Abstract
Coronavirus disease 2019 (COVID-19) pandemic has progressed into second year. The etiologic agent severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has evolved into numerous lineages, some of which are gifted with transmissibility advantages. This underscores the importance of variant surveillance, to keep public health countermeasures and our understanding on the virus up-to-date. In the light of this, we extracted one-year genomic data (August 2020 to July 2021) from Global Initiative on Sharing All Influenza Data (GISAID) EpiCoV™ database and estimated monthly proportions of 11 SARS-CoV-2 variants in various geographical regions. From continental perspective, delta variant of concern (VOC) predominated in Africa, Asia, Europe, North America and Oceania, with proportions ranging from 67.58 to 98.31% in July 2021. In South America, proportion of the expanding delta VOC (23.24%) has been getting closer to the predominant yet diminishing gamma VOC (56.86%). We further analyzed monthly data on new COVID-19 cases, new deaths, vaccination status and variant proportions of 6 countries. Similar to continental data, delta VOC predominated in all countries except Brazil in July 2021. In most occasions, rise and predominance of alpha, beta, gamma, delta and zeta variants were accompanied with surges of new cases, especially after the time points of major lineage interchange. The ascending phases of new cases lasted for 1 to 5 months with 1.69- to 40.63-fold peak growth, whereas new death toll varied with regional vaccination status. Our data suggested surges of COVID-19 cases might be predicted from variant surveillance data. Despite vaccine breakthroughs by delta VOC, death tolls were more stable in countries with better immunization coverage. Another takeaway is the urgent need to improve vaccine efficacy against delta and emerging variants.