Detection of High Level of Co-Infection and the Emergence of Novel SARS CoV-2 Delta-Omicron and Omicron-Omicron Recombinants in the Epidemiological Surveillance of Andalusia Pérez Florido, Javier Ortuño Guzmán, Francisco Manuel De Salazar, Adolfo Viñuela, Laura Fuentes, Ana Chueca, Natalia The Andalusian COVID-19 Sequencing Initiative García, Federico SARS-CoV-2 Co-infection Recombination Surveillance Epidemiology Recombination is an evolutionary strategy to quickly acquire new viral properties inherited from the parental lineages. The systematic survey of the SARS-CoV-2 genome sequences of the Andalusian genomic surveillance strategy has allowed the detection of an unexpectedly high number of co-infections, which constitute the ideal scenario for the emergence of new recombinants. Whole genome sequence of SARS-CoV-2 has been carried out as part of the genomic surveillance programme. Sample sources included the main hospitals in the Andalusia region. In addition to the increase of co-infections and known recombinants, three novel SARS-CoV-2 delta-omicron and omicron-omicron recombinant variants with two break points have been detected. Our observations document an epidemiological scenario in which co-infection and recombination are detected more frequently. Finally, we describe a family case in which co-infection is followed by the detection of a recombinant made from the two co-infecting variants. This increased number of recombinants raises the risk of emergence of recombinant variants with increased transmissibility and pathogenicity. 2023-03-28T08:02:41Z 2023-03-28T08:02:41Z 2023-01-26 journal article Perez-Florido, J... [et al.]. Detection of High Level of Co-Infection and the Emergence of Novel SARS CoV-2 Delta-Omicron and Omicron-Omicron Recombinants in the Epidemiological Surveillance of Andalusia. Int. J. Mol. Sci. 2023, 24, 2419. [https://doi.org/10.3390/ijms24032419] https://hdl.handle.net/10481/80891 10.3390/ijms24032419 eng http://creativecommons.org/licenses/by/4.0/ open access Atribución 4.0 Internacional MDPI