A multidisciplinary team of scientists at Cleveland Clinic and Case Western Reserve University are working to better understand how the earlier COVID-19 mutations and clades altered clinical outcomes.
The team of researchers analyzed the RNA sequences of data from 302 patients with COVID-19 during the first wave of the pandemic in Northeast Ohio from March 11 to April 22, 2020. By sequencing each specimen against the initial strain of the virus discovered in Wuhan, China, Frank Esper, M.D., a pediatric infectious disease physician at Cleveland Clinic Children's and the research team identified 488 unique mutations, correlating with six virus strains (clades Wuhan, S, L, V, G, GH).
Results revealed that during the initial six weeks of the pandemic in Cleveland, the early virus strains were well established and contributed to higher incidents of death from the disease. However, within weeks these early virus strains were outpaced by more transmissible strains that were associated with lower hospitalizations and increased patient survival even when hospitalized.
"This study offers a detailed description of how the different COVID-19 clades evolved and competed once they were brought to Cleveland," said Brian Rubin, M.D., chair of Robert J. Tomsich Pathology and Laboratory Medicine Institute, Cleveland Clinic. "The linkage of viral clades to outcomes is quite important and highlights the importance of viral genome sequencing to gain a deeper understanding of new diseases."
"This study further confirms the importance of studying genomic variants of the virus throughout the pandemic," added Li. "It also clearly demonstrates the value of team science—a highly integrated and interactive team with different strengths and expertise but a shared vision—in addressing the challenge."