December 16, 2022 – This story might be more appropriate for Halloween than the holiday season because of its disturbing implications. New evidence predicts that four Omicron subvariants of the virus that causes COVID-19 will be the most common strains spreading between humans this winter.
Not too scary so far, unless you consider what else the researchers found.
Researcher Qian Wang, Ph.D., and colleagues report that BQ.1, BQ1.1, XBB, and XBB.1 subvariants were the most resistant to neutralizing antibodies. This means that even if you have been vaccinated against COVID-19 or multiple vaccinations and booster vaccines (including bivalent vaccines), you have no or “significantly reduced” protection against infection with these four strains.
Most importantly, all available monoclonal antibody treatments are mostly or completely ineffective against these subvariants.
What does this mean for our near future? The findings are definitely “worrisome,” says Eric Topol, MD, founder and director of the Scripps Translational Research Institute in La Jolla, Calif., and editor-in-chief of Medscape, WebMD’s sister site for healthcare professionals.
But evidence from other countries, notably Singapore and France, suggests that at least two of these variants have not been as damaging as expected, possibly because large numbers of people have been vaccinated or survived previous infections Come down, Topol said.
Aside from the fact that COVID-19 vaccination and previous infection can still reduce the risk of serious outcomes like hospitalization and death, the new findings aren’t much to celebrate, the researchers said. In fact, CDC data released on Friday showed that people who had received four doses of the original COVID-19 vaccine plus a bivalent booster were 57 percent less likely to go to an emergency clinic or emergency room, regardless of age.
“Alarm antibody evasion properties of rising SARS-CoV-2 BQ and XBB subvariants” Research published online this week in the magazine cell.
It appeared when BQ.1 and BQ.1.1 accounted for about 70% of the circulating variants, CDC data display. In addition, the number of hospitalizations has increased by 18% and the number of COVID-19 deaths nationwide has increased by 50% over the past two weeks, New York Times report.
Globally, Topol said, “walls of immunity” have been built in many places. This may not be the case in the US.
“In the U.S., the harder-to-forecast issue is that we’ve had very low rates of recent booster use over the past six months, especially among older adults,” Topol said. E.g, Only 36% of Americans are 65 and olderthe highest-risk group, have received newer bivalent boosters.
These sub-variants successfully replaced BA.5, which became one of the most common Omicron variants in the past year. The latest CDC data shows that BA.5 now accounts for only about 10% of circulating viruses. “The rapid turnover of this virus strain is “raising fears of another wave of infections in the coming months,” the researchers wrote.
The story sounds familiar to researchers. “The rapid increase of these subvariants and their widespread spike mutations are reminiscent of the emergence of the first Omicron variants last year, raising concerns that they may further impair the efficacy of current COVID-19 vaccines and monoclonal antibody therapies,” they write. “The findings we now report suggest that, unfortunately, this concern is justified, especially for XBB and XBB.1 subvariants.”
The BQ.1 subvariant was six times more antibody resistant than its parent strain BA.5, while XBB.1 was 63 times more resistant than its predecessor, BA.2.
The vaccine’s ability to block shifts in subvariants is “particularly concerning,” the researchers wrote.
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Wang and colleagues also tested a panel of 23 monoclonal antibody drugs against four subvariants. These treatments were all effective against the original Omicron variant and included some that were approved for use during the study period through the FDA’s Emergency Use Authorization (EUA) program.
For example, they found that 19 of the 23 mAbs were “substantially or completely” ineffective against XBB and XBB.1.
This isn’t the first time monoclonal antibody therapy has gone from being effective to being ineffective. Previous variants have emerged that no longer respond to treatment with bamlanivimab, casirivimab, cilgavimab, etesevimab, imdevimab, sotrovimab, and tixagevimab. Bebtelovimab now joins this list and is Lilly is no longer available Under EUA due to lack of validity.
The lack of effective monoclonal antibody treatments “represents serious problems for the millions of immunocompromised individuals who have not responded strongly to COVID-19 vaccines,” the researchers wrote, adding that “there is an urgent need to develop clinically active Monoclonal antibodies are obvious.”
Looking ahead, as coronaviruses continue to evolve, developing vaccines and treatments that provide broad protection remains a challenge.
In a grisly end to a scary story, the researchers wrote: “We collectively chased SARS-CoV-2 variants for over 2 years, yet the virus continued to evolve and evade.”