Case Report: Paucisymptomatic College-Age Population as a Reservoir for Potentially Neutralization-Resistant Severe Acute Respiratory Syndrome Coronavirus 2 Variants

Neuman, Benjamin W; Brashear, Wesley A; Brun, Marcel; Chaki, Sankar P; Fischer, Rebecca S B; Guidry, Sierra J; Hill, Joshua E; Hillhouse, Andrew E; Johnson, Charles D; Kahl-McDonagh, Melissa M; Metz, Richard P; Rice-Ficht, Allison C; Shuford, Jennifer A; Skaggs, Tiffany A; Stull, Matthew A; Threadgill, David W; Akpalu, Yao; Zuelke, Kurt

To better understand the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variant lineage distribution in a college campus population, we carried out viral genome surveillance over a 7-week period from January to March 2021. Among the sequences were three novel viral variants: BV-1 with a B.1.1.7/20I genetic background and an additional spike mutation Q493R, associated with a mild but longer-than-usual COVID-19 case in a college-age person, BV-2 with a T478K mutation on a 20B genetic background, and BV-3, an apparent recombinant lineage. This work highlights the potential of an undervaccinated younger population as a reservoir for the spread and generation of novel variants. This also demonstrates the value of whole genome sequencing as a routine disease surveillance tool.