Assessing the Impact of SARS-CoV-2 Lineages and Mutations on Patient Survival Loucera, Carlos Ortuño, Francisco M. Martínez González, Luis Javier Navarro Marí, José María De Salazar, Adolfo Viñuela, Laura Lepe, José Antonio García García, Federico Andalusian COVID-19 Sequencing Initiative SARS-CoV-2 COVID-19 Survival Virus genome Phylogeny Objectives: More than two years into the COVID-19 pandemic, SARS-CoV-2 still remains a global public health problem. Successive waves of infection have produced new SARS-CoV-2 variants with new mutations for which the impact on COVID-19 severity and patient survival is uncertain. Methods: A total of 764 SARS-CoV-2 genomes, sequenced from COVID-19 patients, hospitalized from 19th February 2020 to 30 April 2021, along with their clinical data, were used for survival analysis. Results: A significant association of B.1.1.7, the alpha lineage, with patient mortality (log hazard ratio (LHR) = 0.51, C.I. = [0.14,0.88]) was found upon adjustment by all the covariates known to affect COVID-19 prognosis. Moreover, survival analysis of mutations in the SARS-CoV-2 genome revealed 27 of them were significantly associated with higher mortality of patients. Most of these mutations were located in the genes coding for the S, ORF8, and N proteins. Conclusions: This study illustrates how a combination of genomic and clinical data can provide solid evidence for the impact of viral lineage on patient survival. 2022-10-18T07:46:12Z 2022-10-18T07:46:12Z 2022-08-27 journal article Loucera, C... [et al.]. Assessing the Impact of SARS-CoV-2 Lineages and Mutations on Patient Survival. Viruses 2022, 14, 1893. [https://doi.org/10.3390/v14091893] https://hdl.handle.net/10481/77372 10.3390/v14091893 eng http://creativecommons.org/licenses/by/4.0/ open access Atribución 4.0 Internacional MDPI