Pérez-Cascales Esdenka, Caballero Francesca, Martínez-Ventura Anne, Ayzanoa Brenda, Prado-Zapata Mauricio, Baldiviezo-Soliz Eliana, Carballo-Jiménez Paula, Tinajeros-Guzmán Freddy, Cuicapuza Diego, Tsukayama Pablo
Laboratorio de Diagnóstico e Investigación BIOSCIENCE SRL, Santa Cruz, Bolivia.
Laboratorio de Genómica Microbiana, Facultad de Ciencias e Ingeniería, Universidad Peruana Cayetano Heredia, Lima, Peru.
Microbiol Spectr. 2025 Sep 2;13(9):e0128025. doi: 10.1128/spectrum.01280-25. Epub 2025 Aug 6.
The COVID-19 pandemic has severely impacted Bolivia due to its high social vulnerability and limited healthcare resources. In response to the limited local capacity for genomic surveillance during the pandemic, we characterized the genetic diversity and geographic distribution of SARS-CoV-2 variants across Bolivia from 2020 to 2024. A total of 714 SARS-CoV-2 genomic sequences were analyzed, including 313 newly sequenced samples and 401 retrieved from GISAID, allowing us to track viral evolution across six epidemic waves. The first wave, dominated by the Wuhan B.1 lineage, resulted in 8,943 deaths, while the fourth wave, characterized by the Omicron BA variant, had the highest infection rates, with approximately 80,000 confirmed cases. While mortality decreased in later waves, case numbers remained high due to the emergence of variants with increased transmissibility and immune escape. Our findings underscore the dynamic evolution of SARS-CoV-2 in Bolivia and highlight the critical need for sustained genomic surveillance to monitor emerging variants and inform public health strategies, particularly in resource-limited settings. Strengthening genomic surveillance, especially in cross-border regions, will mitigate future epidemic waves and improve pandemic preparedness.IMPORTANCEBolivia's response to the COVID-19 pandemic was challenged by a fragile healthcare system and high social vulnerability. Despite early containment measures, including strict quarantine, the virus spread widely, leading to multiple epidemiological waves that strained the healthcare system and caused significant economic disruption. In this context, genomic surveillance is essential for understanding the evolution of SARS-CoV-2, identifying emerging variants, tracking transmission patterns, and evaluating mitigation strategies. Our study comprehensively analyzes viral dynamics in Bolivia, identifying key transmission hubs and variant replacements across six epidemic waves. These findings underscore the importance of sustained genomic surveillance in resource-limited settings, where real-time monitoring is crucial to anticipate epidemiological trends and enhance pandemic preparedness. Strengthening genomic surveillance capabilities will enhance Bolivia's ability to respond to future health crises and contribute to regional and global pandemic surveillance efforts.
由于社会脆弱性高且医疗资源有限，新冠疫情给玻利维亚带来了严重影响。为应对疫情期间当地基因组监测能力有限的情况，我们对2020年至2024年期间玻利维亚境内新冠病毒变异株的遗传多样性和地理分布进行了特征分析。共分析了714条新冠病毒基因组序列，其中包括313个新测序样本以及从全球共享流感数据倡议组织（GISAID）获取的401条序列，这使我们能够追踪六波疫情期间病毒的进化情况。第一波疫情以武汉B.1谱系为主，导致8943人死亡，而以奥密克戎BA变异株为特征的第四波疫情感染率最高，确诊病例约8万例。虽然后期疫情波次的死亡率有所下降，但由于具有更高传播性和免疫逃逸能力的变异株出现，病例数仍然居高不下。我们的研究结果强调了玻利维亚境内新冠病毒的动态进化，并突出了持续进行基因组监测以监测新出现变异株并为公共卫生策略提供信息的迫切需求，特别是在资源有限的环境中。加强基因组监测，尤其是在跨境地区，将减轻未来疫情波次的影响并提高大流行防范能力。
重要性
玻利维亚应对新冠疫情面临着脆弱的医疗体系和高社会脆弱性的挑战。尽管采取了包括严格隔离在内的早期防控措施，但病毒仍广泛传播，导致多波疫情，给医疗体系造成压力并带来重大经济破坏。在此背景下，基因组监测对于了解新冠病毒的进化、识别新出现的变异株、追踪传播模式以及评估缓解策略至关重要。我们的研究全面分析了玻利维亚的病毒动态，确定了六个疫情波次中的关键传播中心和变异株更替情况。这些发现强调了在资源有限的环境中持续进行基因组监测的重要性，在这种环境中实时监测对于预测流行病学趋势和加强大流行防范至关重要。加强基因组监测能力将提高玻利维亚应对未来健康危机的能力，并为区域和全球大流行监测工作做出贡献。
