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dc.creatorZhang, Xiaonan
dc.creatorTan, Yun
dc.creatorLing, Yun
dc.creatorLu, Gang
dc.creatorLiu, Feng
dc.creatorYi, Zhigang
dc.creatorJia, Xiaofang
dc.creatorWu, Min
dc.creatorShi, Bisheng
dc.creatorXu, Shuibao
dc.creatorChen, Jun
dc.creatorWang, Wei
dc.creatorChen, Bing
dc.creatorJiang, Lu
dc.creatorYu, Shuting
dc.creatorLu, Jing
dc.creatorWang, Jinzeng
dc.creatorXu, Mingzhu
dc.creatorYuan, Zhenghong
dc.creatorZhang, Qin
dc.creatorZhang, Xinxin
dc.creatorZhao, Guoping
dc.creatorWang, Shengyue
dc.creatorChen, Saijuan
dc.creatorLu, Hongzhou
dc.date.accessioned2020-07-21T14:32:13Z
dc.date.available2020-07-21T14:32:13Z
dc.date.created2020-05-20
dc.identifier.issn1476-4687spa
dc.identifier.otherhttps://www.nature.com/articles/s41586-020-2355-0spa
dc.identifier.urihttp://hdl.handle.net/20.500.12010/10844
dc.format.extent18 páginasspa
dc.format.mimetypeapplication/pdfspa
dc.publisherScience Directeng
dc.sourcereponame:Expeditio Repositorio Institucional UJTLspa
dc.sourceinstname:Universidad de Bogotá Jorge Tadeo Lozanospa
dc.subjectCOVID-19spa
dc.titleViral and host factors related to the clinical outcome of COVID-19spa
dc.type.localArtículospa
dc.subject.lembSíndrome respiratorio agudo gravespa
dc.subject.lembCOVID-19spa
dc.subject.lembSARS-CoV-2spa
dc.subject.lembCoronavirusspa
dc.rights.accessrightsinfo:eu-repo/semantics/openAccessspa
dc.type.hasversioninfo:eu-repo/semantics/acceptedVersionspa
dc.identifier.doihttps://doi.org/10.1038/s41586-020-2355-0spa
dc.description.abstractenglishIn December 2019, coronavirus disease 2019 (COVID-19), which is caused by the new coronavirus severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), was identified in Wuhan (Hubei province, China)1; it soon spread across the world. In this ongoing pandemic, public health concerns and the urgent need for effective therapeutic measures require a deep understanding of the epidemiology, transmissibility and pathogenesis of COVID-19. Here we analysed clinical, molecular and immunological data from 326 patients with confirmed SARS-CoV-2 infection in Shanghai. The genomic sequences of SARS-CoV-2, assembled from 112 high-quality samples together with sequences in the Global Initiative on Sharing All Influenza Data (GISAID) dataset, showed a stable evolution and suggested that there were two major lineages with differential exposure history during the early phase of the outbreak in Wuhan. Nevertheless, they exhibited similar virulence and clinical outcomes. Lymphocytopenia, especially reduced CD4+ and CD8+ T cell counts upon hospital admission, was predictive of disease progression. High levels of interleukin (IL)-6 and IL-8 during treatment were observed in patients with severe or critical disease and correlated with decreased lymphocyte count. The determinants of disease severity seemed to stem mostly from host factors such as age and lymphocytopenia (and its associated cytokine storm), whereas viral genetic variation did not significantly affect outcomes.spa


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