Source: India News  Sep 17, 2020  2 years ago
BREAKING! India News: Study Shows New Mutational Strains And D614G Mutation Emerging In Central India, COVID-19 Crisis In India Expected To Worsen
BREAKING! India News: Study Shows New Mutational Strains And D614G Mutation Emerging In Central India, COVID-19 Crisis In India Expected To Worsen
Source: India News  Sep 17, 2020  2 years ago
India News: Researchers and scientists from the Virology Division of India’s Defense Research and Development Establishment has discovered  that there are multiple viral introduction events in central India, and SARS-CoV-2 coronavirus with D614G mutation is the prevalently circulating strain. Even more concerning are new mutation variants emerging in India.

The study findings are published on a preprint server and have yet to be peer reviewed.
This findings could have implications as contrary to what certain uniformed experts have been saying about the D614G strains, research have actually found these strains to be more infectious as the have a higher binding affinity. Also due to that property, they tend to infect more cells faster, contributing to higher viral loads and faster disease progression, often leading to severity and complications.
The research team studied 5,000 suspected COVID-19 cases to investigate the virus introduction events and its spread in central India. The patient samples, along with detailed patient history, were collected from 10 different districts.
In order to identify confirmed COVID-19 cases, the team performed a reverse transcriptase quantitative polymerase chain reaction, which led to identifying 136 SARS-CoV-2 positive cases.
From  136 cases, 26 were selected for the whole genome sequencing analysis based on patient’s travel history, age, and contact history; patient’s entry links to the study region from outside; index cases (first identified cases), and death cases. Whole-genome sequencing using the Oxford nanopore platform gave rise to consensus genome sequences of representative SARS-CoV-2 that were circulating in 10 different districts in central India.
Study Shows That In Central India, Young Adults Were Getting Infected And Dying From COVID-19
Interestingly, the team’s analysis of patients’ characteristics revealed that the number of infected cases was maximum in the age range of 21 -30 years, and the most common symptoms were fever, breathlessness, and sore throat. In the case of immunocompromised patients, death occurred within 24 -48 hours of hospitalization.
Significantly by comparing the whole genome sequences of experimental SARS-CoV-2 strains with the sequences of globally circulating SARS-CoV-2 strains, the scientists identified 38 amino acid substitution mutations compared to the Wuhan strain. Of these substitutions, the majority (n=24) were observed in ORF1 ab protein, followed by spike protein (n=5), nucleocapsid (n=4), ORF 3a (n=2), and envelope protein, membrane protein, and ORF 7a (n=1 for each protein).
Considering the importance of spike protein in SARS-CoV-2 transmission, the scientists thoroughly analyzed the amino acid substitution observed in the spike protein.
The team identified that 17 viral strains from 4 districts had D614G mutation, making the virus more infectious. Other substitution mutations they identified in the experimental strains included E583D, S884F, S929T, and S943P.
Notably, the scientists identified new strains of  with nonsynonymous substitutions in experimental viral strains. These substitution mutations were A97V in RNA-dependent RNA polymerase, P13L in nucleocapsid protein, and T2016K in non-structural protein 3. These mutations are known to change protein functions, and thus, can be potentially associated with the rapidly expanding COVID-19 pandemic.   
The study team next performed phylogenetic analysis using SARS-CoV-2 whole-genome sequence data available on the Global Initiative on Sharing All Influenza Data (GISAID) database and observed that viruses that were circulating globally between December 2019 and May 2020 belong to A1 – A4 and B clades (Clade: a monophyletic group with a common ancestor and all its lineal descendants).
The study findings showed that In India, circulating SARS-CoV-2 belongs to several evolutionary clades, including A2a, A3, A4, and B. However, three clades (A2a, A4, and B) were identified for the viruses analyzed in the current study; of which, the majority were clustered in A2a clade.   
The study findings reveals that the exponential rise of SARS-CoV-2 positive cases in central India is associated with multiple viral introduction events with diverse geographical linkage, as well as viral expansion within the regions. The phylogenetic data reveal links of viral introduction from Italy, the UK, France, and Southeast and Central Asia.
The increasing evolution of the virus in the studied regions is evidenced by the cluster-wise segregation of SARS-CoV-2.
The study’s identification of D614G mutation as the prevalent one suggests that the highly infectious strain is circulating in central India. A growing pool of evidence suggests that D614G mutation increases the transmission potency of SARS-CoV-2 and is associated with higher viral load and mortality in COVID-19 patients.
More concerning however are the new mutational strains exhibiting the nonsynonymous substitutions mutations A97V in RNA-dependent RNA polymerase, P13L in nucleocapsid protein, and T2016K in non-structural protein 3 as these are known to change protein functions, and thus, can be potentially associated with the rapidly expanding COVID-19 pandemic. More studies are warranted on these emerging strains.
The situation in India is already fast exacerbating on a daily basis with 97,894 new COVID-19 cases reported in the last 24 hours (Thursday) and bringing  the total number COVID-19 infections to the country to now 5,118, 253.
The number of fatalities in the last 24 hours was 1,132 and the total number of Indians who have died so far from COVID-19 is 93,198.
However many local doctors, health experts and academics are saying the actual figures for infections and deaths could be as high as seven fold as there is still inadequate testing and many state governments are under-reporting or concealing figures as in many cases,  patients who were exhibiting symptoms associated with COVID-19 but dying due to heart failure or strokes but have yet to be tested were never classified as COVID-19 related deaths nor were autopsies ever done to properly determine the cause of deaths.
India’s healthcare system is already on the verge of a major collapse with acute shortage of hospital beds and medical equipment and supplies. There are even reports of medical oxygen shortages and also shortages of ventilators.
The fact that most Indians suffer from hypertension, diabetes and also cardiovascular issues is also another contributing factor coupled with the fact that rich and middle class Indians are misers when it comes to spending on preventive healthcare.
In the rural areas unfortunately, the poorer classes have little or no access to proper medical care and even testing, further compounding the problems in the country.
Many other countries out of concern are now also banning all flights from India and also all Indian travellers and also returnees from India irrespective of nationality.
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