key: cord-0798308-y5th0mrf
authors: Coppée, Frédérique; Lechien, Jérôme; Declèves, Anne-Emilie; Tafforeau, Lionel; Saussez, Sven
title: SARS-CoV-2: virus mutations in specific European populations
date: 2020-05-20
journal: New Microbes New Infect
DOI: 10.1016/j.nmni.2020.100696
sha: 1ce69f1dcd03a77c732afd14cd86553b5dcf4631
doc_id: 798308
cord_uid: y5th0mrf

Abstract The SARS-CoV-2 virus is being intensively studied, particularly, its evolution in the increasingly available sequences between countries/continents with classical phylogenetic tree representation. More recently, certain protein mutations are correlated with specific functional impacts. Our clinical data from patients suggest different clinical symptoms between European countries. Among others, SARS-CoV-2 mutations could explain these disparities. Our analyses point out an association of diverse mutations, including co-evolving ones, in a few SARS-CoV-2 proteins, with specific countries. We therefore suggest combining clinical information from patients and the determination of the associated SARS-CoV-2 genome to better understand the specific symptoms.

Our Research Group and co-investigators analyzed the epidemiological and clinical data of 21 1,420 European mild-to-moderate COVID-19 patients. 1 The included patients with similar 22 inclusion criteria came from Spain (30%), Italy (10%) and French-speaking population from 23 different European countries (Switzerland, Belgium, France; 60%). Interestingly, Bayesian 24 analyses have reported that depending on the countries, clinical symptoms were clearly identified and confirms two recent letters. 2 compared with the Italian population (50.0%). However, the prevalence of cough did not vary 31 regarding the country. Occurrences of these different COVID-19 clinical symptoms between 32 countries might be due to virus mutations, angiotensin converting enzyme-2 (ACE2) 33 polymorphisms and others. 1 In this paper, we will focus on the potential virus mutation 34 hypothesis through the GISAID database 4 (https://www.gisaid.org). 35

We analyzed SARS-CoV-2 sequences using CoV_GLUE 5 (http://cov-glue.cvr.gla.ac.uk/, last 37 accessed April 17 th 2020: 9,028 available sequences ('low coverage' excluded), including 38 4,973 European sequences, reporting 2334 non synonymous mutations). Italian population also reported co-evolved mutations (the above reported two main 91 mutations), and other synonymous mutation in nsp1 and in nsp3. 8 92 Previous studies 9-12 suggest that the sequence diversity in SARS-CoV-2 proteins would be 93 associated with the virus pathogenicity/transmission. In Europe, we observe that several 94 countries are associated with specific or several virus clades or mutations and that the 95 frequency in clinical symptoms of Covid-19 patients also varies between these countries. 96

To conclude, our study suggests that patient clinical information (sequence polymorphisms 97 and symptoms) and the sequence determination of the associated infectious genome should be 98 combined to a better understanding of the SARS-CoV-2 pathogenicity and for the 99 development of adapted treatments. 100

Clinical and Epidemiological 117 Characteristics of 1,420 European Patients with mild-to-moderate Coronavirus Disease

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