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What do we know about COVID-19 variants so far?

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We deep dive into how many variants of COVID-19 are there presently and which classify as variants of concern.

In last year’s edition of Arab Health, we had several discussions on the Delta variant’s rapid spread. Delta became the dominant variant of the SARS-CoV-2 virus in the U.S. in 2021 and since then new variants have been detected in England, Brazil, California, and other areas.

More infectious variants, such as beta, which first appeared in South Africa, may have a high capability to re-infect persons who have recovered from previous forms of the coronavirus, as well as being resistant to some of the coronavirus vaccines now being developed. Vaccines now in use, however, appear to provide enough protection against severe illness caused by coronavirus variations.

In an interview with Dr. Wael Faroug Mohamed Elamin, Consultant Clinical Microbiologist, and Infection Control Doctor at G42 Healthcare, we spoke about if the SARS-COV-2 virus keeps mutating and how variants can be categorised. “SARS-CoV-2  is an RNA virus, and what RNA viruses lack is called the proofreading mechanism. While they replicate, they always make mistakes during replication and there is a lack of checking mechanisms during this process. Therefore, mutations in old viruses always exist in RNA viruses more so than DNA viruses. Hence, mutations are not only predictable but are expected. There can be several types of mutations, and some become anonymous, which causes a change in the actual property of the virus, or nonsynonymous, which may not cause an effect. If a mutation is causing a significant change, further study needs to analyse its consequences and severity. Nevertheless, mutations are a part of how viruses replicate, and they have their replication cycle,” he explained.

Dr. Wael affirmed that there are variants of concern and nonvariants of concern. The question is, which one of them are worrisome enough to be considered? 

Categorising Variants

Organisations like the World Health Organization (WHO) and the Centers for Disease Control and Prevention (CDC) classify coronavirus variations into distinct categories:

A variant of interest

Possesses genetic traits that indicate increased transmissibility, evasion of immunity or diagnostic tests, or more severe disease when compared to earlier forms of the virus.

A variant of concern

In persons who have been vaccinated or previously infected, has been found to be more infectious, more likely to cause breakthrough or re-infections. These variants are more likely to induce severe illness, elude detection, and resist antiviral therapy. The SARS-CoV-2 coronavirus's alpha, beta, gamma, and delta variants are classed as variants of concern.

A variant of high consequence

Is a variant against which no existing vaccinations provide protection. There are currently no SARS-CoV-2 mutations of high significance.

New Variants

As long as the coronavirus spreads through the population, mutations will continue to happen, and the delta variant family continues to evolve, according to an article published in Johns Hopkins medicine. Although the virus is mutating, it is likely that most kits would at least give an indication that the virus may exist, adds Dr. Wael.

New variants of the SARS-CoV-2 virus are detected every week, however majority of them come and go, some remain but don't get more prevalent; others grow in population for a while and then fade away says Dr. Stuart Ray, M.D., vice chair of medicine for data integrity and analytics in the same article published in Johns Hopkins medicine.

Variants of concern remain to be alpha, beta, gamma, felta and omicron, as of January 5th according to the European Centre for Disease Prevention and Control, with the CDC highlighting delta and mmicron.

Several stories on flurona and deltacron have been in the public eye, however specialists such as Dr. Ray have clarified that ‘flurona' is not a clinical term, however patients can be infected with the flu and the coronavirus at the same time." Coinfections have existed, and by definition mean a new infection running concurrently with the initial infection.

Deltacron, refers to the combination of the delta and omicron variants. Dr. David Margolius, division director of general internal medicine at MetroHealth, said the idea that the two variants have merged into a brand-new variant isn’t true.

Leondios Kostrikis, professor of biological sciences at the University of Cyprus, called the strain “deltacron,” because of its omicron-like genetic signatures within the delta genomes, Bloomberg said.

There is doubt among speacliasts who may feel Kostrikis’s findings may be a result of a lab errors, which he continues to refute.

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