Sequence Analysis of 20,453 Severe Acute Respiratory Syndrome Coronavirus 2 Genomes from the Houston Metropolitan Area Identifies the Emergence and Widespread Distribution of Multiple Isolates of All Major Variants of Concern

Since the beginning of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic, there has been international concern about emergence virus variants with mutations that increase transmissibility, enhance escape from human immune response, or otherwise alter biologically important phenotypes. In late 2020, several emerged globally, including UK variant (B.1.1.7), South Africa (B.1.351), Brazil (P.1 and P.2), two related California interest (B.1.429 B.1.427). These are believed to have enhanced transmissibility. For variants, is evidence in spike protein permit it some vaccines therapeutic monoclonal antibodies. On basis our extensive genome sequencing program involving 20,453 disease 2019 patient samples collected March 2020 February 2021, we report identification all six these SARS-CoV-2 among Houston Methodist Hospital (Houston, TX) patients residing greater metropolitan area. 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This describes isolates B.1.351, P.1 P.2, B.1.429 B.1.427 through mid-February 2021. findings represent detection Texas time Greater metroplex circulating residents. Our discoveries illustrate need identify help track monitor development assess relationship outcomes. obtained individuals who registered hospitals, facilities (eg, urgent centers), institutions use laboratory services. Virtually had signs symptoms consistent COVID-19. work approved Research Institute Institutional Review Board (IRB1010-0199). Specimens symptomatic high degree suspicion tested Diagnostics Laboratory using assays granted Emergency Use Authorization US Food Drug Administration (https://www.fda.gov/medical-devices/emergency-situations-medical-devices/faqs-diagnostic-testing-sars-cov-2#offeringtests, 2021). testing platforms used, RP2.1 BioFire Film Array instruments (Biofire Diagnostics, Salt Lake City, UT), Xpert Xpress Cepheid GeneXpert Infinity IV (Cepheid, Sunnyvale, CA), Assay Hologic Panther instrument, Aptima Fusion (Hologic, Marlborough, MA), assay Abbott Alinity m (Abbott Laboratories, Park, IL). performed according manufacturer's instructions. 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