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EMERGENCE AND SPREAD OF A B.1.1.28-DERIVED P.6 LINEAGE WITH Q675H AND Q677H SPIKE MUTATIONS IN URUGUAY
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Abstract
Uruguay controlled the viral dissemination during the first nine months of the SARS-CoV-2
pandemic. Unfortunately, towards the end of 2020, the number of daily new cases exponentially increased.
Herein, we analyzed the country-wide genetic diversity of SARS-CoV-2 between November
2020 and April 2021. We identified that the most prevalent viral variant during the first epidemic
wave in Uruguay (December 2020–February 2021) was a B.1.1.28 sublineage carrying Spike mutations
Q675H + Q677H, now designated as P.6, followed by lineages P.2 and P.7. P.6 probably arose around
November 2020, in Montevideo, Uruguay’s capital department, and rapidly spread to other departments,
with evidence of further local transmission clusters; it also spread sporadically to the USA
and Spain. The more efficient dissemination of lineage P.6 with respect to P.2 and P.7 and the presence
of mutations (Q675H and Q677H) in the proximity of the key cleavage site at the S1/S2 boundary
suggest that P.6 may be more transmissible than other lineages co-circulating in Uruguay. Although
P.6 was replaced by the variant of concern (VOC) P.1 as the predominant lineage in Uruguay since
April 2021, the monitoring of the concurrent emergence of Q675H + Q677H in VOCs should be of
worldwide interest.
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