OBJECTIVES: The purpose of this research study is to identify the relative share of COVID-19 variants in Health and Human Services (HHS) regions in the United States, and to examine regional dynamics and prevalence of specific COVID-19 variants in the regions. The findings from this research will offer novel perspectives in analyzing regional distribution and trends of specific COVID-19 variants, which could be complementary to the current research on public health strategies.

METHODS: Utilizing data from the National COVID Cohort Collaborative (N3C) database, we monitored the progression of four prevalent COVID-19 variants (Delta, Omicron BA.5, Alpha, and XBB.1.5) across various U.S. HHS regions at three-month intervals. This approach has given way to a comprehensive analysis of regional trends and variant prevalence.

RESULTS: Our study found clear regional patterns of the distribution of COVID-19 variants of concern. The Delta variant initially surged in the Kansas City region, while the Omicron subvariant BA.5 exhibited a unique nationwide spread. The Alpha variant predominantly surfaced in the Southeast, and the XBB.1.5 variant showed a higher concentration in the Northeast. These findings provide a detailed map of variant distribution across the U.S., highlighting the diverse regional characteristics.

CONCLUSIONS: This research fills a crucial gap in understanding the regional dynamics of COVID-19 variant distribution. By providing detailed insights into the geographical prevalence of specific variants, our study offers valuable information for future targeted public health strategies and policies.