Do you remember BA.3—the weakling cousin of BA.1 & BA.2 that seemed to take the worst from each & had weaker ACE2 binding than even the ancestral Wuhan Virus?
After 3 years, BA.3 is back.
And it is transmitting.
Who saw this coming?
1/13
While the full extent of the new BA.3’s spread is not known, it’s been detected in 2 different South African regions through regular (not targeted) surveillance by @Dikeled61970012, @Tuliodna, & the invaluable South African virology community.
2/13 github.com/cov-lineages/p…
After nearly 3 years of intrahost evolution in a chronically infected person, the new BA.3 is almost unrecognizable. It has ~41 spike AA substitutions (4 of which are 2-nuc muts) to go with 14 AA deletions (∆136-147+∆243-244). We’ve seen nothing like this since 2023.
3/13
The new BA.3 has added 3-4 new glycans in spike at: N101 (via I101T), N185 (K187T), N354 (K356T—in 1/3 sequences), & N529 (K529N). Plus it lacks T19I, so it retains the N17 glycan that we’ve not seen since BA.1 (& which Delta also lacked due to T19R).
4/13
Like BA.2.87.1, the new BA.3 has rearranged its spike NTD (S:1-325) by eliminating the C15-C136 disulfide bond with P9L (which shunts C15 into the signal peptide, which gets cleaved off) & ∆136-147, which eliminates S:C136.
5/13
New BA.3 is also looking quite trim and fit these days! Like several late-XBB variants, it has shorn itself of ORF7ab & ORF8 with a deletion of over 800 nucleotides. It appears to be the same deletion that GW.5.1.1 (an XBB) had.
6/13
As always, there’s a lot to unpack with this new saltation variant. For now, I’ll just briefly mention one fascinating mutation, and save more extensive analysis for later. The new BA.3 has one of my favorite rare, enigmatic mutations: S:A852K.
7/13
S:A852K is a 2-nucleotide mutation that’s appeared almost exclusively in highly divergent chronic-infection sequences. The last sequence to have A852K was a Cryptic-like BA.1 from New York in mid-2023 w/striking similarities to the new BA.3, including...
8/13
...NTD disulfide erasure through P9L + ∆C136, N164K, a new N185 glycan via K187T, the H505Y reversion, H681R, and of course A852K. Fortunately, the new BA.3 does not have the notorious ORF3a:H182D, which seems to kill a disturbing proportion of the people it infects.
9/13
I don’t know what A852K does. K854 used to bond with D614 before D614G became universal, & A852K has appeared with K854N several times. The BA.3 has many mutations in that region, so maybe it affects up/down spike conformation.
10/13 science.org/doi/10.1126/sc…
Will the new BA.3 spread across the world & grow? There’s no way to know. It may sputter & die like BA.2.87.1. But BA.2.87.1 arrived just when JN.1 was sweeping the world & was trampled underfoot. The ground is now more fertile, & a novel-variant seed more likely to bloom.
11/13
It’s been a year and a half since we’ve seen a truly novel variant spread & just saw the weakest winter Covid wave ever. I suspect JN.1 variants have become weaker over time, forced into acquiring infectivity-reducing spike mutations to evade broadening antibodies.
12/13
If the new BA.3 circulates long enough to pick up some transmission-enhancing mutations (think BA.2.86 getting L455S to become JN.1), it could be the next big thing. Or not. Time will tell.
We should see it in other countries pretty soon if it’s the real deal.
13/end
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Fantastic review on chronic SARS-CoV-2 infections by virological superstars Richard Neher & Alex Sigal in Nature Microbiology. I’ll do a short overview, outline a couple minor quibbles, & defend the honor of ORF9b w/some stats & 3 striking sequences from the past week.
1/64
First, let me say that this is well-written, extremely readable, and accessible to non-experts, so you should go read the full paper yourself, if you can find a way to access it. (Just realized it’s paywalled, ugh.) 2/64nature.com/articles/s4157…
Neher & Sigal focus on the 2 most important aspects of SARS-CoV-2 persistence: its relationship to Long Covid (including increased risk of adverse health events) & its vital importance to the evolution of SARS-CoV-2 variants. I’ll focus on the evolutionary aspects.
3/64
In SARS-2 evolution, amino acid (AA) mutations get the lion’s share of attention—& rightfully so, as noncoding & synonymous nucleotide muts—which cause no AA change‚ are mostly inconsequential. But there are many exceptions, including a possible new one I find intriguing. 1/30
I’ll discuss four categories of such “silent” mutations, two of which might be involved in the recent growth of one synonymous mutation.
Maybe the single most remarkable example of convergent evolution in SARS-CoV-2 involves noncoding mutations: the multitude of muts in major variants that have pulverized the nucleocapsid (N) Kozak sequence.
I wrote about this below & a few other 🧵s 3/
@SolidEvidence There was yet another paper this week describing someone chronically infected, with serious symptoms, but who repeatedly tested negative for everything with nasopharyngeal swabs. On bronchoalveolar lavage (BAL), they were Covid-positive. 1/ ijidonline.com/article/S1201-…
@SolidEvidence BAL is very rarely performed, yet there must be dozens of documented cases now where NP-swab PRC-negative patients who were very ill tested positive by BAL. This has to be way more common than we realize.
If we had a similar GI test, I imagine we'd find something similar. 2/
@SolidEvidence Importantly, the patient was treated and improved, likely clearing the virus for good. Many, maybe most, chronic infections could be treated and cleared. But they have to know they're infected for that to happen. 3/
Read full 🧵for explanation, but the short story is that the best apparent escape mutations all interact w/something else—like a nearby spike protomer or other important AA—making mutations there prohibitively costly.
In short, the virus has mutated itself into a corner. 2/6
It's very hard to effectively mutate out such a local fitness peak via stepwise mutation in circulation since multiple simultaneous muts might be required to reach a higher fitness peak. 3/6
It's an interesting thought. I think the evidence is strong that all new, divergent variants have derived from chronic infections. The first wave of such variants—Alpha, Beta, Gamma—IMO involved chronic infections lasting probably ~5-7 months. It's controversial to say.... 1/15
…that Delta originated in a chronic infection, but I think the evidence that it did is strong. One characteristic of chronic-infection branches is a high rate of non-synonymous nucleotide (nuc) substitutions (subs)—i.e. ones that result in an amino acid (AA) change. 2/15
For example, if 80% of nuc subs in coding regions cause an AA change, that’s a very high nonsynonymous rate. The branch leading to Delta has 17 AA changes—from just *15* nuc subs! That’s over 100%. How is this possible? 3/15