Characterizing Co-Circulating Respiratory Virus Genomic Diversity in Switzerland with Hybrid-Capture Sequencing and Phylogenetic Reconstructions: Insights into the 2023/24 Season

Respiratory viruses circulate yearly with strain-specific patterns. Although SARS-CoV-2 and Influenza A/B genomic surveillance is well-developed, most respiratory viruses are unevenly monitored, lacking geographical diversity to capture wider population dynamics. Consequently, insights into respiratory virus evolution are limited. We investigated the genetic diversity of these viruses within one country. During the 2023/24 season, we conducted whole-genome sequencing of 1129 clinical samples using a hybrid-capture protocol. These samples were pre-tested by real-time PCR panels throughout Switzerland. Leveraging publicly-available full-length genomes, we constructed background datasets representative of geographical diversity and built phylogenies for all viruses with more than 40 new high-quality genomes from this study. We detected 981 viruses and recovered 461 high-quality genomes, including 18 co-infections, from 437 PCR-positive and 6 PCR-negative samples. All viruses detected by PCR were also detected by sequencing in 56% of samples. The four most prevalent viruses were Influenza A/H1N1, SARS-CoV-2, RSV-A, and HPIV-3, and their seasonal spread was consistent with wastewater monitoring and influenza-like illness reports. Swiss viral genomes were representative of the global genomic diversity, with evidence for multiple introductions into Switzerland, and we identified putative Swiss clusters. In this proof-of-concept study, we focus on 3 viruses (Influenza A/H1N1, RSV-A/B, and HPIV-3), and we demonstrate the streamlined implementation of a broad respiratory virus genomic surveillance workflow with an off-the-shelf protocol and publicly-available software. In addition, we highlight additional evolutionary insights that can only be derived from genomic surveillance. Going forward, this dataset will be a useful resource for future investigations into respiratory viral genomic diversity.