**2. Methodology**

PubMed, Google Scholar, EBSCOhost, Mendeley, and MedLine Plus were used to conduct the electronic literature search. The search was confined to relevant publications and articles published between January 2020 and April 2022. If a manuscript was relevant to the issue of genetic mutations or variations of SARS-CoV-2, it was chosen. To narrow and guide the search process, the listed keywords were sought after. COVID-19, SARS-CoV-2, variants of interest (VOI), variants of concern (VOC), genetic variances, and genetic mutations are among them.

## **3. Variant being monitored**

Viruses are known to change over time. SARS-CoV-2 has undergone multiple modifications since the start of the COVID-19 pandemic in Wuhan in late 2019 [9]. Comparing the SARS-CoV-2 pathogenic S protein sequence to the Wuhan-Hu-1 reference protein sequence showed about 96.5% of the original S protein sequence has undergone mutations [9]. These mutations lead to genetic differences, which results in the emergence of new variants of the virus [9]. Centers for Disease Control and Prevention (CDC), in collaboration with the SIG, added a fourth class of variant classification named VBM on September 21, 2021, as depicted in **Table 1** [22]. The other classes include VOI, VOC, and VOHC [22].


**Note.** *Researchers and public health authorities globally are using the Pango nomenclature to track the transmission and spread of SARS-CoV-2, including variations of concern and interest. This table contains information on various lineages and their distribution [10–21].*

#### **Table 1.**

*Lineage list.*

The VBM class includes variants under surveillance for mutations leading to increased receptor binding, reduced neutralization by host immune systems, decreased efficacy of treatments, and an increase in disease severity and transmissibility but have not yet been deemed a public health threat by SIG at this time [22]. The VBM class also includes previously designated VOIs and VOCs that are no longer detected or have a decreased prevalence in the population [22]. The variants belonging to the VBM class do not pose a significant risk to public health [22]. Regardless of the minimal risk presented by the VBM class, they are closely monitored for new data [22]. VBM class that warrants more concern can have their classification changed to VOI or VOC if required by SIG [2].
