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Trovao NS, Pan V, Goel C, Gallego-García P, Liu Y, Barbara C, Borg R, Briffa M, Cilia C, Grech L, Vassallo M, Treangen TJ, Posada D, Beheshti A, Borg J, Zahra G. Evolutionary and spatiotemporal analyses reveal multiple introductions and cryptic transmission of SARS-CoV-2 VOC/VOI in Malta. Microbiol Spectr 2023; 11:e0153923. [PMID: 37800925 PMCID: PMC10714767 DOI: 10.1128/spectrum.01539-23] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Accepted: 08/13/2023] [Indexed: 10/07/2023] Open
Abstract
IMPORTANCE Our study provides insights into the evolution of the coronavirus disease 2019 (COVID-19) pandemic in Malta, a highly connected and understudied country. We combined epidemiological and phylodynamic analyses to analyze trends in the number of new cases, deaths, tests, positivity rates, and evolutionary and dispersal patterns from August 2020 to January 2022. Our reconstructions inferred 173 independent severe acute respiratory syndrome coronavirus 2 introductions into Malta from various global regions. Our study demonstrates that characterizing epidemiological trends coupled with phylodynamic modeling can inform the implementation of public health interventions to help control COVID-19 transmission in the community.
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Affiliation(s)
- Nidia S. Trovao
- Fogarty International Center, National Institutes of Health, Bethesda, Maryland, USA
- COVID-19 International Research Team, Medford, Massachusetts, USA
| | - Vincent Pan
- Fogarty International Center, National Institutes of Health, Bethesda, Maryland, USA
- Harvard University, Cambridge, Massachusetts, USA
| | - Chirag Goel
- COVID-19 International Research Team, Medford, Massachusetts, USA
- Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Pilar Gallego-García
- CINBIO, Universidade de Vigo, Vigo, Spain
- Galicia Sur Health Research Institute (IIS Galicia Sur), SERGAS-UVIGO, Vigo, Spain
| | - Yunxi Liu
- Department of Computer Science, Rice University, Houston, Texas, USA
| | - Christopher Barbara
- Molecular Diagnostics-Infectious Diseases, Department of Pathology, Mater Dei Hospital, Msida, Malta
| | - Rebecca Borg
- Molecular Diagnostics-Infectious Diseases, Department of Pathology, Mater Dei Hospital, Msida, Malta
| | - Mark Briffa
- Molecular Diagnostics-Infectious Diseases, Department of Pathology, Mater Dei Hospital, Msida, Malta
| | - Chanelle Cilia
- Molecular Diagnostics-Infectious Diseases, Department of Pathology, Mater Dei Hospital, Msida, Malta
| | - Laura Grech
- Molecular Diagnostics-Infectious Diseases, Department of Pathology, Mater Dei Hospital, Msida, Malta
| | - Mario Vassallo
- Department of Sociology, Faculty of Arts, University of Malta, Msida, Malta
| | - Todd J. Treangen
- Department of Computer Science, Rice University, Houston, Texas, USA
| | - David Posada
- CINBIO, Universidade de Vigo, Vigo, Spain
- Galicia Sur Health Research Institute (IIS Galicia Sur), SERGAS-UVIGO, Vigo, Spain
- Department of Biochemistry, Genetics, and Immunology, Universidade de Vigo, Vigo, Spain
| | - Afshin Beheshti
- COVID-19 International Research Team, Medford, Massachusetts, USA
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA
- KBR, Space Biosciences Division, NASA Ames Research Center, Moffett Field, California, USA
| | - Joseph Borg
- COVID-19 International Research Team, Medford, Massachusetts, USA
- Department of Applied Biomedical Science, Faculty of Health Sciences, University of Malta, Msida, Malta
| | - Graziella Zahra
- Molecular Diagnostics-Infectious Diseases, Department of Pathology, Mater Dei Hospital, Msida, Malta
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