Genomics and epidemiology of the P.1 SARS-CoV-2 lineage in Manaus, Brazil.
Faria NR., Mellan TA., Whittaker C., Claro IM., Candido DDS., Mishra S., Crispim MAE., Sales FCS., Hawryluk I., McCrone JT., Hulswit RJG., Franco LAM., Ramundo MS., de Jesus JG., Andrade PS., Coletti TM., Ferreira GM., Silva CAM., Manuli ER., Pereira RHM., Peixoto PS., Kraemer MUG., Gaburo N., Camilo CDC., Hoeltgebaum H., Souza WM., Rocha EC., de Souza LM., de Pinho MC., Araujo LJT., Malta FSV., de Lima AB., Silva JDP., Zauli DAG., Ferreira ACDS., Schnekenberg RP., Laydon DJ., Walker PGT., Schlüter HM., Dos Santos ALP., Vidal MS., Del Caro VS., Filho RMF., Dos Santos HM., Aguiar RS., Proença-Modena JL., Nelson B., Hay JA., Monod M., Miscouridou X., Coupland H., Sonabend R., Vollmer M., Gandy A., Prete CA., Nascimento VH., Suchard MA., Bowden TA., Pond SLK., Wu C-H., Ratmann O., Ferguson NM., Dye C., Loman NJ., Lemey P., Rambaut A., Fraiji NA., Carvalho MDPSS., Pybus OG., Flaxman S., Bhatt S., Sabino EC.
Cases of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in Manaus, Brazil, resurged in late 2020 despite previously high levels of infection. Genome sequencing of viruses sampled in Manaus between November 2020 and January 2021 revealed the emergence and circulation of a novel SARS-CoV-2 variant of concern. Lineage P.1 acquired 17 mutations, including a trio in the spike protein (K417T, E484K, and N501Y) associated with increased binding to the human ACE2 (angiotensin-converting enzyme 2) receptor. Molecular clock analysis shows that P.1 emergence occurred around mid-November 2020 and was preceded by a period of faster molecular evolution. Using a two-category dynamical model that integrates genomic and mortality data, we estimate that P.1 may be 1.7- to 2.4-fold more transmissible and that previous (non-P.1) infection provides 54 to 79% of the protection against infection with P.1 that it provides against non-P.1 lineages. Enhanced global genomic surveillance of variants of concern, which may exhibit increased transmissibility and/or immune evasion, is critical to accelerate pandemic responsiveness.