%0 Journal Article %J Viruses %D 2022 %T Assessing the Impact of SARS-CoV-2 Lineages and Mutations on Patient Survival. %A Loucera, Carlos %A Perez-Florido, Javier %A Casimiro-Soriguer, Carlos S %A Ortuno, Francisco M %A Carmona, Rosario %A Bostelmann, Gerrit %A Martínez-González, L Javier %A Muñoyerro-Muñiz, Dolores %A Villegas, Román %A Rodríguez-Baño, Jesús %A Romero-Gómez, Manuel %A Lorusso, Nicola %A Garcia-León, Javier %A Navarro-Marí, Jose M %A Camacho-Martinez, Pedro %A Merino-Diaz, Laura %A Salazar, Adolfo de %A Viñuela, Laura %A Lepe, Jose A %A García, Federico %A Dopazo, Joaquin %K COVID-19 %K Genome, Viral %K Humans %K mutation %K Pandemics %K Phylogeny %K SARS-CoV-2 %X

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.

%B Viruses %V 14 %8 2022 Aug 27 %G eng %N 9 %R 10.3390/v14091893