Abstract
Objectives: More than two years into the COVID-19 pandemic, SARS-CoV-2 still remains a global public health problem. Successive waves of infection have produced new SARS-CoV-2 variants with new mutations for which the impact on COVID-19 severity and patient survival is uncertain.
Methods: A total of 764 SARS-CoV-2 genomes, sequenced from COVID-19 patients, hospitalized from 19th February 2020 to 30 April 2021, along with their clinical data, were used for survival analysis.
Results: A significant association of B.1.1.7, the alpha lineage, with patient mortality (log hazard ratio (LHR) = 0.51, C.I. = [0.14,0.88]) was found upon adjustment by all the covariates known to affect COVID-19 prognosis. Moreover, survival analysis of mutations in the SARS-CoV-2 genome revealed 27 of them were significantly associated with higher mortality of patients. Most of these mutations were located in the genes coding for the S, ORF8, and N proteins.
Conclusions: This study illustrates how a combination of genomic and clinical data can provide solid evidence for the impact of viral lineage on patient survival.
Keywords: COVID-19; SARS-CoV-2; phylogeny; survival; virus genome.
【저자키워드】 COVID-19, SARS-CoV-2, survival, Phylogeny, virus genome., 【초록키워드】 Mutation, Hospitalized, Mortality, COVID-19 pandemic, variant, Infection, COVID-19 severity, ORF8, B.1.1.7, Lineage, Alpha, genomic, patients, COVID-19 patients, association, COVID-19 prognosis, Evidence, Combination, Analysis, patient survival, Clinical data, global public health, hazard ratio, SARS-CoV-2 genomes, coding, covariate, N proteins, MOST, patient mortality, virus genome, Affect, new SARS-CoV-2, log, produced, sequenced, significantly, were used, the SARS-CoV-2 genome, 【제목키워드】 Impact, Assessing,