Unraveling the Evolutionary Dynamics of SARS-CoV-2 Virulence: A Phylogenetic and Epidemiological Perspective

Abstract

This review examines the evolution of the virulence of SARS-CoV-2, the virus responsible for the COVID-19 pandemic, from the dual perspectives of phylogenetics and epidemiology. Since its first identification in late 2019, SARS-CoV-2 has posed substantial challenges to global public health, evidenced by its rapid spread and the emergence of multiple variants of concern (VOCs). This review aims to dissect the evolutionary trajectory of the virus's virulence - its capacity to cause disease - and the implications for public health and disease management. Phylogenetic models have traced the virus's lineage and identified critical mutations in the Spike protein, notably in the receptor-binding domain, influencing both host cell entry efficiency and immune evasion strategies. These genetic alterations are correlated with changes in transmission dynamics, disease severity, and vaccine efficacy. Compartmental epidemiological models, such as the Susceptible-Infected-Recovered (SIR) model and its derivatives, have been instrumental in modeling the virus's transmission and predicting public health outcomes. These models, however, have limitations in directly addressing virulence due to their primary focus on transmission dynamics. The review underscores the intricate balance SARS-CoV-2 strikes between transmissibility and virulence, and the importance of a multidisciplinary approach for ongoing surveillance. This study contributes to understanding the evolutionary