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da Cruz TCD, Pavon JAR, de Azevedo FSK, de Souza EC, Ribeiro BM, Slhessarenko RD. Associations between epidemiological and laboratory parameters and disease severity in hospitalized patients with COVID-19 during first and second epidemic waves in middle south Mato Grosso. Braz J Microbiol 2024:10.1007/s42770-024-01379-x. [PMID: 38834861 DOI: 10.1007/s42770-024-01379-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2024] [Accepted: 05/13/2024] [Indexed: 06/06/2024] Open
Abstract
BACKGROUND COVID-19 is a multisystemic disease characterized by respiratory distress. Disease severity is associated with several factors. Here we characterize virological findings and evaluate the association of laboratorial, epidemiological, virological findings and clinical outcomes of 251 patients during the first and second epidemic waves of COVID-19. METHODS This transversal study used biological samples and data from patients hospitalized with COVID-19 between May 2020 and August 2021 in the metropolitan region of Cuiabá, Mato Grosso Brazil. Biological samples were subjected to RT-qPCR and MinION sequencing. Univariate and multivariate logistic regression and Odds ratio were used to correlate clinical, laboratorial, epidemiological data. FINDINGS Patients were represented by males (61.7%) with mean age of 52.4 years, mild to moderate disease (49,0%), overweight/obese (69.3%), with comorbidities (66.1%) and evolving to death (55.38%). Severe cases showing symptoms for prolonged time, ≥ 25% of ground-glass opacities in the lungs and fatality rate increased significantly in second wave. Fatality was statistically associated to > 61 years of age,>25% ground-glass opacities in the lungs, immune, cardiac, or metabolic comorbidities. Higher viral load (p < 0.01/p = 0.02 in each wave), decreased erythrocyte (p < 0.01), hemoglobin (p < 0.05/p < 0.01), hematocrit (p < 0.01), RDW (p < 0.01), lymphocyte (p < 0.01), increased leucocyte (p < 0.01), neutrophil (p < 0.01) and CRP levels (p < 0.01) showed significant association with fatality in both waves, as did Neutrophil/Platelet (NPR; p < 0.01), Neutrophil/Lymphocyte (NLR; p < 0.01) and Monocyte/Lymphocyte ratio (MLR; p < 0.01). SARS-CoV-2 genomes from lineage B.1.1.33(n = 8) and Gamma/P.1(n = 15) shared 6/7 and 20/23 lineage-defining mutations, respectively. MAIN CONCLUSIONS Severity and mortality of COVID-19 associated with a panel of epidemiological and laboratorial findings, being second wave, caused by Gamma variant, more severe in this in-hospital population.
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Affiliation(s)
- Thais Campos Dias da Cruz
- Programa de Pós-Graduação em Ciências da Saúde, Faculdade de Medicina, Universidade Federal de Mato Grosso (UFMT), B Boa Esperança, 78060-900, Cuiabá, MT, Brasil
| | - Janeth Aracely Ramirez Pavon
- Programa de Pós-Graduação em Ciências da Saúde, Faculdade de Medicina, Universidade Federal de Mato Grosso (UFMT), B Boa Esperança, 78060-900, Cuiabá, MT, Brasil
| | - Francisco Scoffoni Kennedy de Azevedo
- Programa de Pós-Graduação em Ciências da Saúde, Faculdade de Medicina, Universidade Federal de Mato Grosso (UFMT), B Boa Esperança, 78060-900, Cuiabá, MT, Brasil
- Hospital e Pronto Socorro de Várzea Grande, Secretaria Municipal de Saúde, UFMT, Várzea Grande, Mato Grosso, Brasil
| | - Edila Cristina de Souza
- Curso de Graduação em Estatística, Universidade Federal de Mato Grosso (UFMT), Cuiabá, Brasil
| | - Bergman Morais Ribeiro
- Departamento de Biologia Celular, Instituto de Ciências Biológicas, Universidade de Brasília (UNB), Brasília, Distrito Federal, Brasil
| | - Renata Dezengrini Slhessarenko
- Programa de Pós-Graduação em Ciências da Saúde, Faculdade de Medicina, Universidade Federal de Mato Grosso (UFMT), B Boa Esperança, 78060-900, Cuiabá, MT, Brasil.
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Machado LC, Dezordi FZ, de Lima GB, de Lima RE, Silva LCA, Pereira LDM, da Silva AF, Silva Neto AMD, Oliveira ALSD, Armstrong ADC, Pessoa-E-Silva R, Loyo RM, Silva BDO, de Almeida AR, da Rocha Pitta MG, Santos FDADS, Mendonça Siqueira M, Resende PC, Delatorre E, Naveca FG, Miyajima F, Gräf T, do Carmo RF, Pereira MC, Campos TDL, Bezerra MF, Paiva MHS, Wallau GDL. Spatiotemporal transmission of SARS-CoV-2 lineages during 2020-2021 in Pernambuco-Brazil. Microbiol Spectr 2024; 12:e0421823. [PMID: 38651879 DOI: 10.1128/spectrum.04218-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Accepted: 04/04/2024] [Indexed: 04/25/2024] Open
Abstract
SARS-CoV-2 virus emerged as a new threat to humans and spread around the world, leaving a large death toll. As of January 2023, Brazil is among the countries with the highest number of registered deaths. Nonpharmacological and pharmacological interventions have been heterogeneously implemented in the country, which, associated with large socioeconomic differences between the country regions, has led to distinct virus spread dynamics. Here, we investigate the spatiotemporal dispersion of SARS-CoV-2 lineages in the Pernambuco state (Northeast Brazil) throughout the distinct epidemiological scenarios that unfolded in the first 2 years of the pandemic. We generated a total of 1,389 new SARS-CoV-2 genomes from June 2020 to August 2021. This sampling captured the arrival, communitary transmission, and the circulation of the B1.1, B.1.1.28, and B.1.1.33 lineages; the emergence of the former variant of interest P.2; and the emergence and fast replacement of all previous variants by the more transmissible variant of concern P.1 (Gamma). Based on the incidence and lineage spread pattern, we observed an East-to-West to inner state pattern of transmission, which is in agreement with the transmission of more populous metropolitan areas to medium- and small-size country-side cities in the state. Such transmission patterns may be partially explained by the main routes of traffic across municipalities in the state. Our results highlight that the fine-grained intrastate analysis of lineages and incidence spread can provide actionable insights for planning future nonpharmacological intervention for air-borne transmissible human pathogens.IMPORTANCEDuring the COVID-19 pandemic, Brazil was one of the most affected countries, mainly due its continental-size, socioeconomic differences among regions, and heterogeneous implementation of intervention methods. In order to investigate SARS-CoV-2 dynamics in the state of Pernambuco, we conducted a spatiotemporal dispersion study, covering the period from June 2020 to August 2021, to comprehend the dynamics of viral transmission during the first 2 years of the pandemic. Throughout this study, we were able to track three significant epidemiological waves of transmission caused by B1.1, B.1.1.28, B.1.1.33, P.2, and P.1 lineages. These analyses provided valuable insights into the evolution of the epidemiological landscape, contributing to a deeper understanding of the dynamics of virus transmission during the early years of the pandemic in the state of Pernambuco.
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Affiliation(s)
- Lais Ceschini Machado
- Departamento de Entomologia, Instituto Aggeu Magalhães (IAM)-Fundação Oswaldo Cruz-FIOCRUZ, Recife, Pernambuco, Brazil
| | - Filipe Zimmer Dezordi
- Departamento de Entomologia, Instituto Aggeu Magalhães (IAM)-Fundação Oswaldo Cruz-FIOCRUZ, Recife, Pernambuco, Brazil
- Núcleo de Bioinformática (NBI), Instituto Aggeu Magalhães (IAM), FIOCRUZ-Pernambuco, Recife, Pernambuco, Brazil
| | - Gustavo Barbosa de Lima
- Núcleo de Plataformas Tecnológicas (NPT), Instituto Aggeu Magalhães (IAM), FIOCRUZ-Pernambuco, Recife, Pernambuco, Brazil
| | - Raul Emídio de Lima
- Núcleo de Plataformas Tecnológicas (NPT), Instituto Aggeu Magalhães (IAM), FIOCRUZ-Pernambuco, Recife, Pernambuco, Brazil
| | - Lilian Caroliny Amorim Silva
- Núcleo de Plataformas Tecnológicas (NPT), Instituto Aggeu Magalhães (IAM), FIOCRUZ-Pernambuco, Recife, Pernambuco, Brazil
| | - Leandro de Mattos Pereira
- Núcleo de Bioinformática (NBI), Instituto Aggeu Magalhães (IAM), FIOCRUZ-Pernambuco, Recife, Pernambuco, Brazil
| | - Alexandre Freitas da Silva
- Departamento de Entomologia, Instituto Aggeu Magalhães (IAM)-Fundação Oswaldo Cruz-FIOCRUZ, Recife, Pernambuco, Brazil
- Núcleo de Bioinformática (NBI), Instituto Aggeu Magalhães (IAM), FIOCRUZ-Pernambuco, Recife, Pernambuco, Brazil
| | | | - André Luiz Sá de Oliveira
- Núcleo de Estatística e Geoprocessamento, Instituto Aggeu Magalhães (IAM)- Fundação Oswaldo Cruz Pernambuco- FIOCRUZ-PE, Recife, Brazil
| | | | - Rômulo Pessoa-E-Silva
- Suely-Galdino Therapeutic Innovation Research Center (NUPIT-SG), Federal University of Pernambuco (UFPE), Recife, Pernambuco, Brazil
| | - Rodrigo Moraes Loyo
- Departamento de Parasitologia, Instituto Aggeu Magalhães (IAM), FIOCRUZ-Pernambuco, Recife, Pernambuco, Brazil
| | - Barbara de Oliveira Silva
- Suely-Galdino Therapeutic Innovation Research Center (NUPIT-SG), Federal University of Pernambuco (UFPE), Recife, Pernambuco, Brazil
| | - Anderson Rodrigues de Almeida
- Suely-Galdino Therapeutic Innovation Research Center (NUPIT-SG), Federal University of Pernambuco (UFPE), Recife, Pernambuco, Brazil
| | - Maira Galdino da Rocha Pitta
- Suely-Galdino Therapeutic Innovation Research Center (NUPIT-SG), Federal University of Pernambuco (UFPE), Recife, Pernambuco, Brazil
| | | | - Marilda Mendonça Siqueira
- Laboratory of Respiratory Viruses and Measles (LVRS), Instituto Oswaldo Cruz, FIOCRUZ-Rio de Janeiro, Rio de Janeiro, Brazil
| | - Paola Cristina Resende
- Laboratory of Respiratory Viruses and Measles (LVRS), Instituto Oswaldo Cruz, FIOCRUZ-Rio de Janeiro, Rio de Janeiro, Brazil
| | - Edson Delatorre
- Departamento de Biologia, Centro de Ciências Exatas, Naturais e da Saúde, Universidade Federal do Espírito Santo, Alegre, Espírito Santo, Brazil
| | - Felipe Gomes Naveca
- Laboratório de Ecologia de Doenças Transmissíveis na Amazônia (EDTA), Instituto Leônidas e Maria Deane, FIOCRUZ-Amazonas, Manaus, Amazonas, Brazil
| | - Fabio Miyajima
- Analytical Competence Molecular Epidemiology Laboratory (ACME), FIOCRUZ-Ceará, Fortaleza, Ceará, Brazil
| | - Tiago Gräf
- Laboratório de Virologia Molecular, Instituto Carlos Chagas, Fundação Oswaldo Cruz, Curitiba, Paraná, Brazil
| | | | - Michelly Cristiny Pereira
- Suely-Galdino Therapeutic Innovation Research Center (NUPIT-SG), Federal University of Pernambuco (UFPE), Recife, Pernambuco, Brazil
| | - Tulio de Lima Campos
- Núcleo de Bioinformática (NBI), Instituto Aggeu Magalhães (IAM), FIOCRUZ-Pernambuco, Recife, Pernambuco, Brazil
| | - Matheus Filgueira Bezerra
- Departamento de Microbiologia, Instituto Aggeu Magalhães (IAM), FIOCRUZ-Pernambuco, Recife, Pernambuco, Brazil
| | - Marcelo Henrique Santos Paiva
- Departamento de Entomologia, Instituto Aggeu Magalhães (IAM)-Fundação Oswaldo Cruz-FIOCRUZ, Recife, Pernambuco, Brazil
- Núcleo de Ciências da Vida, Universidade Federal de Pernambuco (UFPE), Centro Acadêmico do Agreste, Caruaru, Brazil
| | - Gabriel da Luz Wallau
- Departamento de Entomologia, Instituto Aggeu Magalhães (IAM)-Fundação Oswaldo Cruz-FIOCRUZ, Recife, Pernambuco, Brazil
- Núcleo de Bioinformática (NBI), Instituto Aggeu Magalhães (IAM), FIOCRUZ-Pernambuco, Recife, Pernambuco, Brazil
- Department of Arbovirology, Bernhard Nocht Institute for Tropical Medicine, WHO Collaborating Center for Arbovirus and Hemorrhagic Fever Reference and Research, National Reference Center for Tropical Infectious Diseases, Hamburg, Germany
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Mayer ADM, Gröhs Ferrareze PA, de Oliveira LFV, Gregianini TS, Neves CLAM, Caldana GD, Kmetzsch L, Thompson CE. Genomic characterization and molecular evolution of SARS-CoV-2 in Rio Grande do Sul State, Brazil. Virology 2023; 582:1-11. [PMID: 36989935 PMCID: PMC10018445 DOI: 10.1016/j.virol.2023.03.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2023] [Revised: 03/08/2023] [Accepted: 03/10/2023] [Indexed: 03/18/2023]
Abstract
SARS-CoV-2 is the virus responsible for the COVID-19 and has afflicted the world since the end of 2019. Different lineages have been discovered and the Gamma lineage, which started the second wave of infections, was first described in Brazil, one of the most affected countries by pandemic. Therefore, this study analyzed SARS-CoV-2 sequenced genomes from Esteio city in Rio Grande do Sul, Southern Brazil. We also comparatively analyzed genomes of the two first years of the pandemic from Rio Grande do Sul state for understanding their genomic and evolutionary patterns. The phylogenomic analysis showed monophyletic groups for Alpha, Gamma, Delta and Omicron, as well as for other circulating lineages in the state. Molecular evolutionary analysis identified several sites under adaptive selection in membrane and nucleocapsid proteins which could be related to a prevalent stabilizing effect on membrane protein structure, as well as majoritarily destabilizing effects on C-terminal nucleocapsid domain.
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Affiliation(s)
- Amanda de Menezes Mayer
- Center of Biotechnology, Graduate Program in Cell and Molecular Biology (PPGBCM), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - Patrícia Aline Gröhs Ferrareze
- Graduate Program in Health Sciences, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, RS, Brazil
| | | | - Tatiana Schäffer Gregianini
- Laboratório Central de Saúde Pública do Centro Estadual de Vigilância em Saúde da Secretaria de Saúde do Estado do Rio Grande do Sul (LACEN/CEVS/SES-RS), Porto Alegre, RS, Brazil
| | | | - Gabriel Dickin Caldana
- Graduate Program in Health Sciences, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, RS, Brazil
| | - Lívia Kmetzsch
- Center of Biotechnology, Graduate Program in Cell and Molecular Biology (PPGBCM), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - Claudia Elizabeth Thompson
- Center of Biotechnology, Graduate Program in Cell and Molecular Biology (PPGBCM), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil; Graduate Program in Health Sciences, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, RS, Brazil; Department of Pharmacosciences, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, Brazil.
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4
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Sanyaolu A, Marinkovic A, Prakash S, Okorie C, Jan A, Desai P, Fahad Abbasi A, Mangat J, Hosein Z, Hamdy K, Haider N, Khan N, Annan R, Badaru O, Izurieta R, Smith S. Perspective Chapter: SARS-CoV-2 Variants - Two Years Post-Onset of the Pandemic. Infect Dis (Lond) 2022. [DOI: 10.5772/intechopen.105913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Since the pandemic began in China in December 2019, thousands of variants of SARS-CoV-2 have emerged globally since late 2020. The World Health Organization (WHO) defined the SARS-CoV-2 variant of concern (VOC) as a variant with increased transmissibility, virulence, and decreased response to available diagnostics, vaccines, and therapeutics. Areas of the emerging variant of concern arise from countries like the United Kingdom, South Africa, Brazil, and India. These mutations carry a lineage from N501Y, D614G, N439K, Y453F, and others, which are globally dominated by clades 20A, 20B, and 20C. SARS-CoV-2 VOC emerged after 11 months of evolution since the onset through massive human-to-human transmission with five major VOCs recognized by the WHO, namely Alpha, Beta, Gamma, Delta, and Omicron. Their emergence could be attributed to changing immunological dynamics in the human population, which has resulted in resistance or escape from neutralizing antibodies, or to mutations and/or recombinations that increase transmission or pathogenicity. This literature review intends to identify and report on SARS-CoV-2 variants that have evolved two years post-onset of the pandemic and their disease implications.
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5
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Cadegiani FA, Zimerman RA, Fonseca DN, Correia MN, Muller MP, Bet DL, Slaviero MR, Zardo I, Benites PR, Barros RN, Paulain RW, Onety DC, Israel KCP, Gustavo Wambier C, Goren A. Final Results of a Randomized, Placebo-Controlled, Two-Arm, Parallel Clinical Trial of Proxalutamide for Hospitalized COVID-19 Patients: A Multiregional, Joint Analysis of the Proxa-Rescue AndroCoV Trial. Cureus 2021; 13:e20691. [PMID: 34976549 PMCID: PMC8712234 DOI: 10.7759/cureus.20691] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/25/2021] [Indexed: 02/06/2023] Open
Abstract
Background The role of androgens on COVID-19 is well established. Proxalutamide is a second-generation, non-steroidal antiandrogen (NSAA) with the highest antiandrogen potency among NSAAs and concurrent regulation of angiotensin-converting enzyme 2 (ACE2) expression and inflammatory response. Proxalutamide has been demonstrated to be effective to prevent hospitalizations in early COVID-19 in randomized clinical trials (RCTs). Conversely, in hospitalized COVID-19 patients, preliminary results from two different arms of an RCT (The Proxa-Rescue AndroCoV Trial) also demonstrated a reduction in all-cause mortality. This study aims to report the final, joint results of the two arms (North arm and South arm) of the Proxa-Rescue AndroCoV trial of the two arms (North and South arms) combined, and to evaluate whether COVID-19 response to proxalutamide was consistent across different regions (Northern Brazil and Southern Brazil). Materials and methods Upon randomization, hospitalized COVID-19 patients received either proxalutamide 300mg/day or placebo for 14 days, in addition to usual care, in a proxalutamide:placebo ratio of 1:1 in the North arm and 4:1 in the South arm (ratio was modified due to preliminary report of high drug efficacy). Datasets of the South and North arms were combined, and statistical analysis was performed for the overall study population. Proxalutamide was compared to placebo group for 14-day and 28-day recovery (discharge alive from the hospital) and mortality rates, and overall and post-randomization hospitalization stay. Results of proxalutamide and placebo groups were also compared between the North and South arms. Analysis was also performed stratified by sex and baseline WHO COVID Ordinary Score. Results A total of 778 subjects were included (645 from the North, 317 from the proxalutamide group and 328 from the placebo group; 133 from the South arm, 106 from the proxalutamide group and 27 from the placebo group). Recovery rate was 121% higher in proxalutamide than placebo group at day 14 [81.1% vs 36.6%; Recovery ratio (RecR) 2.21; 95% confidence interval (95% CI), 1.92-2.56; p<0.0001], and 81% higher at day 28 (98.1% vs 47.6%; RecR, 1.81; 95% CI, 1.61-2.03; p<0.0001). All-cause mortality rate was 80% lower in proxalutamide than placebo group at Day 14 [8.0% vs 39.2%; Risk ratio (RR), 0.20; 95% CI, 0.14-0.29; p<0.0001], and 78% lower at Day 28 (10.6% vs 48.2%; RR, 0.22; 95% CI 0.16-0.30). Post-randomization time-to-discharge was shorter in proxalutamide [median, 5 days; interquartile range (IQR), 3-8] than placebo group (median, 9 days; IQR, 6-14) (p<0.0001). Results were statistically similar between North and South arms for all measured outcomes. Males and females presented similar results in all outcomes. Patients that did not require oxygen use (scores 3 and 4) did not present statistically significant improvement in recovery and mortality rates, whereas scores 5 and 6 presented significant improvements in all outcomes (p<0.0001 for all). Conclusion Proxalutamide increased recovery rate, reduced mortality rate and shortened hospital stay in hospitalized COVID-19 patients. Results were similar between the two different arms, providing further consistency for the efficacy of proxalutamide when used in late-stage COVID-19.
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Affiliation(s)
| | - Ricardo A Zimerman
- Infectious Disease, Hospital da Brigada Militar de Porto Alegre, Porto Alegre, BRA
| | | | | | | | | | | | - Ivan Zardo
- Cardiology, Hospital Unimed Chapecó, Chapecó, BRA
| | | | - Renan N Barros
- Internal Medicine, Hospital Municipal Jofre Cohen, Parintins, BRA
| | - Raysa W Paulain
- Internal Medicine, Hospital Municipal Jofre Cohen, Parintins, BRA
| | - Dirce C Onety
- Critical Care, Samel & Oscar Nicolau Hospitals, Manaus, BRA
| | | | | | - Andy Goren
- Dermatology, Applied Biology Inc., Irvine, USA
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6
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Moreira FRR, D'arc M, Mariani D, Herlinger AL, Schiffler FB, Rossi ÁD, Leitão IDC, Miranda TDS, Cosentino MAC, Tôrres MCDP, da Costa RMDSC, Gonçalves CCA, Faffe DS, Galliez RM, Junior ODCF, Aguiar RS, Dos Santos AFA, Voloch CM, Castiñeiras TMPP, Tanuri A. Epidemiological dynamics of SARS-CoV-2 VOC Gamma in Rio de Janeiro, Brazil. Virus Evol 2021; 7:veab087. [PMID: 34725568 PMCID: PMC8522364 DOI: 10.1093/ve/veab087] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 09/23/2021] [Accepted: 09/29/2021] [Indexed: 12/12/2022] Open
Abstract
The emergence and widespread circulation of severe acute respiratory syndrome coronavirus 2 variants of concern (VOCs) or interest impose an enhanced threat to global public health. In Brazil, one of the countries most severely impacted throughout the pandemic, a complex dynamics involving variants co-circulation and turnover events has been recorded with the emergence and spread of VOC Gamma in Manaus in late 2020. In this context, we present a genomic epidemiology investigation based on samples collected between December 2020 and May 2021 in the second major Brazilian metropolis, Rio de Janeiro. By sequencing 244 novel genomes through all epidemiological weeks in this period, we were able to document the introduction and rapid dissemination of VOC Gamma in the city, driving the rise of the third local epidemic wave. Molecular clock analysis indicates that this variant has circulated locally since the first weeks of 2021 and only 7 weeks were necessary for it to achieve a frequency above 70 per cent, consistent with rates of growth observed in Manaus and other states. Moreover, a Bayesian phylogeographic reconstruction indicates that VOC Gamma spread throughout Brazil between December 2020 and January 2021 and that it was introduced in Rio de Janeiro through at least 13 events coming from nearly all regions of the country. Comparative analysis of reverse transcription-quantitative polymerase chain reaction (RT-qPCR) cycle threshold (Ct) values provides further evidence that VOC Gamma induces higher viral loads (N1 target; mean reduction of Ct: 2.7, 95 per cent confidence interval = ± 0.7). This analysis corroborates the previously proposed mechanistic basis for this variant-enhanced transmissibility and distinguished epidemiological behavior. Our results document the evolution of VOC Gamma and provide independent assessment of scenarios previously studied in Manaus, therefore contributing to the better understanding of the epidemiological dynamics currently being surveyed in other Brazilian regions.
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Affiliation(s)
- Filipe Romero Rebello Moreira
- Departamento de Genética, Laboratório de Virologia Molecular, Universidade Federal do Rio de Janeiro, Av. Carlos Chagas Filho 373, Centro de Ciências da Saúde, Bloco A, lab 121, Cidade Universitária, Rio de Janeiro 21941-902, Brazil
| | - Mirela D'arc
- Departamento de Genética, Laboratório de Diversidade e Doenças Virais, Universidade Federal do Rio de Janeiro, Av. Carlos Chagas Filho 373, Centro de Ciências da Saúde, Bloco A, lab 120, Cidade Universitária, Rio de Janeiro 21941-902, Brazil
| | | | - Alice Laschuk Herlinger
- Departamento de Genética, Laboratório de Virologia Molecular, Universidade Federal do Rio de Janeiro, Av. Carlos Chagas Filho 373, Centro de Ciências da Saúde, Bloco A, lab 121, Cidade Universitária, Rio de Janeiro 21941-902, Brazil
| | - Francine Bittencourt Schiffler
- Departamento de Genética, Laboratório de Diversidade e Doenças Virais, Universidade Federal do Rio de Janeiro, Av. Carlos Chagas Filho 373, Centro de Ciências da Saúde, Bloco A, lab 120, Cidade Universitária, Rio de Janeiro 21941-902, Brazil
| | - Átila Duque Rossi
- Departamento de Genética, Laboratório de Virologia Molecular, Universidade Federal do Rio de Janeiro, Av. Carlos Chagas Filho 373, Centro de Ciências da Saúde, Bloco A, lab 121, Cidade Universitária, Rio de Janeiro 21941-902, Brazil
| | - Isabela de Carvalho Leitão
- Instituto de Biofísica Carlos Chagas Filho, Universidade Federal do Rio de Janeiro, Av. Carlos Chagas Filho 373, Centro de Cincias da Saúde, Bloco C, Cidade Universitária, Rio de Janeiro 21941-902, Brazil
| | - Thamiris Dos Santos Miranda
- Departamento de Genética, Laboratório de Diversidade e Doenças Virais, Universidade Federal do Rio de Janeiro, Av. Carlos Chagas Filho 373, Centro de Ciências da Saúde, Bloco A, lab 120, Cidade Universitária, Rio de Janeiro 21941-902, Brazil
| | - Matheus Augusto Calvano Cosentino
- Departamento de Genética, Laboratório de Diversidade e Doenças Virais, Universidade Federal do Rio de Janeiro, Av. Carlos Chagas Filho 373, Centro de Ciências da Saúde, Bloco A, lab 120, Cidade Universitária, Rio de Janeiro 21941-902, Brazil
| | - Marcelo Calado de Paula Tôrres
- Departamento de Genética, Laboratório de Virologia Molecular, Universidade Federal do Rio de Janeiro, Av. Carlos Chagas Filho 373, Centro de Ciências da Saúde, Bloco A, lab 121, Cidade Universitária, Rio de Janeiro 21941-902, Brazil
| | - Raíssa Mirella Dos Santos Cunha da Costa
- Departamento de Genética, Laboratório de Virologia Molecular, Universidade Federal do Rio de Janeiro, Av. Carlos Chagas Filho 373, Centro de Ciências da Saúde, Bloco A, lab 121, Cidade Universitária, Rio de Janeiro 21941-902, Brazil
| | - Cássia Cristina Alves Gonçalves
- Departamento de Genética, Laboratório de Virologia Molecular, Universidade Federal do Rio de Janeiro, Av. Carlos Chagas Filho 373, Centro de Ciências da Saúde, Bloco A, lab 121, Cidade Universitária, Rio de Janeiro 21941-902, Brazil
| | - Débora Souza Faffe
- Instituto de Biofísica Carlos Chagas Filho, Universidade Federal do Rio de Janeiro, Av. Carlos Chagas Filho 373, Centro de Cincias da Saúde, Bloco C, Cidade Universitária, Rio de Janeiro 21941-902, Brazil
| | - Rafael Mello Galliez
- Departamento de Doenças Infecciosase Parasitárias, Universidade Federal do Rio de Janeiro, Av. Carlos Chagas Filho 373, Centro de Ciências da Saúde, Bloco K, Cidade Universitária, Rio de Janeiro 21941-902, Brazil
| | - Orlando da Costa Ferreira Junior
- Departamento de Genética, Laboratório de Virologia Molecular, Universidade Federal do Rio de Janeiro, Av. Carlos Chagas Filho 373, Centro de Ciências da Saúde, Bloco A, lab 121, Cidade Universitária, Rio de Janeiro 21941-902, Brazil
| | - Renato Santana Aguiar
- Departamento de Genética, Ecologia e Evolução, Laboratório de Biologia Integrativa, Universidade Federal de Minas Gerais, Belo Horizonte, Av. Antônio Carlos, 6627, Instituto de Ciências Biológicas, G3-60, Pampulha, Belo Horizonte 31270901, Brazil
| | - André Felipe Andrade Dos Santos
- Departamento de Genética, Laboratório de Diversidade e Doenças Virais, Universidade Federal do Rio de Janeiro, Av. Carlos Chagas Filho 373, Centro de Ciências da Saúde, Bloco A, lab 120, Cidade Universitária, Rio de Janeiro 21941-902, Brazil
| | - Carolina Moreira Voloch
- Departamento de Genética, Laboratório de Virologia Molecular, Universidade Federal do Rio de Janeiro, Av. Carlos Chagas Filho 373, Centro de Ciências da Saúde, Bloco A, lab 121, Cidade Universitária, Rio de Janeiro 21941-902, Brazil
| | - Terezinha Marta Pereira Pinto Castiñeiras
- Departamento de Doenças Infecciosas e Parasitárias, Universidade Federal do Rio de Janeiro, Av. Carlos Chagas Filho 373, Centro de Ciências da Saúde, Bloco K, Cidade Universitária, Rio de Janeiro 21941-902, Brazil
| | - Amilcar Tanuri
- Departamento de Genética, Laboratório de Virologia Molecular, Universidade Federal do Rio de Janeiro, Av. Carlos Chagas Filho 373, Centro de Ciências da Saúde, Bloco A, lab 121, Cidade Universitária, Rio de Janeiro 21941-902, Brazil
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Resende PC, Naveca FG, Lins RD, Dezordi FZ, Ferraz MVF, Moreira EG, Coêlho DF, Motta FC, Paixão ACD, Appolinario L, Lopes RS, Mendonça ACDF, da Rocha ASB, Nascimento V, Souza V, Silva G, Nascimento F, Neto LGL, da Silva FV, Riediger I, Debur MDC, Leite AB, Mattos T, da Costa CF, Pereira FM, dos Santos CA, Rovaris DB, Fernandes SB, Abbud A, Sacchi C, Khouri R, Bernardes AFL, Delatorre E, Gräf T, Siqueira MM, Bello G, Wallau GL. The ongoing evolution of variants of concern and interest of SARS-CoV-2 in Brazil revealed by convergent indels in the amino (N)-terminal domain of the spike protein. Virus Evol 2021; 7:veab069. [PMID: 34532067 PMCID: PMC8438916 DOI: 10.1093/ve/veab069] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Revised: 06/29/2021] [Accepted: 08/05/2021] [Indexed: 12/23/2022] Open
Abstract
Mutations at both the receptor-binding domain (RBD) and the amino (N)-terminal domain (NTD) of the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Spike (S) glycoprotein can alter its antigenicity and promote immune escape. We identified that SARS-CoV-2 lineages circulating in Brazil with mutations of concern in the RBD independently acquired convergent deletions and insertions in the NTD of the S protein, which altered the NTD antigenic-supersite and other predicted epitopes at this region. Importantly, we detected the community transmission of different P.1 lineages bearing NTD indels ∆69-70 (which can impact several SARS-CoV-2 diagnostic protocols), ∆144 and ins214ANRN, and a new VOI N.10 derived from the B.1.1.33 lineage carrying three NTD deletions (∆141-144, ∆211, and ∆256-258). These findings support that the ongoing widespread transmission of SARS-CoV-2 in Brazil generates new viral lineages that might be more resistant to antibody neutralization than parental variants of concern.
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Affiliation(s)
| | | | - Roberto D Lins
- Department of Virology, Instituto Aggeu Magalhães, FIOCRUZ-Pernambuco, Av. Professor Moraes Rego, s/n – Cidade Universitária, Recife 50.740-465, Brazil
| | - Filipe Zimmer Dezordi
- Departamento de Entomologia, Instituto Aggeu Magalhães, FIOCRUZ-Pernambuco, Av. Professor Moraes Rego, s/n – Cidade Universitária, Recife 50.740-465, Brazil
- Núcleo de Bioinformática (NBI), Instituto Aggeu Magalhães FIOCRUZ-Pernambuco, Av. Professor Moraes Rego, s/n – Cidade Universitária, Recife 50.740-465, Brazil
| | - Matheus V. F Ferraz
- Department of Virology, Instituto Aggeu Magalhães, FIOCRUZ-Pernambuco, Av. Professor Moraes Rego, s/n – Cidade Universitária, Recife 50.740-465, Brazil
- Department of Fundamental Chemistry, Federal University of Pernambuco, Av. Professor Moraes Rego, s/n – Cidade Universitária, Recife 50.740-560, Brazil
| | - Emerson G Moreira
- Department of Virology, Instituto Aggeu Magalhães, FIOCRUZ-Pernambuco, Av. Professor Moraes Rego, s/n – Cidade Universitária, Recife 50.740-465, Brazil
- Department of Fundamental Chemistry, Federal University of Pernambuco, Av. Professor Moraes Rego, s/n – Cidade Universitária, Recife 50.740-560, Brazil
| | | | - Fernando Couto Motta
- Laboratory of Respiratory Viruses and Measles (LVRS), Instituto Oswaldo Cruz, FIOCRUZ-Rio de Janeiro, Av. Brasil, 4365 - Manguinhos, Rio de Janeiro 21040-900, Brazil
| | - Anna Carolina Dias Paixão
- Laboratory of Respiratory Viruses and Measles (LVRS), Instituto Oswaldo Cruz, FIOCRUZ-Rio de Janeiro, Av. Brasil, 4365 - Manguinhos, Rio de Janeiro 21040-900, Brazil
| | - Luciana Appolinario
- Laboratory of Respiratory Viruses and Measles (LVRS), Instituto Oswaldo Cruz, FIOCRUZ-Rio de Janeiro, Av. Brasil, 4365 - Manguinhos, Rio de Janeiro 21040-900, Brazil
| | - Renata Serrano Lopes
- Laboratory of Respiratory Viruses and Measles (LVRS), Instituto Oswaldo Cruz, FIOCRUZ-Rio de Janeiro, Av. Brasil, 4365 - Manguinhos, Rio de Janeiro 21040-900, Brazil
| | - Ana Carolina da Fonseca Mendonça
- Laboratory of Respiratory Viruses and Measles (LVRS), Instituto Oswaldo Cruz, FIOCRUZ-Rio de Janeiro, Av. Brasil, 4365 - Manguinhos, Rio de Janeiro 21040-900, Brazil
| | - Alice Sampaio Barreto da Rocha
- Laboratory of Respiratory Viruses and Measles (LVRS), Instituto Oswaldo Cruz, FIOCRUZ-Rio de Janeiro, Av. Brasil, 4365 - Manguinhos, Rio de Janeiro 21040-900, Brazil
| | - Valdinete Nascimento
- Laboratório de Ecologia de Doenças Transmissíveis na Amazônia (EDTA), Instituto Leônidas e Maria Deane, FIOCRUZ-Amazonas, Rua Teresina, 476. Adrianópolis, Manaus 69.057-070, Brazil
| | - Victor Souza
- Laboratório de Ecologia de Doenças Transmissíveis na Amazônia (EDTA), Instituto Leônidas e Maria Deane, FIOCRUZ-Amazonas, Rua Teresina, 476. Adrianópolis, Manaus 69.057-070, Brazil
| | - George Silva
- Laboratório de Ecologia de Doenças Transmissíveis na Amazônia (EDTA), Instituto Leônidas e Maria Deane, FIOCRUZ-Amazonas, Rua Teresina, 476. Adrianópolis, Manaus 69.057-070, Brazil
| | - Fernanda Nascimento
- Laboratório de Ecologia de Doenças Transmissíveis na Amazônia (EDTA), Instituto Leônidas e Maria Deane, FIOCRUZ-Amazonas, Rua Teresina, 476. Adrianópolis, Manaus 69.057-070, Brazil
| | - Lidio Gonçalves Lima Neto
- Laboratório Central de Saúde Pública do Estado do Maranhão (LACEN-MA), Rua João Luís, Bairro Diamente, Sao Luis 65020-320, Brazil
| | - Fabiano Vieira da Silva
- Laboratório Central de Saúde Pública do Estado do Maranhão (LACEN-MA), Rua João Luís, Bairro Diamente, Sao Luis 65020-320, Brazil
| | - Irina Riediger
- Laboratório Central de Saúde Pública do Estado do Paraná (LACEN-PR), Rua Ubaldino do Amaral 545 - Alto da XV, Curitiba 80060-190, Brazil
| | - Maria do Carmo Debur
- Laboratório Central de Saúde Pública do Estado do Paraná (LACEN-PR), Rua Ubaldino do Amaral 545 - Alto da XV, Curitiba 80060-190, Brazil
| | - Anderson Brandao Leite
- Laboratório Central de Saúde Pública do Estado do Alagoas (LACEN-AL), Av. Marechal Castelo Branco, 1773 Jatiúca, Alagoas, 57030340 Brazil
| | - Tirza Mattos
- Laboratório Central de Saúde Pública do Amazonas (LACEN-AM), Rua Emílio Moreira, 528 - Centro, Manaus 69020-040, Brazil
| | - Cristiano Fernandes da Costa
- Fundação de Vigilância em Saúde do Amazonas, Av. Torquato Tapajós, 4.010 Colônia Santo Antônio, Manaus 69.093-018, Brazil
| | - Felicidade Mota Pereira
- Laboratório Central de Saúde Pública do Estado da Bahia (LACEN-BA), Rua Waldemar Falcão, 123 - Bairro Brotas, Salvador 40295-001, Brazil
| | - Cliomar Alves dos Santos
- Laboratório Central de Saúde Pública do Estado de Sergipe (LACEN-SE), Rua Campo do Brito, 551 - Bairro São José, Aracajú, Sergipe 49020-380, Brazil
| | - Darcita Buerger Rovaris
- Laboratório Central de Saúde Pública do Estado de Santa Catarina (LACEN-SC), Avenida Rio Branco, 152 – Fundos, Florianópolis, Santa Catarina 88015-201, Brazil
| | - Sandra Bianchini Fernandes
- Laboratório Central de Saúde Pública do Estado de Santa Catarina (LACEN-SC), Avenida Rio Branco, 152 – Fundos, Florianópolis, Santa Catarina 88015-201, Brazil
| | | | - Claudio Sacchi
- Instituto Adolfo Lutz, Av. Dr. Arnaldo, 351, São Paulo 01246-000, Brazil
| | | | - André Felipe Leal Bernardes
- Laboratório Central de Saúde Pública do Estado de Minas Gerais (LACEN-MG), Rua Conde Pereira Carneiro, 80 - Gameleira, Belo Horizonte 30510-010, Brazil
| | - Edson Delatorre
- Departamento de Biologia, Centro de Ciências Exatas, Naturais e da Saúde, Universidade Federal do Espírito Santo, Av. Fernando Ferrari, 514 - Goiabeira, Alegre 29075-910, Brazil
| | | | - Marilda Mendonça Siqueira
- Laboratory of Respiratory Viruses and Measles (LVRS), Instituto Oswaldo Cruz, FIOCRUZ-Rio de Janeiro, Av. Brasil, 4365 - Manguinhos, Rio de Janeiro 21040-900, Brazil
| | - Gonzalo Bello
- Laboratório de AIDS e Imunologia Molecular, Instituto Oswaldo Cruz, FIOCRUZ-Rio de Janeiro, Av. Brasil, 4365 - Manguinhos, Rio de Janeiro 21040-900, Brazil
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