Abstract
OBJECTIVES: The COVID-19 epidemic, caused by SARS-CoV-2, has spread worldwide and remains a major public health challenge. The objective of this study was to assess the prevalence of COVID-19 and characterize the circulating SARS-CoV-2 lineages in the Republic of Serbia during 2024. METHODS: We analyzed SARS-CoV-2-positive samples collected throughout 2024 in Serbia. Viral lineages were identified based on sequencing of the gene encoding the spike protein. The distribution of detected lineages was compared with available European data to evaluate regional differences in variant circulation. RESULTS: The distribution of SARS-CoV-2 lineages in Serbia differed substantially from the European average. The most prevalent variant detected in Serbia was JN.1.16, whereas KP.3.1.1 predominated in Europe. In addition, 95% of analyzed viral sequences contained the ins_S:16:MPLF insertion, a characteristic feature of the GRA clade. CONCLUSION: These findings demonstrate that the distribution of SARS-CoV-2 lineages in Serbia in 2024 differed from the average European distribution in 2024. The observed differences should be considered when evaluating the need for booster vaccination and optimizing national vaccination strategies. To our knowledge, this study provides the only available data on SARS-CoV-2 lineage circulation in Serbia for 2024.