PDF(Pubmed)
Abstract：
BACKGROUND: In August 2023, the BA.2.86 SARS-CoV-2 variant, with over 30 spike protein mutations, emerged amidst the global dominance of XBB sub-lineages. It evolved into JN.1 by late 2023, spreading across 71 countries. JN.1, distinct for its L455S mutation, significantly dominated global sequences, raising concerns over its transmission and clinical impact. The study investigates JN.1\'s clinical severity and its effect on hospital admissions in Maharashtra, India.
METHODS: The present study involved 3,150 curated Indian SARS-CoV-2 whole genome sequences with collection dates between 1st August 2023 and 15th January 2024. Lineage and phylogenetic analysis of sequences was performed using Nextclade. Telephonic interviews were conducted to confirm the demographic details and obtain clinical information on the JN.1* (* indicates JN.1 and all its sub-lineages) cases. The obtained data were recorded and analyzed using Microsoft® Excel (Microsoft Corporation, Redmond, WA).
RESULTS: Out of 3,150 sequences analyzed, JN.1* was the most common lineage (2377/3150, 75.46%), followed by XBB.2.3* (281/3150, 8.92%) and XBB.1.16* (187/3150, 5.94%). In India, it was first identified on 6th October 2023, in Kerala. The highest proportion of JN.1* sequences originated from Maharashtra (628/2377, 26.42%), followed by West Bengal (320/2377, 13.46%), Andhra Pradesh (293/2377, 12.33%), Kerala (288/2377, 12.12%), and Karnataka (285/2377, 11.99%). In Maharashtra, the JN.1* variant was first identified on 23rd November 2023. A total of 279 JN.1* cases were included in the clinical study. Of these, 95.34% (266/279) had symptomatic disease with mild symptoms; cold (187/279, 67.03%) being the most common symptom, followed by fever (156/279, 55.91%), cough (114/279, 40.86%), and headache (28/279, 15.64%). Of all the cases, 13.26% (37/279) required institutional quarantine or hospitalization, and the rest were isolated at home. Among the hospitalized patients, 54.05% (20/37) cases were given conservative treatment while 45.95% (17/37) cases required supplemental oxygen therapy. Regarding the vaccination status, 94.26% (263/279) of cases received at least one dose of the COVID-19 vaccine, while 5.02% (14/279) were not vaccinated, of which most were children aged zero to nine years (5/14, 35.71%). The overall recovery rate among JN.1* cases was 98.57% (275/279), with 1.43% (4/279) cases succumbing to the disease.
CONCLUSIONS: The JN.1* variant, the dominant variant in India, exhibits clinical features similar to previous circulating variants in Maharashtra without increased severity. Its notable transmissibility underscores the importance of studying the ongoing viral evolution. The pressing necessity for swift identification and the clinical features of new variants is essential for effective public health response.
METHODS: The present study involved 3,150 curated Indian SARS-CoV-2 whole genome sequences with collection dates between 1st August 2023 and 15th January 2024. Lineage and phylogenetic analysis of sequences was performed using Nextclade. Telephonic interviews were conducted to confirm the demographic details and obtain clinical information on the JN.1* (* indicates JN.1 and all its sub-lineages) cases. The obtained data were recorded and analyzed using Microsoft® Excel (Microsoft Corporation, Redmond, WA).
RESULTS: Out of 3,150 sequences analyzed, JN.1* was the most common lineage (2377/3150, 75.46%), followed by XBB.2.3* (281/3150, 8.92%) and XBB.1.16* (187/3150, 5.94%). In India, it was first identified on 6th October 2023, in Kerala. The highest proportion of JN.1* sequences originated from Maharashtra (628/2377, 26.42%), followed by West Bengal (320/2377, 13.46%), Andhra Pradesh (293/2377, 12.33%), Kerala (288/2377, 12.12%), and Karnataka (285/2377, 11.99%). In Maharashtra, the JN.1* variant was first identified on 23rd November 2023. A total of 279 JN.1* cases were included in the clinical study. Of these, 95.34% (266/279) had symptomatic disease with mild symptoms; cold (187/279, 67.03%) being the most common symptom, followed by fever (156/279, 55.91%), cough (114/279, 40.86%), and headache (28/279, 15.64%). Of all the cases, 13.26% (37/279) required institutional quarantine or hospitalization, and the rest were isolated at home. Among the hospitalized patients, 54.05% (20/37) cases were given conservative treatment while 45.95% (17/37) cases required supplemental oxygen therapy. Regarding the vaccination status, 94.26% (263/279) of cases received at least one dose of the COVID-19 vaccine, while 5.02% (14/279) were not vaccinated, of which most were children aged zero to nine years (5/14, 35.71%). The overall recovery rate among JN.1* cases was 98.57% (275/279), with 1.43% (4/279) cases succumbing to the disease.
CONCLUSIONS: The JN.1* variant, the dominant variant in India, exhibits clinical features similar to previous circulating variants in Maharashtra without increased severity. Its notable transmissibility underscores the importance of studying the ongoing viral evolution. The pressing necessity for swift identification and the clinical features of new variants is essential for effective public health response.
摘要：
背景：2023年8月，BA.2.86SARS-CoV-2变体，有超过30个刺突蛋白突变，在XBB子谱系的全球主导地位中出现。到2023年底演变成JN.1，遍布71个国家。JN.1，其独特的L455S突变，显著占主导地位的全球序列，引起人们对其传播和临床影响的担忧。该研究调查了JN.1的临床严重程度及其对马哈拉施特拉邦住院人数的影响，印度。
方法：本研究涉及3,150个经过策划的印度SARS-CoV-2全基因组序列，收集日期为2023年8月1日至2024年1月15日。使用Nextclade进行序列的谱系和系统发育分析。进行电话访谈以确认人口统计细节并获得有关JN.1*（*表示JN.1及其所有子谱系）病例的临床信息。使用Microsoft®Excel（MicrosoftCorporation，雷德蒙德,西澳）。
结果：在分析的3,150个序列中，JN.1*是最常见的谱系（2377/3150，75.46%），其次是XBB.2.3*（281/3150，8.92%）和XBB.1.16*（187/3150，5.94%）。在印度,它于2023年10月6日在喀拉拉邦首次被发现。来自马哈拉施特拉邦的JN.1*序列比例最高（628/2377，26.42％），其次是西孟加拉邦(320/2377,13.46%),安得拉邦（293/2377，12.33%），喀拉拉邦（288/2377，12.12%），和卡纳塔克邦（285/2377，11.99%）。在马哈拉施特拉邦,JN.1*变体于2023年11月23日首次鉴定。临床研究共纳入279例JN.1*病例。其中,95.34%（266/279）有症状，症状轻微；感冒（187/279，67.03%）是最常见的症状，其次是发烧（156/279，55.91%），咳嗽（114/279，40.86%），头痛（28/279，15.64%）。在所有案件中，13.26%(37/279)需要机构隔离或住院治疗,其余的人都被隔离在家里。在住院患者中，54.05%(20/37)例给予保守治疗，45.95%(17/37)例需要补充氧疗。关于疫苗接种情况，94.26%（263/279）的病例接受了至少一剂COVID-19疫苗，5.02％（14/279）未接种疫苗，其中大多数是0至9岁的儿童(5/14，35.71%)。JN.1*病例的总治愈率为98.57%(275/279),1.43%(4/279)的病例死于该疾病。
结论：JN.1*变体，印度的主要变种，表现出与马哈拉施特拉邦以前的循环变异相似的临床特征，但严重程度没有增加。它显着的传播性强调了研究正在进行的病毒进化的重要性。快速识别和新变体的临床特征的迫切需要对于有效的公共卫生反应至关重要。
方法：本研究涉及3,150个经过策划的印度SARS-CoV-2全基因组序列，收集日期为2023年8月1日至2024年1月15日。使用Nextclade进行序列的谱系和系统发育分析。进行电话访谈以确认人口统计细节并获得有关JN.1*（*表示JN.1及其所有子谱系）病例的临床信息。使用Microsoft®Excel（MicrosoftCorporation，雷德蒙德,西澳）。
结果：在分析的3,150个序列中，JN.1*是最常见的谱系（2377/3150，75.46%），其次是XBB.2.3*（281/3150，8.92%）和XBB.1.16*（187/3150，5.94%）。在印度,它于2023年10月6日在喀拉拉邦首次被发现。来自马哈拉施特拉邦的JN.1*序列比例最高（628/2377，26.42％），其次是西孟加拉邦(320/2377,13.46%),安得拉邦（293/2377，12.33%），喀拉拉邦（288/2377，12.12%），和卡纳塔克邦（285/2377，11.99%）。在马哈拉施特拉邦,JN.1*变体于2023年11月23日首次鉴定。临床研究共纳入279例JN.1*病例。其中,95.34%（266/279）有症状，症状轻微；感冒（187/279，67.03%）是最常见的症状，其次是发烧（156/279，55.91%），咳嗽（114/279，40.86%），头痛（28/279，15.64%）。在所有案件中，13.26%(37/279)需要机构隔离或住院治疗,其余的人都被隔离在家里。在住院患者中，54.05%(20/37)例给予保守治疗，45.95%(17/37)例需要补充氧疗。关于疫苗接种情况，94.26%（263/279）的病例接受了至少一剂COVID-19疫苗，5.02％（14/279）未接种疫苗，其中大多数是0至9岁的儿童(5/14，35.71%)。JN.1*病例的总治愈率为98.57%(275/279),1.43%(4/279)的病例死于该疾病。
结论：JN.1*变体，印度的主要变种，表现出与马哈拉施特拉邦以前的循环变异相似的临床特征，但严重程度没有增加。它显着的传播性强调了研究正在进行的病毒进化的重要性。快速识别和新变体的临床特征的迫切需要对于有效的公共卫生反应至关重要。
