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Eur J Clin Invest . Clinical Outcomes and Phylogenetic analysis in Reflection with Three Predominant Clades of SARS-CoV-2 Variants

tetano

Editor, Senior Moderator
Eur J Clin Invest


. 2023 Apr 10;e14004.
doi: 10.1111/eci.14004. Online ahead of print.
Clinical Outcomes and Phylogenetic analysis in Reflection with Three Predominant Clades of SARS-CoV-2 Variants


Kameran M Ali[SUP] 1 [/SUP], Peshnyar M A Rashid[SUP] 2 [/SUP], Ayad M Ali[SUP] 3 [/SUP], Ahmed M Tofiq[SUP] 4 [/SUP], Gaza F Salih[SUP] 5 [/SUP], Omer I Dana[SUP] 6 [/SUP], Hassan M Rostam[SUP] 7 [/SUP]



Affiliations

Abstract

The pandemic of coronavirus disease 2019 (COVID-19) has a broad spectrum of clinical manifestations. The severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) undergoes continuous evolution, resulting in the emergence of several variants. Each variant has a different severity and mortality rate. In this study, 1174 COVID-19 patients were studied for mortality and severity over three SARS-CoV-2 predominating variant periods in 2021 and 2022 in Sulaimani Province, Iraq. In each period, a representative, variant virus was subjected to phylogenetic and molecular analysis. Phylogenetic analysis revealed three SARS-CoV-2 variants, belonging to: Delta B.1.617.2, Omicron BA.1.17.2, and Omicron BA.5.6. The Delta variants showed more severe symptoms and a lower PCR-Ct value than Omicron variants regardless of gender, and only 4.3% of the cases were asymptomatic. The morality rate was lower with Omicron (0.5% for BA.5.2 and 1.3% for BA.1.17.2) compared to Delta variants (2.5%). The higher mortality rate with Delta variants was in males (2.84%), while that with Omicron BA1.17.2 and BA.5.2 was in females, 1.05% and 0.0%, respectively. Age group (≥70) years had the highest mortality rate; however, it was (0.0%) in age group (30-49) years with Omicron variants, as compared to (0.96%) in Delta variants. In conclusion, there has been a surge in COVID-19 infection in the city due to the predominant lineages of SARS-CoV-2, B.1.617, Omicron BA.1.17.2, and Omicron BA.5.6, respectively. A higher PCR-Ct value and severity of the Delta variant over Omicron BA.1.17.2 and/or BA.5.2 variants were significantly correlated with a higher death rate in the same order.

Keywords: Delta; Omicron; Phylogenetic; SARS-CoV-2; molecular analysis; predominant lineages.
 
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