Study: When COVID-19 Hit NE Ohio, It Mutated Quickly To Infect More People

More than a year after COVID-19 first hit Northeast Ohio, local researchers are learning more about how the virus infected people as it mutated.

New research released Monday from Cleveland Clinic and Case Western Reserve University shows the virus mutated hundreds of times in just the first two months of the pandemic in Cleveland, and some strains led to more severe cases and complications.

Because COVID-19 mutates more rapidly than initially thought, it’s even more important for people to continue to take precautions to slow the spread of the virus, even as vaccinations increase nationwide, said Dr. Frank Esper, Cleveland Clinic infectious disease researcher who led the study.

The first cases of COVID-19 were confirmed in the Cleveland area in early March 2020, in people who had traveled outside of the country and were exposed to the original strains, Dr. Esper said. 

After analyzing and sequencing thousands of virus samples from March and April 2020, Cleveland researchers found the original coronavirus strains resulted in more severe cases, hospitalizations and deaths, Esper said.

“It was survival of the fittest, and this virus mainly smothered everything else. The weaker strains died out very quickly, and thankfully, the weaker strains were the ones that were more associated with worse outcomes,” Esper said.

Researchers learned the virus mutated much quicker than initially thought. In fact, they identified 488 unique mutations of COVID-19 during these first two months, Esper said.

Researchers grouped the mutated strains into six different variants based on their genetic code.

After government officials imposed travel restrictions and lockdown orders to try to control the spread of COVID-19, the original, deadlier strains died down, but stronger, more contagious ones emerged as the virus rapidly mutated. Cases from those strains were milder, he said.

“As this virus seems to evolve, it’s becoming less and less severe,” Esper said. “This virus doesn’t want to kill you – although it can – this virus wants to spread. And the less sick you get, the more you’re able to spread it.”

Even though the virus appears to weaken the more it spreads, this does not mean new serious or even deadlier variants will not eventually emerge, he added.

“Maybe you’re less severe when you’re acutely sick, but then, it could lead to those post-infection complications that we talk about – the headaches, the fogginess, the [loss of] smelling and taste,” he said.

This research from the early months of the pandemic can also help inform how experts study current and future variant strains, and better prepare physicians and health care workers to treat them, Esper added.

“As medicine continues to advance, we might be able to then identify those variants in any one particular patient,” Esper said. “There are going to be certain strains that we’re going to say - not only did you have coronavirus, but you had this particular type of coronavirus so that we can better help you while you’re first infected, but also even after you’re infected," he said. 

While researchers analyzed Northeast Ohio COVID-19 samples for this study, the results are in line with other studies about the virus throughout the U.S., Esper added. 

For Esper’s study, researchers analyzed sequences of data from hundreds of patients who tested positive for COVID-19 during the first wave of the pandemic in Northeast Ohio. The samples were obtained from Cleveland Clinic’s COVID-19 registry, which contains data from nearly 50,000 patients who were tested for COVID-19 through the hospital system.

The study was published in the peer-reviewed journal JAMA Network Open Monday.