Dinâmica das variantes do SARS-CoV-2 e os diversos fenótipos da COVID-19 em uma coorte de pacientes atendidos na Policlínica Piquet Carneiro no período de abril de 2020 a janeiro de 2022

Abstract

The descriptive and observational study was carried out with the objective of describing the clinical, epidemiological and phylogenetic aspects of patients infected with SARS-COV-2. The study cohort was based on the cases detected by SARS-CoV-2 of patients seen at Policlínica Piquet Carneiro from April 2020 to January 2022. From the registration forms, qRT-PCR results, NGS sequencing, titration of circulating antibodies and neutralizing antibodies, we identified 406 samples that were assigned to the study of geodistribution of lineages within the cohort. Of these, 360 were assigned to the study of the epidemiological profile of professionals treated at the PPC, 22 samples correspond to patients with reinfection and 5 samples from 2 patients with prolonged infection, in which phylogenetic analyzes and immunological profile were performed in the face of vaccination against COVID-19. Of the 406 samples, the dissemination of variants of concern (VOC) was observed in 17 municipalities, the main lineages found were Gamma (P.1), Delta (AY.99.2) and Ômicron (BA.1). Due to the phylogenetic analysis, it was possible to observe a high accumulation of mutations of the Ômicron lineages and the rapid dissemination according to the time of evolution. Within this study, we observed significantly different distributions between the number of substitutions of the Ômicron lineage and circulating antibodies. As for the analysis of professionals, we found that both health professionals and professionals from other areas had high exposure to the virus, but health professionals were the first to be contaminated within this cohort. As for the data from patients with prolonged infection and reinfected, we concluded that both circulating and neutralizing antibodies show a tendency to decrease over time, even with previous immunization due to another infection or vaccination, therefore, booster immunization is essential for the control the circulation of new strains. These data highlight the importance of genomic surveillance that can assist in the screening of new variants and minimize the impacts caused by SARS-CoV-2