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Cell Studies on SARS-CoV-2 Spread in the South, Disease Severity Indicators, COVID-19 Pathogenesis

In a Cell Reports paper, a University of North Carolina-Chapel Hill-led team takes a look at the SARS-CoV-2 evolution and spread in suburban and rural parts of North Carolina, where the first known SARS-CoV-2 case in early March was linked to an individual who traveled to Washington State. Based on high-density amplicon targeted sequencing profiles for SARS-CoV-2 samples collected from 175 SARS-CoV-2-positive, symptomatic COVID-19 patients in North Carolina and insights from dozens of SARS-CoV-2-negative controls, the investigators detected a spike protein mutation in more than half of the cases considered that appeared to coincide with enhanced viral genome copy number. They also described "community spread within local populations and the larger continental United States," and suggested that these and other results may inform future vaccine design by providing a clearer look at viral sequences from a non-urban site with extensive community spread. 

Researchers at the Institute for Systems Biology, University of Washington, and other centers describe a set of blood plasma and host immune cell features that appear to distinguish milder and more severe cases of COVID-19. As they report in a Cell pre-proof paper, the investigators relied on a combination of plasma protein and metabolomic profiling, single-cell 'omics profiling, and electronic health record data to identify immune cell features, secreted and surface protein patterns, transcriptomic features, and more in blood sample collected over time from 139 COVID-19 patients and 268 unaffected blood donors. "We identify a major shift between mild and moderate disease, at which point elevated inflammatory signaling is accompanied by the loss of specific classes of metabolites and metabolic processes," the authors note. "Within this stressed plasma environment at moderate disease, multiple unusual immune cell phenotypes emerge and amplify with increasing disease severity."

A team from the Wuhan Institute of Virology and other centers in China consider blood plasma proteome patterns in 17 COVID-19 survivors with mild or moderate symptoms, eight infection-free controls, and in five individuals who did not survive the coronavirus disease, for a paper in the Cell Press journal Immunity. Using liquid chromatography and tandem mass spectrometry, along with machine learning analyses, the researchers tracked down 11 plasma proteins with potential ties to SARS-CoV-2 infection outcomes — a set of proposed biomarkers that they assessed individually and in different combinations in another set of COVID-19 patients with the help of an enzyme-linked immunosorbent assay approach. "These biomarkers include host proteins that play critical roles in major pathophysiological pathways," they write, "and the abnormal alterations of these proteins in patient plasma probably contribute to the pathogenesis of COVID-19."