The impact of the ABO/Rh blood group on susceptibility and severity among COVID-19 patients in Luanda, Angola (preprint)

SARS-CoV-2 is a public health concern worldwide. Identification of biological factors that could influence transmission and worsen the disease has been the subject of extensive investigation. Herein, we investigate the impact of the ABO/Rh blood group on susceptibility and severity among COVID-19 patients in Luanda, Angola. This was a multicentric cohort study conducted with 101 COVID-19 patients. Chi-square and logistic regression were calculated to check factors related to the worsening of the disease and deemed significant when p<0.05. Blood type O (51.5%) and Rh-positive (93.1%) were the most frequent. Patients from blood type O had a high risk to severe disease [OR: 1.33 (95% CI: 0.42 - 4.18), p=0.630] and hospitalization [OR: 2.59 (95% CI: 0.84 - 8.00), p=0.099]. Also, Rh-positive blood type presented a high risk for severe disease (OR: 10.6, p=0.007) and hospitalization (OR: 6.04, p=0.026). We find a high susceptibility, severity, hospitalization, and mortality, respectively, among blood group O and Rh-positive patients, while blood group AB presented a low susceptibility, severity, hospitalization, and mortality, respectively. Our findings add to the body of evidence suggesting that ABO/Rh blood groups play an important role in the course of SARS-CoV-2 infection.

Blood pressure pattern among blood donors exposed to SARS-CoV-2 in Luanda, Angola (preprint)

Background SARS-CoV-2 infection is a global public health concern. Several aspects related to the pattern of infection remain unclear. Herein, we investigated the blood pressure pattern among blood donors exposed to SARS-CoV-2 in Luanda, the capital city of Angola, a sub-Saharan African country.Methods We performed a retrospective analysis containing 343 blood donors from December 2019 to September 2020. Parametric tests compared means while Chi-square and logistic regression checked features associated with high blood pressure and were considered significant when p < 0.05.Results The mean age of blood donors was 32.2 ± 8.81 years (ranging from 18 to 61 years) and 93% of the men's gender. Overall, 4.7% of the studied population had been exposed to SARS-CoV-2. High blood pressure prevalence increased from unexposed to exposed SARS-CoV-2 (6.7–18.8%, p = 0.071). SARS-CoV-2 exposure increase systole (131 ± 12.2mmHg to 136 ± 14.2mmHg, p = 0.098), diastole (79.9 ± 9.53mmHg to 84.2 ± 12.7mmHg, p = 0.086), pulse in beats per minute (72.0 ± 11.1 to 73.7 ± 8.50, p = 0.553), and decrease donating time (6.31 ± 3.72 minutes to 5.48 ± 1.61 minutes, p = 0.371). Chances of having high blood pressure were high [OR: 3.20 (95% CI: 0.85–12.1), p = 0.086] in exposed SARS-CoV-2. Blood donors exposed to SARS-CoV-2 with abnormal donation time increased from the donor up to 40 years to over 40 years (from 35.7–50%, p = 0.696). The mean systolic, diastolic, and pulse pressure were higher for non-O blood group donors (p > 0.05). A statistically significant link was observed, between the Rhesus factor and blood pressure status (p = 0.032).Conclusions We showed important variations in blood pressure indices of the Angolan population exposed to SARS-CoV-2. Older age and non-O blood groups appear to be important biological factors for SARS-CoV-2 infection, as well as the risk of developing cardiovascular disease after or during SARS-CoV-2 exposure. Further studies assessing the impact on cardiovascular functions with ongoing or long-term SARS-CoV-2 exposure in individuals from resource-limited countries should be considered.

The evolving SARS-CoV-2 epidemic in Africa: Insights from rapidly expanding genomic surveillance. (preprint)

Investment in Africa over the past year with regards to SARS-CoV-2 genotyping has led to a massive increase in the number of sequences, exceeding 100,000 genomes generated to track the pandemic on the continent. Our results show an increase in the number of African countries able to sequence within their own borders, coupled with a decrease in sequencing turnaround time. Findings from this genomic surveillance underscores the heterogeneous nature of the pandemic but we observe repeated dissemination of SARS-CoV-2 variants within the continent. Sustained investment for genomic surveillance in Africa is needed as the virus continues to evolve, particularly in the low vaccination landscape. These investments are very crucial for preparedness and response for future pathogen outbreaks.

A novel variant of interest of SARS-CoV-2 with multiple spike mutations is identified from travel surveillance in Africa (preprint)

At the end of 2020, the Network for Genomic Surveillance in South Africa (NGS-SA) detected a SARS-CoV-2 variant of concern (VOC) in South Africa (501Y.V2 or PANGO lineage B.1.351)1. 501Y.V2 is associated with increased transmissibility and resistance to neutralizing antibodies elicited by natural infection and vaccination2,3. 501Y.V2 has since spread to over 50 countries around the world and has contributed to a significant resurgence of the epidemic in southern Africa. In order to rapidly characterize the spread of this and other emerging VOCs and variants of interest (VOIs), NGS-SA partnered with the Africa Centres for Disease Control and Prevention and the African Society of Laboratory Medicine through the Africa Pathogen Genomics Initiative to strengthen SARS-CoV-2 genomic surveillance across the region. Here, we report the first genomic surveillance results from Angola, which has had 21 500 reported cases and around 500 deaths from COVID-19 up to March 2021 (Supplemental Fig S1). On 15 January 2021, in response to the international spread of VOCs, the government instituted compulsory rapid antigen testing of all passengers arriving at the main international airport, in addition to the existing requirement to present a negative PCR test taken within 72 hours of travel. All individuals with a positive antigen test are isolated in a government facility for a minimum of 14 days and require two negative RT-PCR tests at least 48 hours apart for de-isolation, whilst all travelers with a negative test on arrival proceed to mandatory self-quarantine for 10 days followed by a repeat test. In March 2021, we received 118 nasopharyngeal swab samples collected between June 2020 and February 2021, a number of which were from incoming air travelers (Supplemental Fig S1). From these, we produced 73 high quality genomes (>80% coverage), 14 of which were known VOCs/VOIs (seven 501Y.V2/B.1.351, six B.1.1.7, one B.1.525), 44 of which were C.16 (a common lineage circulating in Portugal), and twelve of which were other lineages (Supplemental Fig S2). In addition, we detected a new VOI in three incoming travelers from Tanzania who were tested together at the airport in mid-February. The three genomes from these passengers were almost identical and presented highly divergent sequences within the A lineage (Figure 1A & 1B). The GISAID database contains nine other sequences reported to be sampled from cases involving travel from Tanzania, two of which are basal to the three sampled in Angola (Figure 1A, Supplemental Table S1). This new VOI, temporarily designated A.VOI.V2, has 31 amino acid substitutions (11 in spike) and three deletions (all in spike) (Figure 1C & 1D). The spike mutations include three substitutions in the receptor-binding domain (R346K, T478R and E484K); five substitutions and three deletions in the N-terminal domain, some of which are within the antigenic supersite (Y144{Delta}, R246M, SYL247-249{Delta} and W258L)4; and two substitutions adjacent to the S1/S2 cleavage site (H655Y and P681H). Several of these mutations are present in other VOCs/VOIs and are evolving under positive selection.