我们使用两种 SARS-CoV-2 分离株研究了宿主内遗传进化，该分离株来自完全接种疫苗的 [初级接种 x2 剂阿斯利康加一剂辉瑞加强剂]，该患者年龄超过 70 岁，有淋巴瘤和高血压病史。在死于 COVID-19 之前已感染 SARS-CoV-2 三周。从相隔十三天采集的样本中确定了两个完整基因组序列，两者都属于 Pango 谱系 FL.2：在博茨瓦纳首次检测到这种 Omicron 亚变体。 FL.2 是 XBB.1.9.1 的子系列。刺突蛋白中的突变和少数变异的全部内容在两个时间点之间有所不同。值得注意的是，我们还观察到 ORF1a 和膜蛋白内的缺失；这两个区域都与高 T 细胞表位密度相关。免疫抑制个体的内部环境可能会加速 SARS-CoV-2 的进化，因此有必要进行密切监测。版权所有 © 2023。由 Elsevier Ltd 出版。

We investigated intra-host genetic evolution using two SARS-CoV-2 isolates from a fully vaccinated [primary schedule x2 doses of AstraZeneca plus a booster of Pfizer], greater than 70-year-old woman with a history of lymphoma and hypertension who presented a SARS-CoV-2 infection for three weeks prior to succumbing to COVID-19. Two full genome sequences were determined from samples taken thirteen days apart with both belonging to Pango lineage FL.2: the first detection of this Omicron sub-variant in Botswana. FL.2 is a sub-lineage of XBB.1.9.1. The repertoire of mutations and minority variants in the Spike protein differed between the two-time points. Notably, we also observed deletions within the ORF1a and Membrane proteins; both regions are associated with high T-cell epitope density. The internal milieu of immune-suppressed individuals may accelerate SARS-CoV-2 evolution hence close monitoring is warranted.Copyright © 2023. Published by Elsevier Ltd.