Evolution and monitoring of SARS-COV-2 genetic mutations in Ecuador

Since its emergence in December 2019, SARS-CoV-2 has shown rapid genetic evolution, leading to various variants that have significantly influenced the dynamics of the pandemic. Mutations in the spike protein (S) have increased the virus's transmissibility and, in some cases, its virulence, affecting the efficacy of control measures, including vaccination and antiviral treatments. This retrospective and descriptive study, covering from March 2020 to the present, used national and international genomic data to analyze the evolution of variants in Ecuador. A total of 3,457 genomic sequences were collected, and key variants such as Alpha, Beta, Gamma, Delta, and Omicron were identified. Phylogenetic analyses revealed critical mutations like N501Y and E484K, associated with increased immune escape. Despite mass vaccination campaigns, the emergence of variants reduced vaccine efficacy in preventing infections, although vaccines continued to protect against severe cases. The evaluation of genomic surveillance systems highlighted the need to improve the speed and accuracy in detecting new variants. To optimize public health strategies, it is recommended to strengthen genomic surveillance, enhance coordination between institutions, update vaccination programs, and develop early warning systems. These measures are essential for improving the response to the ongoing evolution of the virus and minimizing its impact on public health