Evidence map›Paper›PMID 41606515›Full record

ArticleBMC infectious diseases2026

Genomic and clinical epidemiology of SARS-CoV-2 in Lebanon: a prospective multicenter study 2020-2024.

Fatima Dakroub, Celina F Boutros, Diego Teixeira, Habib Alkalamouni, Nagham Hamzah, Nancy Hourani, Amani Haddara, Samar Dalle, Dima Khreis, Elsy Tawil and 23 more

Abstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC infectious diseases, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

33 authors.

Fatima DakroubCenter for Infectious Diseases Research (CIDR) and WHO Collaborating Center for Reference and Research on Bacterial Pathogens, American University of Beirut, Beirut, Lebanon. fd31@aub.edu.lb.
Celina F Boutros *Center for Infectious Diseases Research (CIDR) and WHO Collaborating Center for Reference and Research on Bacterial Pathogens, American University of Beirut, Beirut, Lebanon.
Diego Teixeira *Parasites and Microbes Programme, Wellcome Sanger Institute, Hinxton, UK.
Habib AlkalamouniCenter for Infectious Diseases Research (CIDR) and WHO Collaborating Center for Reference and Research on Bacterial Pathogens, American University of Beirut, Beirut, Lebanon.
Nagham HamzahCenter for Infectious Diseases Research (CIDR) and WHO Collaborating Center for Reference and Research on Bacterial Pathogens, American University of Beirut, Beirut, Lebanon.
Nancy HouraniCenter for Infectious Diseases Research (CIDR) and WHO Collaborating Center for Reference and Research on Bacterial Pathogens, American University of Beirut, Beirut, Lebanon.
Amani HaddaraCenter for Infectious Diseases Research (CIDR) and WHO Collaborating Center for Reference and Research on Bacterial Pathogens, American University of Beirut, Beirut, Lebanon.
Samar DalleCenter for Infectious Diseases Research (CIDR) and WHO Collaborating Center for Reference and Research on Bacterial Pathogens, American University of Beirut, Beirut, Lebanon.
Dima KhreisCenter for Infectious Diseases Research (CIDR) and WHO Collaborating Center for Reference and Research on Bacterial Pathogens, American University of Beirut, Beirut, Lebanon.
Elsy TawilCenter for Infectious Diseases Research (CIDR) and WHO Collaborating Center for Reference and Research on Bacterial Pathogens, American University of Beirut, Beirut, Lebanon.
Silma BaasiriCenter for Infectious Diseases Research (CIDR) and WHO Collaborating Center for Reference and Research on Bacterial Pathogens, American University of Beirut, Beirut, Lebanon.
Zeinab El ZeinCenter for Infectious Diseases Research (CIDR) and WHO Collaborating Center for Reference and Research on Bacterial Pathogens, American University of Beirut, Beirut, Lebanon.
Mayse NaserCenter for Infectious Diseases Research (CIDR) and WHO Collaborating Center for Reference and Research on Bacterial Pathogens, American University of Beirut, Beirut, Lebanon.
Rawan KormanCenter for Infectious Diseases Research (CIDR) and WHO Collaborating Center for Reference and Research on Bacterial Pathogens, American University of Beirut, Beirut, Lebanon.
Maher SrajCenter for Infectious Diseases Research (CIDR) and WHO Collaborating Center for Reference and Research on Bacterial Pathogens, American University of Beirut, Beirut, Lebanon.
Yara SalamehCenter for Infectious Diseases Research (CIDR) and WHO Collaborating Center for Reference and Research on Bacterial Pathogens, American University of Beirut, Beirut, Lebanon.
Sarah MerhiCenter for Infectious Diseases Research (CIDR) and WHO Collaborating Center for Reference and Research on Bacterial Pathogens, American University of Beirut, Beirut, Lebanon.
Kawthar FaourCenter for Infectious Diseases Research (CIDR) and WHO Collaborating Center for Reference and Research on Bacterial Pathogens, American University of Beirut, Beirut, Lebanon.
Nadim TfailyCenter for Infectious Diseases Research (CIDR) and WHO Collaborating Center for Reference and Research on Bacterial Pathogens, American University of Beirut, Beirut, Lebanon.
Stephanie DamajCenter for Infectious Diseases Research (CIDR) and WHO Collaborating Center for Reference and Research on Bacterial Pathogens, American University of Beirut, Beirut, Lebanon.
Mohammad TalebCenter for Infectious Diseases Research (CIDR) and WHO Collaborating Center for Reference and Research on Bacterial Pathogens, American University of Beirut, Beirut, Lebanon.
Soha GhanemDepartment of Pediatrics, Makassed General Hospital, Achrafieh, Beirut, Lebanon.
Ghenwa DakdoukiDepartment of Pediatrics, Hammoud Hospital University Medical Center, Saida, Lebanon.
Rouba ShakerDepartment of Pediatrics, New Mazloum Hospital, Tripoli, North, Lebanon.
Imad ChokrDepartment of Pediatrics, Rafic Hariri University Hospital, Beirut, Lebanon.
David BreishDepartment of Pediatrics, Bekaa Hospital, Bekaa, Lebanon.
Maria KaramDepartment of Pediatrics, Keserwan Medical Center, Jounieh, Mount Lebanon, Lebanon.
Nada M MelhemCenter for Infectious Diseases Research (CIDR) and WHO Collaborating Center for Reference and Research on Bacterial Pathogens, American University of Beirut, Beirut, Lebanon.
Antoine Abou FayadCenter for Infectious Diseases Research (CIDR) and WHO Collaborating Center for Reference and Research on Bacterial Pathogens, American University of Beirut, Beirut, Lebanon.
Hassan ZaraketCenter for Infectious Diseases Research (CIDR) and WHO Collaborating Center for Reference and Research on Bacterial Pathogens, American University of Beirut, Beirut, Lebanon.
Ewan M HarrisonParasites and Microbes Programme, Wellcome Sanger Institute, Hinxton, UK.
Ghassan M MatarCenter for Infectious Diseases Research (CIDR) and WHO Collaborating Center for Reference and Research on Bacterial Pathogens, American University of Beirut, Beirut, Lebanon. gmatar@aub.edu.lb.
Ghassan S DbaiboCenter for Infectious Diseases Research (CIDR) and WHO Collaborating Center for Reference and Research on Bacterial Pathogens, American University of Beirut, Beirut, Lebanon. gdbaibo@aub.edu.lb.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundGlobally, the trajectory of COVID-19 has been shaped by viral evolution, widespread vaccination and immunity from prior infections. We assessed the epidemiological and clinical patterns of COVID-19 in Lebanon between 2020 and 2024, identified the predominant SARS-CoV-2 clades and evaluated risk factors for COVID-19 associated mortality.

methodsThis multicenter prospective study enrolled 1302 patients hospitalized with COVID-19 in Lebanon between November 2020 and October 2024. Multivariate logistic regression was used to determine predictors of COVID-19 associated mortality. Whole genome sequencing (WGS) was utilized to investigate the genomic epidemiology of SARS-CoV-2 and infer viral interactions between Lebanon and other countries. Multiple sequence alignment and phylogenetic analysis were conducted using the augur pipeline.

resultsA progressive and significant reduction in severe outcomes, including pneumonia and mortality was observed throughout the study period. Pneumonia (AOR, 6.714; CI, 4.140-10.888; p < 0.0001) and age ≥ 60 years (AOR, 6.051; CI, 2.190-16.723; p = 0.001) were identified as independent predictors of COVID-19 mortality. Moreover, receiving 3 doses of a COVID-19 vaccine significantly reduced the odds of mortality (AOR, 0.229; CI, 0.108-0.486; p < 0.0001). Genomic analysis revealed multiple introductions of the same SARS-CoV-2 clades into Lebanon, which seeded local transmission chains.

conclusionsThe transition of COVID-19 from pandemic to endemic in Lebanon was associated with reduced disease severity. Vaccination remains essential, particularly in older adult patients who are at high risk of mortality. Moreover, early diagnosis and management of pneumonia are crucial, given its association with COVID-19 mortality. Furthermore, WGS has proven valuable in tracking the local evolution of SARS-CoV-2 and its impact on clinical outcomes.

Indexed as

COVID-19SARS-CoV-2AdultAgedFemaleGenome, ViralHumansLebanonMaleMiddle AgedPhylogenyProspective StudiesRisk FactorsWhole Genome SequencingClinical characteristicsCOVID-19EpidemiologyPneumoniaSARS-CoV-2Whole genome sequencing

Identifiers

PMID41606515
PMCPMC12924613

What OpenQuestion holds

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LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.