Fundamentos de la epidemiología genómica, lecciones aprendidas de la enfermedad por coronavirus (COVID-19) y nuevas direcciones
DOI:
https://doi.org/10.54502/msuceva.v2n2a5Palabras clave:
COVID-19, epidemiología molecular, secuenciación genómica, vigilancia genómica mejorada, virulenciaResumen
La pandemia de la enfermedad por coronavirus 2019 (COVID-19) fue una de las principales causas de muerte en todo el mundo en 2020. La enfermedad es causada por el coronavirus 2 (SARS-CoV-2), un virus de ARN de la subfamilia Orthocoronavirinae relacionado con otros 2 coronavirus clínicamente relevantes, SARS-CoV y MERS-CoV. Al igual que otros coronavirus y varios otros virus, el SARS-CoV-2 se originó en los murciélagos. Sin embargo, a diferencia de otros coronavirus, el SARS-CoV-2 resultó en una pandemia devastadora. La pandemia de SARS-CoV-2 continúa, debido a la evolución viral que conduce a variantes más transmisibles e inmunes evasivas. Tecnologías como la secuenciación genómica, ha impulsado el cambio de la epidemiología sindrómica a la molecular, y promete una mejor comprensión de las variantes. La pandemia de COVID-19 ha expuesto obstáculos críticos que deben abordarse para desarrollar la ciencia de las pandemias. Gran parte del progreso se está aplicando en el mundo desarrollado.
Sin embargo, persisten las barreras para el uso de la epidemiología molecular en los países de ingresos bajos y medianos (LMIC), incluida la falta de logística para equipos y reactivos y la falta de capacitación en análisis. Revisamos la literatura de epidemiología molecular para comprender sus orígenes desde la epidemia de SARS (2002-2003) hasta los eventos de influenza y la pandemia actual de COVID-19. Abogamos por una mejor vigilancia genómica del SARS-CoV y por comprender la diversidad de patógenos en posibles huéspedes zoonóticos. Este trabajo requerirá capacitación en computación filogenética y de alto rendimiento para mejorar los análisis del origen y la propagación de patógenos. Los objetivos generales son comprender y reducir el riesgo de zoonosis a través de la colaboración interdisciplinaria y la reducción de las barreras logísticas.
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