Mendiola-Pastrana Indira R, López-Ortiz Eduardo, Río de la Loza-Zamora José G, González James, Gómez-García Anel, López-Ortiz Geovani
Subdivisión de Medicina Familiar, Facultad de Medicina, Universidad Nacional Autónoma de México, Ciudad de Mexico 04510, Mexico.
Departamento de Biología Celular, Facultad de Ciencias, Universidad Nacional Autónoma de México, Ciudad de Mexico 04510, Mexico.
Life (Basel). 2022 Jan 25;12(2):170. doi: 10.3390/life12020170.
From the start of the COVID-19 pandemic, new SARS-CoV-2 variants have emerged that potentially affect transmissibility, severity, and immune evasion in infected individuals. In the present systematic review, the impact of different SARS-CoV-2 variants on clinical outcomes is analyzed.
A systematic review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020. Two databases (PubMed and ScienceDirect) were searched for original articles published from 1 January 2020 to 23 November 2021. The articles that met the selection criteria were appraised according to the Newcastle-Ottawa Quality Assessment Scale.
Thirty-three articles were included, involving a total of 253,209 patients and 188,944 partial or complete SARS-CoV-2 sequences. The most reported SARS-CoV-2 variants showed changes in the spike protein, N protein, RdRp and NSP3. In 28 scenarios, SARS-CoV-2 variants were found to be associated with a mild to severe or even fatal clinical outcome, 15 articles reported such association to be statistically significant. Adjustments in eight of them were made for age, sex and other covariates.
SARS-CoV-2 variants can potentially have an impact on clinical outcomes; future studies focused on this topic should consider several covariates that influence the clinical course of the disease.
自新冠疫情开始以来，出现了新的严重急性呼吸综合征冠状病毒2（SARS-CoV-2）变体，这些变体可能会影响感染者的传播性、严重程度和免疫逃逸能力。在本系统评价中，分析了不同SARS-CoV-2变体对临床结局的影响。
根据系统评价和Meta分析的首选报告项目（PRISMA）2020进行系统评价。检索了两个数据库（PubMed和ScienceDirect），以查找2020年1月1日至2021年11月23日发表的原创文章。根据纽卡斯尔-渥太华质量评估量表对符合入选标准的文章进行评估。
纳入33篇文章，共涉及253209例患者和188944条部分或完整的SARS-CoV-2序列。报告最多的SARS-CoV-2变体在刺突蛋白、核衣壳蛋白、RNA依赖的RNA聚合酶（RdRp）和非结构蛋白3（NSP3）中出现了变化。在28种情况下，发现SARS-CoV-2变体与轻度至重度甚至致命的临床结局相关，15篇文章报告这种关联具有统计学意义。其中8篇文章对年龄、性别和其他协变量进行了调整。
SARS-CoV-2变体可能会对临床结局产生影响；未来针对该主题的研究应考虑影响疾病临床进程的几个协变量。
