Samenvatting
What did you want to address in this study and why?
In COVID-19 patients from different European countries, we studied SARS-CoV-2 evolution and how SARS-CoV-2 variants, both at clade level and through specific genetic mutations, impact disease presentation (mild or severe). Quasi-species (i.e. slightly differing forms of a recognised variant co-infecting a patient) prevalence was also investigated. The overarching aim was to identify clinical and viral genetic markers associated with COVID-19 severity.
What have we learnt from this study?
Mutation rates increased steeply with emergence of variants of concern (VOCs) and were remarkably variable across sub-genomic regions, compared with pre-Alpha variants. Only four hotspots (i.e. positions in the genome where average mutation rates exceed 85.0%) were found common to all variants. Being immunocompromised was associated with severe disease, as were 27 mutations. Quasi-species in COVID-19 patients were commonly found.
What are the implications of your findings for public health?
The frequent occurrence of quasi-species might influence associations between variants and disease severity as well as therapeutic and vaccination outcomes. We thus suggest analysing these additionally to the dominant infecting variant, e.g. by representing mutation probabilities or prevalence within a patient sample. This would enable inclusion of minority variants and mutations in future molecular epidemiological and viral transmission studies.
In COVID-19 patients from different European countries, we studied SARS-CoV-2 evolution and how SARS-CoV-2 variants, both at clade level and through specific genetic mutations, impact disease presentation (mild or severe). Quasi-species (i.e. slightly differing forms of a recognised variant co-infecting a patient) prevalence was also investigated. The overarching aim was to identify clinical and viral genetic markers associated with COVID-19 severity.
What have we learnt from this study?
Mutation rates increased steeply with emergence of variants of concern (VOCs) and were remarkably variable across sub-genomic regions, compared with pre-Alpha variants. Only four hotspots (i.e. positions in the genome where average mutation rates exceed 85.0%) were found common to all variants. Being immunocompromised was associated with severe disease, as were 27 mutations. Quasi-species in COVID-19 patients were commonly found.
What are the implications of your findings for public health?
The frequent occurrence of quasi-species might influence associations between variants and disease severity as well as therapeutic and vaccination outcomes. We thus suggest analysing these additionally to the dominant infecting variant, e.g. by representing mutation probabilities or prevalence within a patient sample. This would enable inclusion of minority variants and mutations in future molecular epidemiological and viral transmission studies.
| Originele taal-2 | English |
|---|---|
| Artikelnummer | 2400038 |
| Pagina's (van-tot) | 13 |
| Aantal pagina's | 18 |
| Tijdschrift | Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin |
| Volume | 30 |
| Nummer van het tijdschrift | 10 |
| DOI's | |
| Status | Published - 13-mrt.-2025 |