RESUMO
SARS-CoV-2 evolution has continued to generate variants, responsible for new pandemic waves locally and globally. Varying disease presentation and severity has been ascribed to inherent variant characteristics and vaccine immunity. This study analyzed genomic data from 305 whole genome sequences from SARS-CoV-2 patients before and through the third wave in India. Delta variant was responsible for disease in patients without comorbidity(97%), while Omicron BA.2 caused disease primarily in those with comorbidity(77%). Tissue adaptation studies brought forth higher propensity of Omicron variants to bronchial tissue than lung, contrary to observation in Delta variants from Delhi. Study of codon usage pattern distinguished the prevalent variants, clustering them separately, Omicron BA.2 isolated in February grouped away from December strains, and all BA.2 after December acquired a new mutation S959P in ORF1b (44.3% of BA.2 in the study) indicating ongoing evolution. Loss of critical spike mutations in Omicron BA.2 and gain of immune evasion mutations including G142D, reported in Delta but absent in BA.1, and S371F instead of S371L in BA.1 could possibly be due to evolutionary trade-off and explain very brief period of BA.1 in December 2021, followed by complete replacement by BA.2.
RESUMO
We report a 10 year-old girl with panhypopituitarism and coexistent ocular and neurocysticercosis. Intrasellar cystic lesions whether neoplastic or non-neoplastic in origin are often difficult to distinguish because their symptoms, signs, and radiological characteristics are similar. The diagnosis of intrasellar cysticercosis was initially considered because of high endemicity, positive serology for cysticercus and radiological evidence of cysticercosis in the eye and parietal lobe. However, since there was no improvement with cysticidal therapy and no radiological resolution of the sellar lesion, surgery was performed, which revealed a Rathke's cleft cyst.
