{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T15:57:41Z","timestamp":1753891061883,"version":"3.41.2"},"reference-count":40,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2024,12,18]],"date-time":"2024-12-18T00:00:00Z","timestamp":1734480000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>The COVID-19 pandemic had a widespread global impact and presented numerous challenges. The emergence of SARS-CoV-2 variants has changed transmission rates and immune evasion, possibly impacting the severity. This study aims to investigate the impact of variants on clinical outcomes in southern Brazil.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In total, samples from 277 patients, hospitalized and non-hospitalized, were collected between March 2020 and March 2021, before the vaccine was made widely available to the general population in Brazil. Whole genome sequencing of SARS-CoV-2 was performed and bioinformatics and biostatistics analyses were implemented on molecular and clinical data, respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The study identified significant demographic and clinical differences. The hospitalized group exhibited a higher proportion of males (51.9%) and an increased prevalence of comorbidities, including hypertension (66.0%), obesity (42.6%), and chronic kidney disease (23.6%). Patients were identified with twelve SARS-CoV-2 strains, predominantly B.1.1.28 and B.1.1.33 in the early 2020 first wave, and P.1 overlapping in the late 2020 and early 2021 second wave of COVID-19. Significant differences in hospitalization rates were found among patients infected with the different SARS-CoV-2 lineages: B.1.1.33 (46.0%), B.1.1.28 (65.9%), and P.1 (97.9%). Severity markers, such as pneumonia (62.5%, p=0.002), acute respiratory distress syndrome (ARDS, 72.9%, p&amp;lt;0.001), and oxygen support &amp;gt;6 L\/min O<jats:sub>2<\/jats:sub> (64.6%, p&amp;lt;0.001), were more frequent in patients from the second wave. These findings highlight the impact of different variants on the clinical evolution and prognosis of COVID-19, especially when comparing the first and second waves of the pandemic.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The study underscores the association between SARS-CoV-2 strains and COVID-19 severity by integrating clinical and viral data for public health responses during different pandemic phases, highlighting the importance of adapting pandemic strategies as the pandemic evolves.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fimmu.2024.1444620","type":"journal-article","created":{"date-parts":[[2024,12,18]],"date-time":"2024-12-18T12:09:31Z","timestamp":1734523771000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["SARS-CoV-2 strains and clinical profiles of COVID-19 patients in a Southern Brazil hospital"],"prefix":"10.3389","volume":"15","author":[{"given":"Bibiana S. de Oliveira","family":"Fam","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nathan Araujo","family":"Cadore","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Renan","family":"Sbruzzi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marilea Furtado","family":"Feira","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giovanna C\u00e2mara","family":"Giudicelli","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luiz G. 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