Publication date: Jun 20, 2026
SARS-CoV-2 evolution has shifted towards convergent variants such as the NB. 1.8. 1 and PQ series. However, the correlation between these genomic shifts and clinical phenotypes is unclear. We aimed to delineate the viral evolutionary trajectory, relative replacement dynamics, and clinical Ct-value correlations in Zhangzhou, China. We retrospectively analysed 593 SARS-CoV-2 genomes collected between 2022 and 2025. High-quality sequences were typed using the PANGOLIN software. Non-parametric tests and Spearman’s correlation were employed to assess the relationships between dominant lineages, patient age, and diagnostic N-gene cycle threshold (Ct) values). Genomic surveillance revealed dynamic lineage replacements from Omicron BA. 5.2/BF. 7 to XBB, followed by XDV. 1, and culminating in the dominance of the NB. 1.8. 1 and PQ lineages. Clinical N-gene Ct-value distributions were comparable across major lineages (P > 0. 05). Patient age was not associated with N-gene Ct values (Spearman r = 0. 01, P = 0. 842). The sequential replacement of SARS-CoV-2 lineages in Zhangzhou occurred without detectable shifts in clinical N-gene Ct-value distributions or age-related infection patterns. These findings support sustained regional genomic surveillance but should not be interpreted as direct evidence of unchanged intrinsic viral fitness or transmissibility.
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| Concepts | Keywords |
|---|---|
| China | Genomic surveillance |
| Genomic | Molecular evolution |
| Pangolin | SARS-CoV-2 |
| Viral | Viral load |
Semantics
| Type | Source | Name |
|---|---|---|
| disease | MESH | infection |