{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,24]],"date-time":"2025-12-24T14:46:40Z","timestamp":1766587600554,"version":"build-2065373602"},"reference-count":24,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2023,12,22]],"date-time":"2023-12-22T00:00:00Z","timestamp":1703203200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"King Faisal Specialist Hospital and Research Centre","award":["#220 0009"],"award-info":[{"award-number":["#220 0009"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Viruses"],"abstract":"<jats:p>RNA viruses, including SARS-CoV-2, rely on genetic mutation as a major evolutionary mechanism, leading to the emergence of variants. Organ transplant recipients (OTRs) may be particularly vulnerable to such mutations, making it crucial to monitor the spread and evolution of SARS-CoV-2 in this population. This cohort study investigated the molecular epidemiology of SARS-CoV-2 by comparing the SARS-CoV-2 whole genome, demographic characteristics, clinical conditions, and outcomes of COVID-19 illness among OTRs (n = 19) and non-OTRs with (n = 38) or without (n = 30) comorbid conditions. Most patients without comorbidities were female, whereas most OTRs were male. Age varied significantly among the three groups: patients with comorbidities were the oldest, and patients without comorbidities were the youngest. Whole-genome sequencing revealed that OTRs with mild disease had higher numbers of unusual mutations than patients in the other two groups. Additionally, OTRs who died had similar spike monoclonal antibody resistance mutations and 3CLpro mutations, which may confer resistance to nirmatrelvir, ensitrelvir, and GC37 therapy. The presence of those unusual mutations may impact the severity of COVID-19 illness in OTRs by affecting the virus\u2019s ability to evade the immune system or respond to treatment. The higher mutation rate in OTRs may also increase the risk of the emergence of new virus variants. These findings highlight the importance of monitoring the genetic makeup of SARS-CoV-2 in all immunocompromised populations and patients with comorbidity.<\/jats:p>","DOI":"10.3390\/v16010025","type":"journal-article","created":{"date-parts":[[2023,12,22]],"date-time":"2023-12-22T08:53:01Z","timestamp":1703235181000},"page":"25","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Molecular Epidemiology of SARS-CoV-2 and Clinical Manifestations among Organ Transplant Recipients with COVID-19"],"prefix":"10.3390","volume":"16","author":[{"given":"Abeer N.","family":"Alshukairi","sequence":"first","affiliation":[{"name":"Department of Medicine, King Faisal Specialist Hospital and Research Centre, Jeddah 21362, Saudi Arabia"},{"name":"College of Medicine, Alfaisal University, Riyadh 11211, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4584-5739","authenticated-orcid":false,"given":"Ahmed A.","family":"Al-Qahtani","sequence":"additional","affiliation":[{"name":"College of Medicine, Alfaisal University, Riyadh 11211, Saudi Arabia"},{"name":"Department of Infection and Immunity, King Faisal Specialist Hospital and Research Centre, Riyadh 11211, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0251-1894","authenticated-orcid":false,"given":"Dalia A.","family":"Obeid","sequence":"additional","affiliation":[{"name":"Organ Transplant Center of Excellence, King Faisal Specialist Hospital and Research Centre, Riyadh 11211, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ashraf","family":"Dada","sequence":"additional","affiliation":[{"name":"Department of Medicine, King Faisal Specialist Hospital and Research Centre, Jeddah 21362, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Reem S.","family":"Almaghrabi","sequence":"additional","affiliation":[{"name":"Organ Transplant Center of Excellence, King Faisal Specialist Hospital and Research Centre, Riyadh 11211, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9675-7195","authenticated-orcid":false,"given":"Maha A.","family":"Al-Abdulkareem","sequence":"additional","affiliation":[{"name":"Department of Infection and Immunity, King Faisal Specialist Hospital and Research Centre, Riyadh 11211, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Basma M.","family":"Alahideb","sequence":"additional","affiliation":[{"name":"Department of Infection and Immunity, King Faisal Specialist Hospital and Research Centre, Riyadh 11211, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Madain S.","family":"Alsanea","sequence":"additional","affiliation":[{"name":"Department of Infection and Immunity, King Faisal Specialist Hospital and Research Centre, Riyadh 11211, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Feda A.","family":"Alsuwairi","sequence":"additional","affiliation":[{"name":"Department of Infection and Immunity, King Faisal Specialist Hospital and Research Centre, Riyadh 11211, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1765-4310","authenticated-orcid":false,"given":"Fatimah S.","family":"Alhamlan","sequence":"additional","affiliation":[{"name":"College of Medicine, Alfaisal University, Riyadh 11211, Saudi Arabia"},{"name":"Department of Infection and Immunity, King Faisal Specialist Hospital and Research Centre, Riyadh 11211, Saudi Arabia"},{"name":"Department of Pathology and Laboratory Medicine, King Faisal Specialist Hospital and Research Centre, Riyadh 11211, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,12,22]]},"reference":[{"key":"ref_1","unstructured":"WHO (2023, April 11). 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