Intra-Host Evolution Provides for the Continuous Emergence of SARS-CoV-2 Variants
Justin T. Landis, Razia Moorad, Linda Pluta, Carolina Caro‐Vegas, Ryan P. McNamara, Anthony B. Eason, Aubrey Bailey, Femi Cleola S. Villamor, Angelica Juarez, Jason P. Wong, Brian Yang, Grant S. Broussard, Blossom Damania, Dirk P. Dittmer
Abstract
New SARS-CoV-2 variants can potentially disrupt ongoing public health measures and vaccine efforts. Still, little is known regarding how frequently new viral variants emerge and under what circumstances. Based on this study, we estimate that in hospitalized COVID-19 cases, variants with multiple mutations may emerge locally in as little as 1 month, even in patients without overt immune deficiency. Surveillance by sequencing for continuously shedding patients, patients suspected of reinfection, and patients with diminished immune function may offer broad public health benefits.