{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T02:29:06Z","timestamp":1760149746924,"version":"build-2065373602"},"reference-count":26,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2023,9,15]],"date-time":"2023-09-15T00:00:00Z","timestamp":1694736000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Ministry of Education and Science, Bulgaria","award":["KP-06-H43\/1-27.11.2020","BG05M2OP001-1.002-0001-C04"],"award-info":[{"award-number":["KP-06-H43\/1-27.11.2020","BG05M2OP001-1.002-0001-C04"]}]},{"name":"European Regional Development Fund","award":["KP-06-H43\/1-27.11.2020","BG05M2OP001-1.002-0001-C04"],"award-info":[{"award-number":["KP-06-H43\/1-27.11.2020","BG05M2OP001-1.002-0001-C04"]}]},{"name":"PON \u201cRicerca e Innovazione\u201d 2014\u20132020","award":["KP-06-H43\/1-27.11.2020","BG05M2OP001-1.002-0001-C04"],"award-info":[{"award-number":["KP-06-H43\/1-27.11.2020","BG05M2OP001-1.002-0001-C04"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Viruses"],"abstract":"<jats:p>The COVID-19 pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has brought about significant challenges worldwide. In this study, we present a comprehensive analysis of the genomic epidemiology and lineage dynamics of SARS-CoV-2 in Bulgaria over a three-year period. Through extensive genomic sequencing and data analysis, we investigated the evolution of the virus, the emergence of variants of concern (VOCs), and their impact on the country\u2019s pandemic trajectory. We also assessed the relationship between viral diversity and COVID-19 morbidity and mortality in Bulgaria. Our findings shed light on the temporal and spatial distribution of SARS-CoV-2 lineages and provide crucial insights into the dynamics of the pandemic in the country. The interplay between international travel and viral transmission plays a significant role in the emergence and dissemination of different SARS-CoV-2 variants. The observed proportions of exportation to various continents provide insights into the potential pathways through which these lineages spread globally. Understanding the genomic epidemiology of SARS-CoV-2 in Bulgaria is essential for formulating targeted public health strategies, enhancing vaccination efforts, and effectively managing future outbreaks.<\/jats:p>","DOI":"10.3390\/v15091924","type":"journal-article","created":{"date-parts":[[2023,9,15]],"date-time":"2023-09-15T03:50:10Z","timestamp":1694749810000},"page":"1924","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Genomic Epidemiology and Lineage Dynamics of SARS-CoV-2 in Bulgaria: Insights from a Three-Year Pandemic Analysis"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5849-7326","authenticated-orcid":false,"given":"Marta","family":"Giovanetti","sequence":"first","affiliation":[{"name":"Instituto Rene Rachou Funda\u00e7\u00e3o Oswaldo Cruz, Belo Horizonte 30190-009, Brazil"},{"name":"Sciences and Technologies for Sustainable Development and One Health, Universit\u00e0 Campus Bio-Medico di Roma, 00128 Rome, Italy"},{"name":"Climate Amplified Diseases and Epidemics (CLIMADE), Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7870-9744","authenticated-orcid":false,"given":"Eleonora","family":"Cella","sequence":"additional","affiliation":[{"name":"Burnett School of Biomedical Sciences, University of Central Florida, Orlando, FL 32816, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2616-894X","authenticated-orcid":false,"given":"Ivan","family":"Ivanov","sequence":"additional","affiliation":[{"name":"National Center of Infectious and Parasitic Diseases, 1504 Sofia, Bulgaria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lyubomira","family":"Grigorova","sequence":"additional","affiliation":[{"name":"National Center of Infectious and Parasitic Diseases, 1504 Sofia, Bulgaria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9924-8553","authenticated-orcid":false,"given":"Ivan","family":"Stoikov","sequence":"additional","affiliation":[{"name":"National Center of Infectious and Parasitic Diseases, 1504 Sofia, Bulgaria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7447-7627","authenticated-orcid":false,"given":"Deyan","family":"Donchev","sequence":"additional","affiliation":[{"name":"National Center of Infectious and Parasitic Diseases, 1504 Sofia, Bulgaria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7711-6798","authenticated-orcid":false,"given":"Reneta","family":"Dimitrova","sequence":"additional","affiliation":[{"name":"National Center of Infectious and Parasitic Diseases, 1504 Sofia, Bulgaria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0805-6140","authenticated-orcid":false,"given":"Svetoslav Nanev","family":"Slavov","sequence":"additional","affiliation":[{"name":"Butantan Institute, S\u00e3o Paulo 05508-040, Brazil"},{"name":"Blood Center of Ribeir\u00e3o Preto, Faculty of Medicine of Ribeir\u00e3o Preto, University of S\u00e3o Paulo, Ribeir\u00e3o Preto 14051-140, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3819-5520","authenticated-orcid":false,"given":"Carla","family":"Mavian","sequence":"additional","affiliation":[{"name":"Emerging Pathogens Institute, Department of Pathology, Immunology and Laboratory Medicine, College of Medicine, University of Florida, Gainesville, FL 32610, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5521-6448","authenticated-orcid":false,"given":"Vagner","family":"Fonseca","sequence":"additional","affiliation":[{"name":"Department of Exact and Earth Sciences, University of the State of Bahia, Salvador 40285-001, Brazil"},{"name":"Coordena\u00e7\u00e3o de Vigil\u00e2ncia, Prepara\u00e7\u00e3o e Resposta \u00e0 Emerg\u00eancias e Desastres (PHE), Organiza\u00e7\u00e3o Pan-Americana da Sa\u00fade\/Organiza\u00e7\u00e3o Mundial da Sa\u00fade (OPAS\/OMS), Brasilia 70312-970, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3501-714X","authenticated-orcid":false,"given":"Fabio","family":"Scarpa","sequence":"additional","affiliation":[{"name":"Department of Biomedical Sciences, University of Sassari, 07100 Sassari, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5401-135X","authenticated-orcid":false,"given":"Alessandra","family":"Borsetti","sequence":"additional","affiliation":[{"name":"National HIV\/AIDS Research Center (CNAIDS), National Institute of Health, 00118 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3188-2283","authenticated-orcid":false,"given":"Neli","family":"Korsun","sequence":"additional","affiliation":[{"name":"National Center of Infectious and Parasitic Diseases, 1504 Sofia, Bulgaria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4543-6831","authenticated-orcid":false,"given":"Ivelina","family":"Trifonova","sequence":"additional","affiliation":[{"name":"National Center of Infectious and Parasitic Diseases, 1504 Sofia, Bulgaria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Veselin","family":"Dobrinov","sequence":"additional","affiliation":[{"name":"National Center of Infectious and Parasitic Diseases, 1504 Sofia, Bulgaria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Todor","family":"Kantardjiev","sequence":"additional","affiliation":[{"name":"National Center of Infectious and Parasitic Diseases, 1504 Sofia, Bulgaria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Iva","family":"Christova","sequence":"additional","affiliation":[{"name":"National Center of Infectious and Parasitic Diseases, 1504 Sofia, Bulgaria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3866-9239","authenticated-orcid":false,"given":"Massimo","family":"Ciccozzi","sequence":"additional","affiliation":[{"name":"Unit of Medical Statistics and Molecular Epidemiology, Universita Campus Bio-Medico di Roma, 00128 Rome, 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