Clinical outcomes and phylogenetic analysis in reflection with three predominant clades of SARS‐CoV‐2 variants

Abstract

AbstractBackgroundThe 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.Materials and MethodsIn 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 and clinical analysis.ResultsPhylogenetic 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 mortality rate was lower with Omicron (.5% for BA.5.2 and 1.3% for BA.1.17.2) compared with 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%, respectively. Age group (≥70) years had the highest mortality rate; however, it was (.0%) in the age group (30–49) years with Omicron variants, compared with (.96%) in Delta variants.ConclusionsThere 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.