , Humans , Retrospective Studies , Tissue Distribution
12.
Psychon Bull Rev ; 28(3): 992-1002, 2021 Jun.
Article in English | MEDLINE | ID: covidwho-1319758

ABSTRACT

Seeing a person's mouth move for [ga] while hearing [ba] often results in the perception of "da." Such audiovisual integration of speech cues, known as the McGurk effect, is stable within but variable across individuals. When the visual or auditory cues are degraded, due to signal distortion or the perceiver's sensory impairment, reliance on cues via the impoverished modality decreases. This study tested whether cue-reliance adjustments due to exposure to reduced cue availability are persistent and transfer to subsequent perception of speech with all cues fully available. A McGurk experiment was administered at the beginning and after a month of mandatory face-mask wearing (enforced in Czechia during the 2020 pandemic). Responses to audio-visually incongruent stimuli were analyzed from 292 persons (ages 16-55), representing a cross-sectional sample, and 41 students (ages 19-27), representing a longitudinal sample. The extent to which the participants relied exclusively on visual cues was affected by testing time in interaction with age. After a month of reduced access to lipreading, reliance on visual cues (present at test) somewhat lowered for younger and increased for older persons. This implies that adults adapt their speech perception faculty to an altered environmental availability of multimodal cues, and that younger adults do so more efficiently. This finding demonstrates that besides sensory impairment or signal noise, which reduce cue availability and thus affect audio-visual cue reliance, having experienced a change in environmental conditions can modulate the perceiver's (otherwise relatively stable) general bias towards different modalities during speech communication.


Subject(s)
Adaptation, Physiological/physiology , Cues , Facial Recognition/physiology , Lipreading , Masks , Speech Perception/physiology , Adolescent , Adult , Age Factors , COVID-19/prevention & control , Female , Humans , Male , Middle Aged , Young Adult
13.
BMC Pregnancy Childbirth ; 21(1): 515, 2021 Jul 19.
Article in English | MEDLINE | ID: covidwho-1318278

ABSTRACT

BACKGROUND: In light of the pandemic, pregnant women are particularly vulnerable to increased psychological distress and in need of imperative preventive measures. This study aimed to investigate the impact of the pandemic on mental health, lifestyle adaptations, and their determinants among pregnant women in the United Arab Emirates. METHODS: A survey was conducted electronically between June and August 2020. Pregnant women were recruited from prenatal clinics in the UAE and invited to participate in an online survey developed on Google Forms. The questionnaire included socio-demographic characteristics, the Impact of Event Scale- Revised, the Perceived Support Scale and lifestyle-related factors. RESULTS: A total of 384 pregnant women completed the questionnaire of whom 20.6% were in their 1st trimester, 46.1% in their 2nd and 33.3% in their 3rd trimester. The mean IES-R score for the respondents was 26.15 ± 13.55, corresponding to a mild stressful impact, which did not differ significantly among trimesters of pregnancy. Pregnant women expressed increased stress from staying home (64%), work (40%), feeling frightened (66%) and apprehensive (59%). Women reported increased support and sharing their feelings with family members (59%), mainly in the 1st and 3rd trimester of pregnancy (P < 0.05). There was a greater attention to mental health (48%), resting time (55.3%), and relaxing time (57.3%); while a decreased amount of time was spent engaging in physical activities (53.6%), which differed significantly between trimesters (P = 0.02). CONCLUSIONS: The COVID-19 pandemic was associated with a mild stressful impact among pregnant women in the UAE, braced by strong family support and self-care mental health behaviors.


Subject(s)
Adaptation, Physiological , Adaptation, Psychological , COVID-19 , Pregnant Women/psychology , Adult , Communicable Disease Control , Cross-Sectional Studies , Exercise , Female , Health Behavior , Humans , Pregnancy , Social Support , Stress, Psychological/etiology , Surveys and Questionnaires , United Arab Emirates
14.
Proc Natl Acad Sci U S A ; 118(29)2021 07 20.
Article in English | MEDLINE | ID: covidwho-1307383

ABSTRACT

Understanding the trends in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) evolution is paramount to control the COVID-19 pandemic. We analyzed more than 300,000 high-quality genome sequences of SARS-CoV-2 variants available as of January 2021. The results show that the ongoing evolution of SARS-CoV-2 during the pandemic is characterized primarily by purifying selection, but a small set of sites appear to evolve under positive selection. The receptor-binding domain of the spike protein and the region of the nucleocapsid protein associated with nuclear localization signals (NLS) are enriched with positively selected amino acid replacements. These replacements form a strongly connected network of apparent epistatic interactions and are signatures of major partitions in the SARS-CoV-2 phylogeny. Virus diversity within each geographic region has been steadily growing for the entirety of the pandemic, but analysis of the phylogenetic distances between pairs of regions reveals four distinct periods based on global partitioning of the tree and the emergence of key mutations. The initial period of rapid diversification into region-specific phylogenies that ended in February 2020 was followed by a major extinction event and global homogenization concomitant with the spread of D614G in the spike protein, ending in March 2020. The NLS-associated variants across multiple partitions rose to global prominence in March to July, during a period of stasis in terms of interregional diversity. Finally, beginning in July 2020, multiple mutations, some of which have since been demonstrated to enable antibody evasion, began to emerge associated with ongoing regional diversification, which might be indicative of speciation.


Subject(s)
Adaptation, Physiological/genetics , Evolution, Molecular , SARS-CoV-2/genetics , Amino Acid Substitution , COVID-19/diagnosis , COVID-19/epidemiology , COVID-19/prevention & control , COVID-19/virology , COVID-19 Testing , Coronavirus Nucleocapsid Proteins/genetics , Epistasis, Genetic , Genome, Viral/genetics , Humans , Immune Evasion/genetics , Mutation , Nuclear Localization Signals/genetics , Phosphoproteins/genetics , Phylogeny , Protein Interaction Domains and Motifs/genetics , SARS-CoV-2/classification , Selection, Genetic , Spike Glycoprotein, Coronavirus/genetics , Vaccination
15.
Methods Mol Biol ; 2099: 3-8, 2020.
Article in English | MEDLINE | ID: covidwho-1292543

ABSTRACT

Forced viral adaptation is a powerful technique employed to study the ways viruses may overcome various selective pressures that reduce viral replication. Here, we describe methods for in vitro serial passaging of Middle East respiratory syndrome coronavirus (MERS-CoV) to select for mutations which increase replication on semi-permissive cell lines as described in Letko et al., Cell Rep 24, 1730-1737, 2018.


Subject(s)
Adaptation, Physiological/genetics , Coronavirus Infections/virology , Middle East Respiratory Syndrome Coronavirus/genetics , Virus Replication/genetics , Animals , Biological Evolution , Cell Line , Chlorocebus aethiops , Host Specificity , Humans , Middle East Respiratory Syndrome Coronavirus/physiology , Serial Passage , Vero Cells
16.
Science ; 372(6541): 466-467, 2021 04 30.
Article in English | MEDLINE | ID: covidwho-1290179
17.
EBioMedicine ; 67: 103381, 2021 May.
Article in English | MEDLINE | ID: covidwho-1228017

ABSTRACT

BACKGROUND: An ideal animal model to study SARS-coronavirus 2 (SARS-CoV-2) pathogenesis and evaluate therapies and vaccines should reproduce SARS-CoV-2 infection and recapitulate lung disease like those seen in humans. The angiotensin-converting enzyme 2 (ACE2) is a functional receptor for SARS-CoV-2, but mice are resistant to the infection because their ACE2 is incompatible with the receptor-binding domain (RBD) of the SARS-CoV-2 spike protein . METHODS: SARS-CoV-2 was passaged in BALB/c mice to obtain mouse-adapted virus strain. Complete genome deep sequencing of different generations of viruses was performed to characterize the dynamics of the adaptive mutations in SARS-CoV-2. Indirect immunofluorescence analysis and Biolayer interferometry experiments determined the binding affinity of mouse-adapted SARS-CoV-2 WBP-1 RBD to mouse ACE2 and human ACE2. Finally, we tested whether TLR7/8 agonist Resiquimod (R848) could also inhibit the replication of WBP-1 in the mouse model. FINDINGS: The mouse-adapted strain WBP-1 showed increased infectivity in BALB/c mice and led to severe interstitial pneumonia. We characterized the dynamics of the adaptive mutations in SARS-CoV-2 and demonstrated that Q493K and Q498H in RBD significantly increased its binding affinity towards mouse ACE2. Additionally, the study tentatively found that the TLR7/8 agonist Resiquimod was able to protect mice against WBP-1 challenge. Therefore, this mouse-adapted strain is a useful tool to investigate COVID-19 and develop new therapies. INTERPRETATION: We found for the first time that the Q493K and Q498H mutations in the RBD of WBP-1 enhanced its interactive affinities with mACE2. The mouse-adapted SARS-CoV-2 provides a valuable tool for the evaluation of novel antiviral and vaccine strategies. This study also tentatively verified the antiviral activity of TLR7/8 agonist Resiquimod against SARS-CoV-2 in vitro and in vivo. FUNDING: This research was funded by the National Key Research and Development Program of China (2020YFC0845600) and Emergency Science and Technology Project of Hubei Province (2020FCA046) and Robert A. Welch Foundation (C-1565).


Subject(s)
Amino Acid Substitution , Angiotensin-Converting Enzyme 2/metabolism , COVID-19/virology , Imidazoles/administration & dosage , SARS-CoV-2/pathogenicity , Spike Glycoprotein, Coronavirus/metabolism , Adaptation, Physiological , Animals , Binding Sites , COVID-19/metabolism , COVID-19/prevention & control , Caco-2 Cells , Chlorocebus aethiops , Disease Models, Animal , Female , High-Throughput Nucleotide Sequencing , Humans , Imidazoles/pharmacology , Mice , Mice, Inbred BALB C , SARS-CoV-2/genetics , Serial Passage , Spike Glycoprotein, Coronavirus/chemistry , Spike Glycoprotein, Coronavirus/genetics , Vero Cells , Virus Replication/drug effects , Whole Genome Sequencing
18.
J Mol Evol ; 89(6): 341-356, 2021 07.
Article in English | MEDLINE | ID: covidwho-1227833

ABSTRACT

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.


Subject(s)
COVID-19/epidemiology , COVID-19/virology , Codon Usage/genetics , Evolution, Molecular , Host-Pathogen Interactions/genetics , SARS-CoV-2/genetics , SARS-CoV-2/physiology , Adaptation, Physiological/genetics , Animals , COVID-19/transmission , Chiroptera/genetics , Genome, Viral/genetics , Humans , Mutation , Pandemics , Principal Component Analysis , Selection, Genetic/genetics , Time Factors , Virus Replication
19.
Nurs Forum ; 56(3): 571-578, 2021 Jul.
Article in English | MEDLINE | ID: covidwho-1199709

ABSTRACT

AIM: This study sought to describe the experiences of critical care nurses caring for patients infected by coronavirus disease 2019 (COVID-19). DESIGN: A qualitative phenomenological design was used. METHODS: We enrolled 15 nurses who provided care for patients infected by COVID-19 purposively and through snowballing, using a phenomenological approach in critical care units of Iran's public hospitals between May and June 2020. The semi-structured interviews were carried out either via face-to-face or telephone and were analyzed using the 7-step method of Colaizzi. RESULTS: The experiences of nurses caring for patients infected with COVID-19 were categorized into four challenges, including psychological (eight subthemes), organizational (six subthemes), social (six subthemes), and professional (five subthemes). In general, based on the current classification, there seems to be a mixture of positive and negative effects on the psychological, social, and professional challenges and the negative effect only on the organizational challenges. CONCLUSIONS: Positive and negative emotions and experiences have coexisted for the critical care nurses since the COVID-19 outbreak. Emotional support and psychological counseling play an important role in maintaining nurses' optimal mental health during the COVID-19 crisis. Adequate protective equipment, financial and nonfinancial supports, effective communication, training and hiring of staff, and appropriate work shifts are also required to reduce nurses' negative experiences when providing care for the affected individuals.


Subject(s)
Adaptation, Physiological , Adaptation, Psychological , COVID-19/nursing , Critical Care/psychology , Nursing Staff, Hospital/psychology , Stress, Physiological , Stress, Psychological , Adult , Female , Humans , Iran , Male , Middle Aged , Qualitative Research
20.
J Gen Virol ; 102(4)2021 04.
Article in English | MEDLINE | ID: covidwho-1186013

ABSTRACT

SARS-CoV-2 is thought to have originated in the human population from a zoonotic spillover event. Infection in humans results in a variety of outcomes ranging from asymptomatic cases to the disease COVID-19, which can have significant morbidity and mortality, with over two million confirmed deaths worldwide as of January 2021. Over a year into the pandemic, sequencing analysis has shown that variants of SARS-CoV-2 are being selected as the virus continues to circulate widely within the human population. The predominant drivers of genetic variation within SARS-CoV-2 are single nucleotide polymorphisms (SNPs) caused by polymerase error, potential host factor driven RNA modification, and insertion/deletions (indels) resulting from the discontinuous nature of viral RNA synthesis. While many mutations represent neutral 'genetic drift' or have quickly died out, a subset may be affecting viral traits such as transmissibility, pathogenicity, host range, and antigenicity of the virus. In this review, we summarise the current extent of genetic change in SARS-CoV-2, particularly recently emerging variants of concern, and consider the phenotypic consequences of this viral evolution that may impact the future trajectory of the pandemic.


Subject(s)
Adaptation, Physiological/genetics , COVID-19/virology , SARS-CoV-2/genetics , Animals , Antigens, Viral/genetics , Antigens, Viral/immunology , COVID-19/epidemiology , COVID-19/immunology , COVID-19/transmission , Humans , Immune Evasion/genetics , Mutation , RNA, Viral/biosynthesis , RNA, Viral/genetics , SARS-CoV-2/isolation & purification , SARS-CoV-2/pathogenicity , SARS-CoV-2/physiology , Spike Glycoprotein, Coronavirus/genetics , Spike Glycoprotein, Coronavirus/metabolism , Viral Proteins/genetics , Viral Proteins/metabolism , Virus Internalization , Virus Replication , Zoonoses/transmission , Zoonoses/virology
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