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Mariane Talon de Menezes

Bio: Mariane Talon de Menezes is an academic researcher from Federal University of Rio de Janeiro. The author has contributed to research in topics: Medicine & Virus. The author has an hindex of 4, co-authored 9 publications receiving 560 citations.
Topics: Medicine, Virus, Dengue virus, Dengue fever, Biology

Papers
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Journal ArticleDOI
Darlan da Silva Candido1, Darlan da Silva Candido2, Ingra Morales Claro2, Jaqueline Goes de Jesus2, William Marciel de Souza, Filipe R. R. Moreira3, Simon Dellicour4, Simon Dellicour5, Thomas A. Mellan6, Louis du Plessis1, Rafael Henrique Moraes Pereira, Flavia C. S. Sales2, Erika R. Manuli2, Julien Thézé7, Luiz Carlos de Almeida, Mariane Talon de Menezes3, Carolina M. Voloch3, Marcílio Jorge Fumagalli, Thais M. Coletti2, Camila A. M. Silva2, Mariana S. Ramundo2, Mariene R. Amorim8, Henrique Hoeltgebaum6, Swapnil Mishra6, Mandev S. Gill5, Luiz Max Carvalho9, Lewis F Buss2, Carlos A. Prete2, Jordan Ashworth10, Helder I. Nakaya2, Pedro S. Peixoto2, Oliver J. Brady11, Samuel M. Nicholls12, Amilcar Tanuri3, Átila Duque Rossi3, Carlos Kaue Vieira Braga, Alexandra L. Gerber, Ana Paula de C Guimarães, Nelson Gaburo, Cecila Salete Alencar2, Alessandro C. S. Ferreira, Cristiano Xavier Lima13, José Eduardo Levi14, Celso Francisco Hernandes Granato, Giulia M. Ferreira15, Ronaldo da Silva Francisco, Fabiana Granja16, Fabiana Granja8, Márcia Teixeira Garcia8, Maria Luiza Moretti8, Mauricio W. Perroud8, Terezinha M. P. P. Castineiras3, Carolina S. Lazari2, Sarah C. Hill17, Sarah C. Hill1, Andreza Aruska de Souza Santos1, Camila L. Simeoni8, Julia Forato8, Andrei C. Sposito8, Angelica Zaninelli Schreiber8, Magnun N. N. Santos8, Camila Zolini de Sá13, Renan P. Souza13, Luciana C. Resende-Moreira13, Mauro M. Teixeira13, Josy Hubner13, Patricia Asfora Falabella Leme8, Rennan G. Moreira13, Maurício Lacerda Nogueira18, Neil M. Ferguson2, Silvia Figueiredo Costa8, José Luiz Proença-Módena, Ana Tereza Ribeiro de Vasconcelos6, Samir Bhatt5, Philippe Lemey19, Chieh-Hsi Wu10, Andrew Rambaut12, Nicholas J. Loman13, Renato Santana Aguiar1, Oliver G. Pybus2, Ester Cerdeira Sabino1, Ester Cerdeira Sabino2, Ester Cerdeira Sabino6, Nuno R. Faria2, Nuno R. Faria6, Nuno R. Faria1 
23 Jul 2020-Science
TL;DR: New light is shed on the epidemic transmission and evolutionary trajectories of SARS-CoV-2 lineages in Brazil and evidence that current interventions remain insufficient to keep virus transmission under control in this country is provided.
Abstract: Brazil currently has one of the fastest-growing severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) epidemics in the world. Because of limited available data, assessments of the impact of nonpharmaceutical interventions (NPIs) on this virus spread remain challenging. Using a mobility-driven transmission model, we show that NPIs reduced the reproduction number from >3 to 1 to 1.6 in Sao Paulo and Rio de Janeiro. Sequencing of 427 new genomes and analysis of a geographically representative genomic dataset identified >100 international virus introductions in Brazil. We estimate that most (76%) of the Brazilian strains fell in three clades that were introduced from Europe between 22 February and 11 March 2020. During the early epidemic phase, we found that SARS-CoV-2 spread mostly locally and within state borders. After this period, despite sharp decreases in air travel, we estimated multiple exportations from large urban centers that coincided with a 25% increase in average traveled distances in national flights. This study sheds new light on the epidemic transmission and evolutionary trajectories of SARS-CoV-2 lineages in Brazil and provides evidence that current interventions remain insufficient to keep virus transmission under control in this country.

286 citations

Journal ArticleDOI
Nuno R. Faria1, Moritz U. G. Kraemer1, Moritz U. G. Kraemer2, Moritz U. G. Kraemer3, Sarah C. Hill1, Jaqueline Goes de Jesus4, Renato S. Aguiar5, Felipe Campos de Melo Iani6, Joilson Xavier4, Joshua Quick7, L. du Plessis1, Simon Dellicour8, Julien Thézé1, Rodrigo Dias de Oliveira Carvalho6, Guy Baele8, Chieh-Hsi Wu1, Paola P. Silveira5, Monica B. Arruda5, Maira Alves Pereira, Gavin Pereira, José Lourenço1, Uri Obolski1, Leandro Abade1, Tetyana I. Vasylyeva1, Marta Giovanetti6, Marta Giovanetti4, D. Yi3, Daniel J. Weiss1, William Wint1, Freya M Shearer1, Sebastian Funk9, Birgit Nikolay10, Vagner Fonseca11, Vagner Fonseca6, Talita Émile Ribeiro Adelino, Marluce Aparecida Assunção Oliveira, Marcos Vieira Silva, Lívia Sacchetto6, Poliana de Oliveira Figueiredo6, Izabela Maurício de Rezende6, Érica Munhoz de Mello6, Rodrigo Fabiano do Carmo Said, Deise Aparecida dos Santos, Marcela Lencine Ferraz, Mariana Gontijo de Brito, Ludmila Ferraz de Santana, Mariane Talon de Menezes5, Rodrigo Brindeiro5, Amilcar Tanuri5, Fabiana Cristina Pereira dos Santos12, Mariana Sequetin Cunha12, Juliana Silva Nogueira12, Iray Maria Rocco12, A. C. da Costa13, Shirley Vasconcelos Komninakis14, Vasco Azevedo6, Alexandre Otavio Chieppe, Eliane Saraiva Machado de Araújo4, Marcos Cesar Lima de Mendonça4, Carolina Cardoso dos Santos4, Cintia Damasceno dos Santos Rodrigues4, Maria Angelica Mares Guia4, Rita Maria Ribeiro Nogueira4, Patrícia Carvalho de Sequeira4, Ricardo Gadelha de Abreu, Marcio Henrique de Oliveira Garcia, André Luis de Abreu, Osnei Okumoto, Erna Geessien Kroon6, Carlos Frederico Campelo de Albuquerque, Kuiama Lewandowski15, Steven T. Pullan15, Miles W. Carroll15, T. de Oliveira11, T. de Oliveira16, T. de Oliveira4, Ester Cerdeira Sabino13, Renato Pereira de Souza12, Marc A. Suchard17, Philippe Lemey8, Giliane de Souza Trindade6, Betânia Paiva Drumond6, Ana Maria Bispo de Filippis4, Nicholas J. Loman7, Simon Cauchemez10, Luiz Carlos Junior Alcantara4, Luiz Carlos Junior Alcantara6, Oliver G. Pybus1 
31 Aug 2018-Science
TL;DR: It is shown that the age and sex distribution of human cases is characteristic of sylvatic transmission, which establishes a framework for monitoring YFV transmission in real time that will contribute to a global strategy to eliminate future YFFV epidemics.
Abstract: The yellow fever virus (YFV) epidemic in Brazil is the largest in decades. The recent discovery of YFV in Brazilian Aedes species mosquitos highlights a need to monitor the risk of reestablishment of urban YFV transmission in the Americas. We use a suite of epidemiological, spatial, and genomic approaches to characterize YFV transmission. We show that the age and sex distribution of human cases is characteristic of sylvatic transmission. Analysis of YFV cases combined with genomes generated locally reveals an early phase of sylvatic YFV transmission and spatial expansion toward previously YFV-free areas, followed by a rise in viral spillover to humans in late 2016. Our results establish a framework for monitoring YFV transmission in real time that will contribute to a global strategy to eliminate future YFV epidemics.

261 citations

DOI
Darlan da Silva Candido, Ingra Morales Claro, Jaqueline Goes de Jesus, William Marciel de Souza, Filipe R. R. Moreira, Simon Dellicour, Thomas A. Mellan, Louis du Plessis, Rafael Henrique Moraes Pereira, Flavia C. S. Sales, Erika R. Manuli, Julien Thézé, Luiz Carlos de Almeida, Mariane Talon de Menezes, Carolina M. Voloch, Marcílio Jorge Fumagalli, Thais M. Coletti, Camila A. M. Silva, Mariana S. Ramundo, Mariene R. Amorim, Henrique Hoeltgebaum, Swapnil Mishra, Mandev S. Gill, Luiz Max Carvalho, Lewis F Buss, Carlos A. Prete, Jordan Ashworth, Helder I. Nakaya, Pedro S. Peixoto, Oliver J. Brady, Samuel M. Nicholls, Amilcar Tanuri, Átila Duque Rossi, Carlos Kaue Vieira Braga, Alexandra L. Gerber, Ana Paula de C Guimarães, Nelson Gaburo, Cecila Salete Alencar, Alessandro C. S. Ferreira, Cristiano Xavier Lima, José Eduardo Levi, Celso Francisco Hernandes Granato, Giulia M. Ferreira, Ronaldo da Silva Francisco, Fabiana Granja, Márcia Teixeira Garcia, Maria Luiza Moretti, Mauricio W. Perroud, Terezinha M. P. P. Castineiras, Carolina S. Lazari, Sarah C. Hill, Andreza Aruska de Souza Santos, Camila L. Simeoni, Julia Forato, Andrei C. Sposito, Angelica Zaninelli Schreiber, Magnun N. N. Santos, Camila Zolini de Sá, Renan P. Souza, Luciana C. Resende-Moreira, Mauro M. Teixeira, Josy Hubner, Patricia Asfora Falabella Leme, Rennan G. Moreira, Maurício Lacerda Nogueira, Neil M. Ferguson, Silvia Figueiredo Costa, José Luiz Proença-Módena, Ana Tereza Ribeiro de Vasconcelos, Samir Bhatt, Philippe Lemey, Chieh-Hsi Wu, Andrew Rambaut, Nicholas J. Loman, Renato Santana Aguiar, Oliver G. Pybus, Ester Cerdeira Sabino, Nuno R. Faria 
05 Aug 2020
TL;DR: New light is shed on the epidemic transmission and evolutionary trajectories of SARS-CoV-2 lineages in Brazil, and evidence that current interventions remain insufficient to keep virus transmission under control in the country is provided.
Abstract: Brazil currently has one of the fastest growing SARS-CoV-2 epidemics in the world. Owing to limited available data, assessments of the impact of non-pharmaceutical interventions (NPIs) on virus spread remain challenging. Using a mobility-driven transmission model, we show that NPIs reduced the reproduction number from >3 to 1–1.6 in Sao Paulo and Rio de Janeiro. Sequencing of 427 new genomes and analysis of a geographically representative genomic dataset identified >100 international virus introductions in Brazil. We estimate that most (76%) of the Brazilian strains fell in three clades that were introduced from Europe between 22 February11 March 2020. During the early epidemic phase, we found that SARS-CoV-2 spread mostly locally and within-state borders. After this period, despite sharp decreases in air travel, we estimated multiple exportations from large urban centers that coincided with a 25% increase in average travelled distances in national flights. This study sheds new light on the epidemic transmission and evolutionary trajectories of SARS-CoV-2 lineages in Brazil, and provide evidence that current interventions remain insufficient to keep virus transmission under control in the country.

138 citations

Posted ContentDOI
Darlan da Silva Candido1, Ingra Morales Claro2, Jaqueline Goes de Jesus2, William Marciel de Souza, Filipe R. R. Moreira3, Simon Dellicour4, Thomas A. Mellan5, Louis du Plessis1, Rafael Henrique Moraes Pereira, Flavia C. S. Sales2, Erika R. Manuli2, Julien Thézé, Luiz Carlos de Almeida6, Mariane Talon de Menezes3, Carolina M. Voloch3, Marcílio Jorge Fumagalli, Thais M. Coletti2, Camila A. M. Silva2, Mariana S. Ramundo2, Mariene R. Amorim5, Henrique Hoeltgebaum, Swapnil Mishra, Mandev S. Gill, Luiz Max Carvalho2, Lewis F Buss2, Carlos A. Prete7, Jordan Ashworth2, Helder I. Nakaya2, Pedro S. Peixoto8, Oliver J. Brady8, Oliver J. Brady9, Samuel M. Nicholls, Amilcar Tanuri3, Átila Duque Rossi3, Carlos Kaue Vieira Braga, Alexandra L. Gerber6, Ana Paula de C Guimarães6, Nelson Gaburo2, Cecila Salete Alencar, Alessandro C. S. Ferreira10, Cristiano Xavier Lima11, José Eduardo Levi, Celso Francisco Hernandes Granato12, Giula M. Ferreira13, Ronaldo da Silva Francisco, Fabiana Granja6, Márcia Teixeira Garcia6, Maria Luiza Moretti6, Mauricio W. Perroud3, Terezinha M. P. P. Castineiras14, Carolina S. Lazari, Sarah C. Hill1, Andreza Aruska de Souza Santos6, Camila L. Simeoni5, Julia Forato5, Andrei C. Sposito6, Angelica Zaninelli Schreiber10, Magnun N. N. Santos10, Camila Zolini de Sá10, Renan P. Souza10, Luciana C. Resende-Moreira10, Mauro M. Teixeira10, Josy Hubner6, Patricia Asfora Falabella Leme10, Rennan G. Moreira15, Maurício Lacerda Nogueira16, CADDE-Genomic-Network5, Neil M. Ferguson, Silvia Figueiredo Costa2, José Luiz Proença-Módena5, Ana Tereza Ribeiro de Vasconcelos6, Samir Bhatt5, Philippe Lemey, Chieh-Hsi Wu7, Andrew Rambaut7, Nicholas J. Loman, Renato Santana Aguiar10, Oliver G. Pybus1, Ester Cerdeira Sabino2, Nuno R. Faria1, Nuno R. Faria2, Nuno R. Faria5 
23 Jun 2020-medRxiv
TL;DR: Light is shed on the role of large and highly connected populated centres in the rapid ignition and establishment of SARS-CoV-2, and evidence that current interventions remain insufficient to keep virus transmission under control in Brazil is provided.
Abstract: Brazil currently has one of the fastest growing SARS-CoV-2 epidemics in the world. Due to limited available data, assessments of the impact of non-pharmaceutical interventions (NPIs) on virus transmission and epidemic spread remain challenging. We investigate the impact of NPIs in Brazil using epidemiological, mobility and genomic data. Mobility-driven transmission models for Sao Paulo and Rio de Janeiro cities show that the reproduction number (Rt) reached below 1 following NPIs but slowly increased to values between 1 to 1.3 (1.0 - -1.6). Genome sequencing of 427 new genomes and analysis of a geographically representative genomic dataset from 21 of the 27 Brazilian states identified >100 international introductions of SARS-CoV-2 in Brazil. We estimate that three clades introduced from Europe emerged between 22 and 27 February 2020, and were already well-established before the implementation of NPIs and travel bans. During this first phase of the epidemic establishment of SARS-CoV-2 in Brazil, we find that the virus spread mostly locally and within-state borders. Despite sharp decreases in national air travel during this period, we detected a 25% increase in the average distance travelled by air passengers during this time period. This coincided with the spread of SARS-CoV-2 from large urban centers to the rest of the country. In conclusion, our results shed light on the role of large and highly connected populated centres in the rapid ignition and establishment of SARS-CoV-2, and provide evidence that current interventions remain insufficient to keep virus transmission under control in Brazil.

73 citations

Journal ArticleDOI
TL;DR: The establishment of Delta is presented, providing evidence of its enhanced transmissibility and showing that this variant shift did not aggravate the epidemiological scenario in a high immunity setting.
Abstract: Abstract The emergence and global dissemination of Severe Acute Respiratory Syndrome virus 2 (SARS-CoV-2) variants of concern (VOCs) have been described as the main factor driving the Coronavirus Disease 2019 pandemic. In Brazil, the Gamma variant dominated the epidemiological scenario during the first period of 2021. Many Brazilian regions detected the Delta variant after its first description and documented its spread. To monitor the introduction and spread of VOC Delta, we performed Polymerase Chain Reaction (PCR) genotyping and genome sequencing in ten regional sentinel units from June to October 2021 in the State of Minas Gerais (MG). We documented the introduction and spread of Delta, comprising 70 per cent of the cases 8 weeks later. Comparing the viral loads of the Gamma and Delta dominance periods, we provide additional evidence that the latter is more transmissible. The spread and dominance of Delta did not culminate in the increase in cases and deaths, suggesting that the vaccination may have restrained the epidemic growth. Analysis of 224 novel Delta genomes revealed that Rio de Janeiro state was the primary source for disseminating this variant in the state of MG. We present the establishment of Delta, providing evidence of its enhanced transmissibility and showing that this variant shift did not aggravate the epidemiological scenario in a high immunity setting.

8 citations


Cited by
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01 May 2020-Science
TL;DR: Real-time mobility data from Wuhan and detailed case data including travel history are used to elucidate the role of case importation in transmission in cities across China and to ascertain the impact of control measures.
Abstract: The ongoing coronavirus disease 2019 (COVID-19) outbreak expanded rapidly throughout China. Major behavioral, clinical, and state interventions were undertaken to mitigate the epidemic and prevent the persistence of the virus in human populations in China and worldwide. It remains unclear how these unprecedented interventions, including travel restrictions, affected COVID-19 spread in China. We used real-time mobility data from Wuhan and detailed case data including travel history to elucidate the role of case importation in transmission in cities across China and to ascertain the impact of control measures. Early on, the spatial distribution of COVID-19 cases in China was explained well by human mobility data. After the implementation of control measures, this correlation dropped and growth rates became negative in most locations, although shifts in the demographics of reported cases were still indicative of local chains of transmission outside of Wuhan. This study shows that the drastic control measures implemented in China substantially mitigated the spread of COVID-19.

2,362 citations

Journal ArticleDOI
Nuno R. Faria, Thomas A. Mellan1, Charles Whittaker1, Ingra Morales Claro2, Darlan da Silva Candido3, Darlan da Silva Candido2, Swapnil Mishra1, Myuki A E Crispim, Flavia C. S. Sales2, Iwona Hawryluk1, John T. McCrone4, Ruben J.G. Hulswit3, Lucas A M Franco2, Mariana S. Ramundo2, Jaqueline Goes de Jesus2, Pamela S Andrade2, Thais M. Coletti2, Giulia M. Ferreira5, Camila A. M. Silva2, Erika R. Manuli2, Rafael Henrique Moraes Pereira, Pedro S. Peixoto2, Moritz U. G. Kraemer3, Nelson Gaburo, Cecilia da C. Camilo, Henrique Hoeltgebaum1, William Marciel de Souza2, Esmenia C. Rocha2, Leandro Marques de Souza2, Mariana C. Pinho2, Leonardo José Tadeu de Araújo6, Frederico S V Malta, Aline B. de Lima, Joice do P. Silva, Danielle A G Zauli, Alessandro C. S. Ferreira, Ricardo P Schnekenberg3, Daniel J Laydon1, Patrick G T Walker1, Hannah M. Schlüter1, Ana L. P. dos Santos, Maria S. Vidal, Valentina S. Del Caro, Rosinaldo M. F. Filho, Helem M. dos Santos, Renato Santana Aguiar7, José Luiz Proença-Módena8, Bruce Walker Nelson9, James A. Hay10, Melodie Monod1, Xenia Miscouridou1, Helen Coupland1, Raphael Sonabend1, Michaela A. C. Vollmer1, Axel Gandy1, Carlos A. Prete2, Vitor H. Nascimento2, Marc A. Suchard11, Thomas A. Bowden3, Sergei L Kosakovsky Pond12, Chieh-Hsi Wu13, Oliver Ratmann1, Neil M. Ferguson1, Christopher Dye3, Nicholas J. Loman14, Philippe Lemey15, Andrew Rambaut4, Nelson Abrahim Fraiji, Maria Perpétuo Socorro Sampaio Carvalho, Oliver G. Pybus3, Oliver G. Pybus16, Seth Flaxman1, Samir Bhatt1, Samir Bhatt17, Ester Cerdeira Sabino2 
21 May 2021-Science
TL;DR: In this article, the authors used a two-category dynamical model that integrates genomic and mortality data to 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.
Abstract: 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.

985 citations

Journal ArticleDOI
08 Jan 2021-Science
TL;DR: The SARS-CoV-2 virus was initially introduced by humans and has since evolved, most likely reflecting widespread circulation among mink in the beginning of the infection period, several weeks before detection.
Abstract: Animal experiments have shown that nonhuman primates, cats, ferrets, hamsters, rabbits, and bats can be infected by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). In addition, SARS-CoV-2 RNA has been detected in felids, mink, and dogs in the field. Here, we describe an in-depth investigation using whole-genome sequencing of outbreaks on 16 mink farms and the humans living or working on these farms. We conclude that the virus was initially introduced by humans and has since evolved, most likely reflecting widespread circulation among mink in the beginning of the infection period, several weeks before detection. Despite enhanced biosecurity, early warning surveillance, and immediate culling of animals in affected farms, transmission occurred between mink farms in three large transmission clusters with unknown modes of transmission. Of the tested mink farm residents, employees, and/or individuals with whom they had been in contact, 68% had evidence of SARS-CoV-2 infection. Individuals for which whole genomes were available were shown to have been infected with strains with an animal sequence signature, providing evidence of animal-to-human transmission of SARS-CoV-2 within mink farms.

802 citations

Journal ArticleDOI
TL;DR: The utility of PrimalSeq is demonstrated by measuring Zika and West Nile virus diversity from varied sample types and the accumulation of genetic diversity is influenced by experimental and biological systems.
Abstract: How viruses evolve within hosts can dictate infection outcomes; however, reconstructing this process is challenging. We evaluate our multiplexed amplicon approach, PrimalSeq, to demonstrate how virus concentration, sequencing coverage, primer mismatches, and replicates influence the accuracy of measuring intrahost virus diversity. We develop an experimental protocol and computational tool, iVar, for using PrimalSeq to measure virus diversity using Illumina and compare the results to Oxford Nanopore sequencing. We demonstrate the utility of PrimalSeq by measuring Zika and West Nile virus diversity from varied sample types and show that the accumulation of genetic diversity is influenced by experimental and biological systems.

612 citations

Journal ArticleDOI
TL;DR: The emergence of SARS-CoV-2 variants with novel spike protein mutations that are influencing the epidemiological and clinical aspects of the COVID-19 pandemic has been witnessed as mentioned in this paper.
Abstract: The past several months have witnessed the emergence of SARS-CoV-2 variants with novel spike protein mutations that are influencing the epidemiological and clinical aspects of the COVID-19 pandemic. These variants can increase rates of virus transmission and/or increase the risk of reinfection and reduce the protection afforded by neutralizing monoclonal antibodies and vaccination. These variants can therefore enable SARS-CoV-2 to continue its spread in the face of rising population immunity while maintaining or increasing its replication fitness. The identification of four rapidly expanding virus lineages since December 2020, designated variants of concern, has ushered in a new stage of the pandemic. The four variants of concern, the Alpha variant (originally identified in the UK), the Beta variant (originally identified in South Africa), the Gamma variant (originally identified in Brazil) and the Delta variant (originally identified in India), share several mutations with one another as well as with an increasing number of other recently identified SARS-CoV-2 variants. Collectively, these SARS-CoV-2 variants complicate the COVID-19 research agenda and necessitate additional avenues of laboratory, epidemiological and clinical research.

593 citations