The Covid-19 virus, in Lombardy, before January 2020 seems to have not yet been there. What the doctors saw in the ward, with even severe symptomatic manifestations, were pneumonia yes, but not induced by Coronavirus. This was stated in a study published in the journal Travel Medicine and Infectious Disease, led by the teams of the Molecular Virology Laboratory of the San Matteo Polyclinic in Pavia, led by Fausto Baldanti, and the Department of Biomedical Sciences for Health of the University of Milan, led by Elena Pariani.
1,581 swabs analyzed. This result was achieved after analyzing 1,581 nasal swabs collected throughout Lombardy as part of the surveillance of severe respiratory infections caused by influenza and sentinel surveillance of flu-like syndromes. The purpose of the analysis was to highlight the possible presence of SARS-CoV-2 RNA in a period prior to the first case of COVID-19 diagnosed in Lombardy on February 20, 2020.
Of these 1581 samples, taken from 1 October 2020, none revealed positivity to SARS-CoV-2. And what emerged, according to the researchers, suggests that there is no evidence of coronavirus circulation in Lombardy between October 2019 and the beginning of January 2020. “The results of this study are added to others we have previously obtained – explains Baldanti -, or rather that the virus began to circulate silently in the Lombardy region from the second half of January 2020, or about a month before the case diagnosed in the province of Lodi “.
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The Lombard variants. But Baldanti had also ascertained something else: seven Covid-19 variants identified in Lombardy already in the first months of the pandemic. The San Matteo di Pavia, in recent weeks had made the discovery known and specified that the Covid variants continue to emerge: there is the latest arrival of last winter, the English one, known for the speed of contagion that characterizes it, but there are also those in Spain, Switzerland, Croatia, the Balkans and the United States, all documented by the Polyclinic of Pavia.
The San Matteo researchers, together with colleagues from the Niguarda hospital in Milan and the State University of Milan, investigated the variability of SARS-CoV-2 through a mapping of the virus circulating in Lombardy already from the first months of the epidemic.
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346 genomes sequenced. The research, supported by the Cariplo Foundation and published on Nature Communications, allowed the complete sequencing of 346 genomes collected throughout the Lombardy region between February and April 2020. The researchers highlighted the massive presence of 7 viral variants: some of these were probably selected within the same region, while others are were introduced from geographically dispersed territories in a short time interval. Three out of 7 variants have undergone such amplification to determine the birth of large local transmission outbreaks, the origin of which dates back to the first days of February. This indicates that SARS-CoV-2 was circulating silently throughout the Lombardy region already one month before the case diagnosed in the province of Lodi.
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Due sub-epidemie. Thanks to a phylo-geographic approach, the circulation of the different lineages was also strongly linked to the territory. This led to the identification of at least two sub-epidemics sustained by different variants: one predominant in southern Lombardy, with the provinces of Lodi and Cremona heavily invested, and the other which spread mainly in northern Lombardy, with Bergamo and the its most affected adjacent territories (for example Alzano and Nembro). The work of San Matteo and Niguarda underlines the importance and the need for a continuous epidemiological surveillance of the genomes circulating in the territory, which can immediately identify new mutations, stopping their spread, genetic surveillance that the San Matteo has been carrying out since February 2020.
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