Characterisation of a new recombinant, #XD (a Delta-Omicron recombinant)
➡️ The XD is a chimeric SARS2 virus having recombination of Delta AY.4 & Omicron BA.1.
➡️ The XD spike carries a larger fraction of the signature changes of BA.1, including the entirety of the RBD
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There are two breakpoints, one at the beginning of spike & one within ORF 3a
➡️ Immune escape:
-With pseudovirus, only a small reduction in NAb titers ag #Delta compared to WT
-In contrast, both XD & BA.1 were barely neutralized by sera sampled 1 or 6 mo after 2 doses
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-The titers were all much higher 1 month after a 3rd immunization, although they displayed an 8-fold to 10-fold reduction in neutralization efficacy against both BA.1 and XD compared to the WT virus.
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Likewise, in individuals infected and vaccinated with one dose, NAb titers towards BA.1 and XD were reduced 3.4- and 3.7-fold (but not significant), respectively
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➡️ Intrinsic severity of XD
Researchers infected hACE2-mice with test dose of either the recombinant or each parental lineage virus. They compared the viral load in the lungs & nasal turbinates at 3 days post-infection. 5/
The levels of viral RNA in the lungs of mice infected with BA.1 or XD viruses were comparable, and 3.7-fold lower than those of AY.4-infected animals
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In contrast, the viral load in nasal turbinates of the XD-infected mice was 8.5-fold higher than that in BA.1-infected animals, & only slightly lower than that of AY.4 infected mice
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They also monitored mice for body weight loss and disease over 11 days. Like the main Delta lineage, the parental AY.4 isolate resulted in disease with weight loss that accelerated at 3 dpi, and 6/7 mice reached humane endpoints between dpi 7 and 9.
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BA.1 infection was not associated with weight loss nor lethality.
With the XD virus, no weight loss during the first 5 dpi was observed, but all mice deteriorated rapidly between day 5 and 8 and died or had to be euthanized by day 9.
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These results indicate that #XD is associated w/ clinical features distinct from those of BA.1 in hACE2-mice
It further suggests that attenuated phenotype of BA.1 in this model cannot be only linked to variations in spike such as in the RBD or near the furin cleavage site 10/
Conclusions:
The XD recombinant exhibits immune escape properties similar to Omicron, while its behavior in mice expressing the human ACE2 receptor is more similar to Delta. 11/
Though this XD recombinant looks more threatening than XE or all other BA.1 X BA.2 recombinants, but does not seem to outcompete current dominant lineage BA.2
The one to watch is Delta X BA.2 spike recombinant!! 12/
Welcome sublineages of BA.2: (sublineages mean stuff clearly derived from known omicrons (BA.2 or BA.1.1. or whatever)
⚠️ BA.4 & BA.5 just got designated
➡️ BA.4 (S:L452R+486V +N:151S + orf9b:11F)
➡️ BA.5 (S:L452R+486V +M:D3N)
So BA.4 & BA.5 would be new omicrons! 1/
➡️ BA.* sublineages with S:L452R and S:F486V (79 sequences as of 2022-04-05, mainly South Africa)
➡️ Mutations on top of BA.2:
S: L452R, F486V
ORF7b: L11F*
N: P151S*
nuc: G12160A
*these two don't always seem to be picked up, G12160A is a better marker outside the spike 2/
➡️ Notably, 452 and 486 are two of the biggest antigenic sites that are not already hit by BA.2 mutations; 452R might knock out some of the same antibodies that 446S does in BA.1. 3/
#SARS2 can cause acute respiratory distress & death in some patients. Although severe #COVID19 disease is linked to exuberant inflammation, how #SARS2 triggers inflammation is not understood. 1/
Monocytes & macrophages are the key sentinel cells that sense invasive infection to form inflammasomes that activate inflammatory cascade by secreting caspase-1 and gasdermin D, leading to inflammatory death (pyroptosis) & release of potent inflammatory mediators. 2/
~6% of monocytes in COVID patients are infected w/ SARS2
Monocyte infection depends on uptake of Ab-opsonized virus by Fcγ receptors
SARS2 begins to replicate in monocytes, but infection is aborted & infectious virus is not detected in infected monocyte culture supernatants. 3/
➡️ Israeli MoH data, 1,252,331 persons 60 y/o or above, Study period: Jan 10-March 2, 2022
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➡️ Rate of confirmed infection & severe Covid as a function of time:
-Four-dose groups (8 days after receipt of a 4th dose)
-Three dose group: among persons who had received only 3 doses
-Internal control group: among persons who had received a 4th dose 3 to 7 days earlier 2/
➡️ Number of cases of *severe* Covid19 per 100,000 person-days:
-1.5 in four-dose groups,
-3.9 in the three-dose group,
-4.2 in the internal control group
Am I taking a break from pandemic-related news? Is the pandemic over? No, then why in the midst of the pandemic, I’m doing this long thread on something different? Will disclose the reason in the end.....but I think this fascinating tale needed to be told to my twitter family 1/
Most of my close associates are aware of this saga. But most of the Twitterati are oblivious of this journey. It all started in the autumn of 1998 when I got two young kids with a weird behaviour—combative & agitated, chewing their body parts along w/ fever, vomiting, stupor.. 2/
Clinically and even after performing basic investigations, their clinical profile was not fitting in a proper known clinical entity. It was not encephalitis, not hepatic coma, nor another known multi-system disease. And this was not a stray incident. 3/
Limited differences between the intrinsic generation time of the #Omicron variant as compared to previous estimates on ancestral lineages, #Alpha and #Delta. Like for previous lineages, pre-symptomatic transmission appears to play a key role for Omicron transmission. 1/
The result that the intrinsic generation time of the #Omicron is not significantly shorter than previous lineages may be surprising w/ respect to the intuition suggested by repeated observations of shorter incubation periods & serial intervals 2/
Realized serial intervals are a biased proxy for generation time since they depend strongly on epidemiological conditions of study population; in particular, they tend to be shorter when transmissibility is higher (as Omicron) & thus the competition for susceptible is stronger 3/
Boosting with variant-matched or historical #mRNA vaccines protects against #Omicron infection in mice
➡️ Researchers evaluated in mice the protective efficacy of the #Moderna mRNA-1273 vaccine against BA.1 before or after boosting. 1/
Whereas 2 doses of mRNA-1273 vaccine induced high levels of neutralizing antibodies against WA1/2020 strains, lower levels against BA.1 were associated with breakthrough infection & inflammation in the lung. 2/
A primary vaccination series with mRNA-1273.529, an Omicron-matched vaccine, potently neutralized BA.1 but inhibited historical or other SARS2 variants less effectively. 3/