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dc.contributor.authorNaveca, Felipe Gomes-
dc.contributor.authorNascimento, Valdinete Alves Do-
dc.contributor.authorSouza, Victor Costa de-
dc.contributor.authorCorado, André Lima Guerra-
dc.contributor.authorNascimento, Fernanda Oliveira Do-
dc.contributor.authorSilva, George Allan Villarouco Da-
dc.contributor.authorCosta, Ágatha-
dc.contributor.authorDuarte, Débora Camila Gomes-
dc.contributor.authorPessoa, Karina Pinheiro-
dc.contributor.authorMejía, Matilde Del Carmen Contreras-
dc.contributor.authorBrandão, Maria Júlia-
dc.contributor.authorJesus, Michele S.-
dc.contributor.authorGonçalves, Luciana Mara Fé-
dc.contributor.authorda Costa, Cristiano Fernandes-
dc.contributor.authorS. Sampaio, Vanderson-
dc.contributor.authorBarros, Daniel-
dc.contributor.authorSilva, Marineide-
dc.contributor.authorMattos, Tirza-
dc.contributor.authorPontes, Gemilson Soares-
dc.contributor.authorAbdalla, Lígia Fernandes-
dc.contributor.authorSantos, João Hugo Abdalla-
dc.contributor.authorArantes, Ighor L.G.-
dc.contributor.authorDezordi, Filipe Zimmer-
dc.contributor.authorSiqueira, Marilda Mendonça Teixeira De-
dc.contributor.authorWallau, G. L.-
dc.contributor.authorResende, Paola Cristina-
dc.contributor.authorDelatorre, Edson Oliveira-
dc.contributor.authorGräf, Tiago-
dc.contributor.authorBello, Gonzalo-
dc.description.abstractThe northern state of Amazonas is among the regions in Brazil most heavily affected by the COVID-19 epidemic and has experienced two exponentially growing waves, in early and late 2020. Through a genomic epidemiology study based on 250 severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) genomes from different Amazonas municipalities sampled between March 2020 and January 2021, we reveal that the first exponential growth phase was driven mostly by the dissemination of lineage B.1.195, which was gradually replaced by lineage B.1.1.28 between May and June 2020. The second wave coincides with the emergence of the variant of concern (VOC) P.1, which evolved from a local B.1.1.28 clade in late November 2020 and replaced the parental lineage in <2 months. Our findings support the conclusion that successive lineage replacements in Amazonas were driven by a complex combination of variable levels of social distancing measures and the emergence of a more transmissible VOC P.1 virus. These data provide insights to understanding the mechanisms underlying the COVID-19 epidemic waves and the risk of dissemination of SARS-CoV-2 VOC P.1 in Brazil and, potentially, worldwide. © 2021, The Author(s), under exclusive licence to Springer Nature America, Inc.en
dc.rightsAttribution-NonCommercial-NoDerivs 3.0 Brazil*
dc.titleCOVID-19 in Amazonas, Brazil, was driven by the persistence of endemic lineages and P.1 emergencepor
dc.publisher.journalNature Medicinepor
Appears in Collections:Artigos

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