SARS-CoV-2 genome sequences from Lucknow, Uttar Pradesh, India by Nanopore Sequencing

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has emerged as a significant challenge worldwide. Rapid genome sequencing of SARS-CoV-2 is going on across the globe to detect mutations and genomic modifications in SARS-CoV-2. In this study, we have sequenced twenty-three SARS-CoV-2 positive samples collected during the first pandemic from the state of Uttar Pradesh, India. We observed a range of already reported mutations (2-22), including; D614G, L452R, Q613H, Q677H, T1027I in the S gene; S194L in the N gene; Q57H, L106F, T175I in the ORF3. Few unreported mutations such as P309S in the ORF1ab gene; T379I in the N gene; and L52F, V77I in the ORF3a gene were also detected. Phylogenetic genome analysis showed similarity with other SARS-CoV-2 viruses reported from Uttar Pradesh. The observed mutations may be associated with SARS-CoV-2 virus pathogenicity or disease severity.

Changing clinical manifestations of dengue infection in north India

Dengue infection is endemic in many parts of India, including the state of Uttar Pradesh. This study describes the changing clinical picture of dengue viral infections observed by us in children admittedto a teaching hospital in Lucknow, India.A total of 139 children with suspected dengue were admitted during this period, of which 124 couldbe tested by dengue IgM capture ELISA and 102 were positive. However, only 80 of these 102 patientscould be followed up. Average age was 5.9 (±3.1) years and 87.5% of them were from rural areas. Themale:female ratio was 1.6:1. Seizures were observed in 45% cases, altered sensorium in 53.7%, vomitingin 41.2%, haemorrhage in 38.8%, skin rash in 37.5%, abdominal pain in 25%, headache in 18.8% andjaundice in 2% cases. Gastrointestinal tract was the commonest site of bleeding. On examination,edema was present in 47.5% cases, hepatomegaly in 62.5%, splenomegaly in 60.0% and hypotensionin 10.0% cases. The investigations revealed a low platelet count of less than 100000/mm3 in 60.3%cases. Mean liver enzyme levels were mildly raised. Definitions of WHO criteria for DHF were presentin only 18 (22.5%) cases. Mean total duration of fever in survivors was 14.9±7.3 days. The overall fatality rate in hospital was 5.0%.The results indicated a significant proportion of children presented with little-described features ofencephalopathy, edema, splenomegaly and prolonged fever rather than the typical dengue presentation.These features were not noted during the past epidemics and in previous years.