Highly recurrent multi-nucleotide mutations in SARS-CoV-2

Multi-nucleotide mutations (MNMs) simultaneously replace multiple nu-cleotides. They are a significant contributor to evolution and disease, as well as to misdiagnosis, misannotation and other biases in genome data analysis. MNMs are generally thought to be rare and random events. However, by processing millions of publicly shared genomes, we show that certain MNMs are highly recurrent in SARS-CoV-2: they repeatedly and consistently modify the same multiple nucleotides at the same genome position in the same way. The most frequent of these MNMs have independently occurred hundreds of times across all SARS-CoV-2 lineages. The vast majority of these recurrent MNMs are linked to transcription regulatory sequences. We propose a mechanism that explains them through template switching as part of the natural transcription process of the virus. This previously unknown mutational pattern increases our understanding of the evolution of SARS-CoV-2 and potentially many other nidoviruses. It also has important consequences for computational evolutionary biology: we show that for example recurrent MNMs cause approximately 14% of false positives during inference of recombination in SARS-CoV-2.