Epidemiology of SARS-CoV-2 in West African countries

Title:
Molecular epidemiology of SARS-CoV-2 in West African countries: sequencing and metagenomic analyses to monitor virus evolution and pathogenesis

The experience of SARS-CoV-2 in Africa, particularly West Africa, seems to deviate from what is observed elsewhere. Cases tend to be asymptomatic or mild. It is therefore imperative to understand the biological basis of these observations. This knowledge would have an impact on the potential efficacy of therapeutics and vaccines, especially in the region.

One hypothesis is that this difference in presentation may be due to differences in virus: host interactions in West Africa driven in part by protein expression patterns in respiratory interfaces. Two of the host proteins have already been implicated as being important for SARS-CoV-2 infection; angiotensin-converting enzyme 2 (ACE-2) and transmembrane serine Protease 2 (TMPRSS2).

It is important to detect polymorphisms of these proteins across our participants, as well as to determine whether there is a previously unidentified host proteins involved in SARS-CoV-2 infection. In particular, knowing the viral genotype as well as specific expression patterns at the virus: host interphase would help choose which of the many candidate vaccines would elicit host responses that block these interactions.
This study would also highlight whether there is a need to design a new candidate that could be more specific to West African COVID-19, as well as opening up new avenues for targeted therapies.

The need for a study of this nature is heightened by the spectrum of new circulating and highly transmissible variants of SARS-CoV-2, P.1 (Brazilian variant), B.1.1.7 (British variant) and B1.351 (SA variant), which are also found in the region. This study would provide a better understanding of: the level of these variants, their transmission dynamics, their changes during sampling, and provide information on their interactions with host proteins.