Rapid Emergence and Evolution of SARS-CoV-2 Intrahost Variants among COVID-19 Patients with Prolonged Infections, Singapore

The evolution and spread of SARS-CoV-2 variants have driven successive waves of global COVID-19 outbreaks, yet the longitudinal dynamics of intrahost variation within the same patient remain less clear. We conducted a longitudinal cohort study by deep sequencing 198 swab samples collected from COVI...

Full description

Saved in:
Bibliographic Details
Main Authors: Yvonne C.F. Su, Michael A. Zeller, Peter Cronin, Rong Zhang, Yan Zhuang, Jordan Ma, Foong Ying Wong, Giselle G.K. Ng, Áine O’Toole, Andrew Rambaut, Jenny G. Low, Gavin J.D. Smith
Format: Article
Language:English
Published: Centers for Disease Control and Prevention 2025-08-01
Series:Emerging Infectious Diseases
Subjects:
Online Access:https://wwwnc.cdc.gov/eid/article/31/8/24-1419_article
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849251784343683072
author Yvonne C.F. Su
Michael A. Zeller
Peter Cronin
Rong Zhang
Yan Zhuang
Jordan Ma
Foong Ying Wong
Giselle G.K. Ng
Áine O’Toole
Andrew Rambaut
Jenny G. Low
Gavin J.D. Smith
author_facet Yvonne C.F. Su
Michael A. Zeller
Peter Cronin
Rong Zhang
Yan Zhuang
Jordan Ma
Foong Ying Wong
Giselle G.K. Ng
Áine O’Toole
Andrew Rambaut
Jenny G. Low
Gavin J.D. Smith
author_sort Yvonne C.F. Su
collection DOAJ
description The evolution and spread of SARS-CoV-2 variants have driven successive waves of global COVID-19 outbreaks, yet the longitudinal dynamics of intrahost variation within the same patient remain less clear. We conducted a longitudinal cohort study by deep sequencing 198 swab samples collected from COVID-19 patients with varying infection durations. Our analysis showed that prolonged infections enhanced viral genomic diversity, leading to emergence of co-occurring variants that maintained high (>20%) frequency and became dominant in virus populations. We observed heterogeneous intrahost dynamics among individual patients, 2 of whom exhibited a minor variant of the spike D614G substitution over the course of infection. The increase in intrahost variants strongly correlated with prolonged infections, highlighting the complex interplay between viral diversity and host factors. This study revealed the intricate evolutionary mechanisms driving the emergence of de novo variants and lineage dominance, which could inform development of effective vaccine candidates and strategies to protect public health.
format Article
id doaj-art-8b439eb7aecf463899e041cbce41f455
institution Kabale University
issn 1080-6040
1080-6059
language English
publishDate 2025-08-01
publisher Centers for Disease Control and Prevention
record_format Article
series Emerging Infectious Diseases
spelling doaj-art-8b439eb7aecf463899e041cbce41f4552025-08-20T03:56:49ZengCenters for Disease Control and PreventionEmerging Infectious Diseases1080-60401080-60592025-08-013181537154910.3201/eid3108.241419Rapid Emergence and Evolution of SARS-CoV-2 Intrahost Variants among COVID-19 Patients with Prolonged Infections, SingaporeYvonne C.F. SuMichael A. ZellerPeter CroninRong ZhangYan ZhuangJordan MaFoong Ying WongGiselle G.K. NgÁine O’TooleAndrew RambautJenny G. LowGavin J.D. Smith The evolution and spread of SARS-CoV-2 variants have driven successive waves of global COVID-19 outbreaks, yet the longitudinal dynamics of intrahost variation within the same patient remain less clear. We conducted a longitudinal cohort study by deep sequencing 198 swab samples collected from COVID-19 patients with varying infection durations. Our analysis showed that prolonged infections enhanced viral genomic diversity, leading to emergence of co-occurring variants that maintained high (>20%) frequency and became dominant in virus populations. We observed heterogeneous intrahost dynamics among individual patients, 2 of whom exhibited a minor variant of the spike D614G substitution over the course of infection. The increase in intrahost variants strongly correlated with prolonged infections, highlighting the complex interplay between viral diversity and host factors. This study revealed the intricate evolutionary mechanisms driving the emergence of de novo variants and lineage dominance, which could inform development of effective vaccine candidates and strategies to protect public health. https://wwwnc.cdc.gov/eid/article/31/8/24-1419_articleCOVID-19respiratory infectionssevere acute respiratory syndrome coronavirus 2SARS-CoV-2SARScoronavirus disease
spellingShingle Yvonne C.F. Su
Michael A. Zeller
Peter Cronin
Rong Zhang
Yan Zhuang
Jordan Ma
Foong Ying Wong
Giselle G.K. Ng
Áine O’Toole
Andrew Rambaut
Jenny G. Low
Gavin J.D. Smith
Rapid Emergence and Evolution of SARS-CoV-2 Intrahost Variants among COVID-19 Patients with Prolonged Infections, Singapore
Emerging Infectious Diseases
COVID-19
respiratory infections
severe acute respiratory syndrome coronavirus 2
SARS-CoV-2
SARS
coronavirus disease
title Rapid Emergence and Evolution of SARS-CoV-2 Intrahost Variants among COVID-19 Patients with Prolonged Infections, Singapore
title_full Rapid Emergence and Evolution of SARS-CoV-2 Intrahost Variants among COVID-19 Patients with Prolonged Infections, Singapore
title_fullStr Rapid Emergence and Evolution of SARS-CoV-2 Intrahost Variants among COVID-19 Patients with Prolonged Infections, Singapore
title_full_unstemmed Rapid Emergence and Evolution of SARS-CoV-2 Intrahost Variants among COVID-19 Patients with Prolonged Infections, Singapore
title_short Rapid Emergence and Evolution of SARS-CoV-2 Intrahost Variants among COVID-19 Patients with Prolonged Infections, Singapore
title_sort rapid emergence and evolution of sars cov 2 intrahost variants among covid 19 patients with prolonged infections singapore
topic COVID-19
respiratory infections
severe acute respiratory syndrome coronavirus 2
SARS-CoV-2
SARS
coronavirus disease
url https://wwwnc.cdc.gov/eid/article/31/8/24-1419_article
work_keys_str_mv AT yvonnecfsu rapidemergenceandevolutionofsarscov2intrahostvariantsamongcovid19patientswithprolongedinfectionssingapore
AT michaelazeller rapidemergenceandevolutionofsarscov2intrahostvariantsamongcovid19patientswithprolongedinfectionssingapore
AT petercronin rapidemergenceandevolutionofsarscov2intrahostvariantsamongcovid19patientswithprolongedinfectionssingapore
AT rongzhang rapidemergenceandevolutionofsarscov2intrahostvariantsamongcovid19patientswithprolongedinfectionssingapore
AT yanzhuang rapidemergenceandevolutionofsarscov2intrahostvariantsamongcovid19patientswithprolongedinfectionssingapore
AT jordanma rapidemergenceandevolutionofsarscov2intrahostvariantsamongcovid19patientswithprolongedinfectionssingapore
AT foongyingwong rapidemergenceandevolutionofsarscov2intrahostvariantsamongcovid19patientswithprolongedinfectionssingapore
AT gisellegkng rapidemergenceandevolutionofsarscov2intrahostvariantsamongcovid19patientswithprolongedinfectionssingapore
AT aineotoole rapidemergenceandevolutionofsarscov2intrahostvariantsamongcovid19patientswithprolongedinfectionssingapore
AT andrewrambaut rapidemergenceandevolutionofsarscov2intrahostvariantsamongcovid19patientswithprolongedinfectionssingapore
AT jennyglow rapidemergenceandevolutionofsarscov2intrahostvariantsamongcovid19patientswithprolongedinfectionssingapore
AT gavinjdsmith rapidemergenceandevolutionofsarscov2intrahostvariantsamongcovid19patientswithprolongedinfectionssingapore