COVID-19 imported cases and severity: expected information from genomic characterization of SARS-CoV-2 strains in Mozambique

Abstract

Introduction: The novel coronavirus, severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), etiological agent of coronavirus disease 2019 (COVID-19) was first reported in China in December 2019 and spread worldwide. As of March 6th, 2021, there have been 116,670,105 million confirmed cases globally including 2,592,085 deaths. COVID-19 cases have been reported in 219 countries and territories, creating global panic. Mozambique has witnessed the evolution of COVID-19 epidemic associated with the weakness of health system, mostly in terms of laboratory diagnosis capacity, concerns on compliance to effective public health measures including physical distancing, use of masks in crowded indoor areas, hand hygiene, isolation and quarantine of people.
 Methodology: The data included in this study were collected from published articles regarding COVID-19 imported cases and severity in Africa, especially in Mozambique. Additionally, official documents of COVID-19 epidemiology from Minister of Health and National Institute of Health of Mozambique from 22nd of March 2020 to 1st of August 2020 were included.
 Results: The SARS-CoV-2 strains imported mainly from South Africa and European countries might have been playing an important role on COVID-19 epidemic evolution in Mozambique.
 Conclusions: These circulating strains in the country, might be similar enough to the strains found in other countries, yet the genomic characterization is needed particularly during the phase of borders reopening through understanding the source of infections and guiding the implementation of containment and mitigation measures in the country.

Genomic epidemiology of SARS-CoV-2 during the first four waves in Mozambique

“…In agreement with these findings, a recent event of an Italian traveler returning from Mozambique, exported the Omicron variant into Italy [35,38]. Taken together, the results of this study, and that of others [28,34,37], suggest that SARS-CoV-2 variants were introduced, circulated, continued to evolve in Mozambique, and that lineages unique to Mozambique can potentially be disseminated to other countries.…”

“…Despite these limitations, our analyses show that variants such as the C.1 and C1.1 lineages, and VOCs, such as Alpha, Beta, and Delta, were mostly introduced from South Africa during this study period. Previous investigations indicated initial introduction into Mozambique originated from European and North American travelers [34,37]. Notably, when travel restrictions were implemented during 2020, fewer introduction events were inferred.…”

Tracking SARS-CoV-2 introductions in Mozambique using pandemic-scale phylogenies: a retrospective observational study

“…In March–April, 2021, alpha was the dominating variant in Europe, absent in our dataset, while beta prevailed in South Africa and rapidly became dominant in Mozambique by February, 2021, 8 , 21 suggesting that international movement restrictions had little effect on stopping introductions into Mozambique from neighbouring countries. 8 , 13 Despite the international travel and tourism restrictions, some essential movements between Mozambique and South Africa were allowed (repatriations, transport of essential services or goods, medical needs). Additionally, regional trade in southern Africa returned to pre-pandemic levels by December, 2020, 21 and clandestine movement between neighbouring countries might also have been a source of introductions.…”

“… 9 , 10 , 11 , 12 To date, no studies have reported on SARS-CoV-2 genomic lineages in Mozambique and how, when, and from where they were initially introduced. 13 Importantly, identification and quantification of import and export events is highly conditioned by the dataset used to compare. Phylogenetic tools are now available to incorporate the entire deposited Global Initiative on Sharing Avian Influenza Data (GISAID) database, 14 which includes millions of SARS-CoV-2 sequences to evaluate and understand local epidemics.…”

“…The first COVID-19 case was reported in Mozambique on March 22, 2020 in a 75-year-old patient who returned from the UK; since then, the country has experienced four waves. 13 Concern about the potential spread of SARS-CoV-2 was elevated in late March, 2020, when more than 14 000 Mozambicans returned from South Africa over the Ressano Garcia border, as South Africa declared a lockdown. By June 2, 2021, Mozambique had reported a total of 70 850 confirmed cases and 836 deaths, with community-driven transmission.…”