# Diversity and clinical correlations of SARS-CoV-2 variant during the introduction of the Delta variant in Guatemala

## TL;DR

This study analyzes SARS-CoV-2 genomes in Guatemala during the Delta variant's introduction, highlighting its dominance and differences in transmission and symptoms.

## Contribution

The study provides novel genomic and epidemiological insights into SARS-CoV-2 variant dynamics in Central America.

## Key findings

- Delta variant (clade 21J) was the most prevalent in Guatemala during the study period.
- Delta-infected patients had a lower proportion of contact-traced cases compared to non-Delta variants.
- Delta-infected patients showed a higher frequency of fever history compared to non-Delta cases.

## Abstract

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) genomic surveillance is crucial for understanding viral evolution and guiding public health responses. However, many countries, particularly in Central America, have limited sequencing capacity, resulting in scarce and delayed data. This study addresses this gap by analysing 320 SARS-CoV-2 genomes sequenced from a major diagnostic centre in Guatemala City, Guatemala, between April and August 2021. Clade 21J (Delta) was predominant (46.2%), followed by 19B (29.4%) and 20J (Gamma, 6.6%). The most reported symptoms were cough, headache, malaise and myalgia/arthralgia. Among patients infected with the Delta variant, 39.9% reported being contacts from a confirmed case, less than reported by the patients infected with non-Delta variants (53.2%, P=0.017). The proportion of signs and symptoms was similar among these two groups, except for the history of fever, which was increased by ~twofold in the Delta group. This research contributes valuable genomic and epidemiological data to elucidate SARS-CoV-2 variant dynamics in Central America and emphasizes the importance of global genomic surveillance for pandemic preparedness and response.