{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,8]],"date-time":"2025-10-08T15:40:08Z","timestamp":1759938008373,"version":"build-2065373602"},"reference-count":0,"publisher":"Journal of Infection in Developing Countries","issue":"09","license":[{"start":{"date-parts":[[2025,9,30]],"date-time":"2025-09-30T00:00:00Z","timestamp":1759190400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100004214","name":"Pamukkale \u00dcniversitesi","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004214","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Infect Dev Ctries"],"abstract":"<jats:p>Introduction: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants that emerged shortly after the coronavirus disease 2019 (COVID-19) pandemic began have altered epidemiological and clinical findings; and these variants changed the course of this health crisis.\nMethodology: Whole-genome sequencing was performed on SARS-CoV-2 strains isolated from 21 patients with COVID-19. The frequency of structural changes in the virus and their effects on clinical findings of the disease were analyzed.\nResults: The spike Q493R mutation was detected more frequently in patients who had received four or more doses of a COVID-19 vaccine (p = 0.043). The clinical effect of the spike R346K and A263T mutations (reported in T\u00fcrkiye for the first time) detected in a patient who had received four doses of the vaccine in the 3 months prior to being infected with COVID-19 could be related to escape from the antibody response. The spike R21T mutation may increase the virus\u2019s entry into intestinal cells; and, as a result it may be responsible for severe clinical course and gastrointestinal symptoms. The patient infected with the Omicron BA.2 subvariant with the spike L452M mutation exhibited a significant increase in inflammatory parameters; suggesting that this mutation may trigger an excessive immune response and hyperinflammation.\nConclusions: This is the first study based in T\u00fcrkiye that evaluated the clinical impact of variations in the sequences of SARS-CoV-2 variants. There is a need for further investigation into the clinical impact of these results in a larger population spread over more centers, and more sequencing studies.<\/jats:p>","DOI":"10.3855\/jidc.19720","type":"journal-article","created":{"date-parts":[[2025,10,8]],"date-time":"2025-10-08T15:04:11Z","timestamp":1759935851000},"page":"1322-1329","source":"Crossref","is-referenced-by-count":0,"title":["Whole genome sequencing and analysis of the clinical implications of SARS-CoV-2 strains"],"prefix":"10.3855","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8995-0165","authenticated-orcid":false,"given":"Firuze","family":"Soyak","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3204-2371","authenticated-orcid":false,"given":"Tugba","family":"Sari","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0537-9032","authenticated-orcid":false,"given":"Onur","family":"Tokgun","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1156-3787","authenticated-orcid":false,"given":"Ahmet","family":"Caliskan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Huseyin","family":"Turgut","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2222","published-online":{"date-parts":[[2025,9,30]]},"container-title":["The Journal of Infection in Developing Countries"],"original-title":[],"link":[{"URL":"https:\/\/www.jidc.org\/index.php\/journal\/article\/download\/19720\/3729","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.jidc.org\/index.php\/journal\/article\/download\/19720\/3729","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,8]],"date-time":"2025-10-08T15:04:11Z","timestamp":1759935851000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.jidc.org\/index.php\/journal\/article\/view\/19720"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,30]]},"references-count":0,"journal-issue":{"issue":"09","published-online":{"date-parts":[[2025,9,30]]}},"URL":"https:\/\/doi.org\/10.3855\/jidc.19720","relation":{},"ISSN":["1972-2680"],"issn-type":[{"value":"1972-2680","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9,30]]}}}