Case series of four re-infections with a SARS-CoV-2 B.1.351 variant, Luxembourg, February 2021

Staub, Thérèse; Arendt, Vic; Vega, Esther Calvo Lasso de la; Braquet, P.; Michaux, Christian; Kohnen, Michel; Tsobo, Chantal; Abdelrahman, Tamer; Wienecke-Baldacchino, Anke; François, Jean-Hugues

doi:10.2807/1560-7917.es.2021.26.18.2100423

Cited by 17 publications

(10 citation statements)

References 8 publications

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“…Furthermore, five mutations in the NTD of the S gene were proposed to contribute to improved viral microenvironment adaptations ( Li et al., 2021 ). This lineage is also associated with increased spreading ( Garcia-Beltran et al, 2021a ) and reinfection cases in subjects previously infected with the original SARS-CoV-2 ( Staub et al., 2021 ).…”

Section: Sars-cov-2 Spike Gene Mutationsmentioning

confidence: 99%

SARS-COV-2 Variants: Differences and Potential of Immune Evasion

Hirabara

Serdan

Gorjão

et al. 2022

Front. Cell. Infect. Microbiol.

194

162

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The structural spike (S) glycoprotein of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) plays an essential role in infection and is an important target for neutralizing antibody recognition. Mutations in the S gene can generate variants of concern (VOCs), which improve “viral fitness” through selective or survival advantages, such as increased ACE-2 receptor affinity, infectivity, viral replication, higher transmissibility, resistance to neutralizing antibodies and immune escape, increasing disease severity and reinfection risk. Five VOCs have been recognized and include B.1.1.7 (U.K.), B.1.351 (South Africa), P.1 (Brazil), B.1.617.2 (India), and B.1.1.529 (multiple countries). In this review, we addressed the following critical points concerning VOCs: a) characteristics of the SARS-CoV-2 VOCs with mutations in the S gene; b) possible evasion of variants from neutralizing antibodies generated through vaccination, previous infection, or immune therapies; c) potential risk of new pandemic waves induced by the variants worldwide; and d) perspectives for further studies and actions aimed at preventing or reducing the impact of new variants during the current COVID-19 pandemic.

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Section: Sars-cov-2 Spike Gene Mutationsmentioning

confidence: 99%

SARS-COV-2 Variants: Differences and Potential of Immune Evasion

Hirabara

Serdan

Gorjão

et al. 2022

Front. Cell. Infect. Microbiol.

194

162

View full text Add to dashboard Cite

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“…Auch wenn der Einfluss der Beta-Variante auf den klinischen Schweregrad derzeit gering zu sein scheint, so ist eine Immunevasion zu beachten. Es wurden Patienten beschrieben, die eine Reinfektion mit der Beta-Variante erlitten hatten, nachdem sie zuvor eine Erkrankung mit einem vor der Ausbreitung dieser Mutante gängigen Stamm durchgemacht hatten [ 25 ]. Eine andere Studie hat gezeigt, dass 21 von 44 Plasmen (48 %) von Patienten, die eine Erkrankung mit dem Virusstamm Wuhan‑1 D614G durchgemacht hatten, in vitro keine neutralisierende Wirkung gegenüber der Beta-Variante hatten [ 26 ].…”

Section: Mutante „Beta“ (B1351 Oder „Südafrikanische Mutante“)unclassified

COVID-19: Epidemiologie und Mutationen

2021

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Mutationen von SARS-CoV‑2 können die Ausbreitungsfähigkeit und Infektiosität erhöhen sowie die Schutzwirkung von Antikörpern vermindern, die nach einer Infektion, einer Impfung oder einer Antikörpertherapie vorhanden sind. Die Alpha-Variante (B.1.1.7), die zuerst in Kent/Großbritannien beobachtet wurde, hat zu einer Erhöhung des R‑Werts und damit der Infektiosität um 75 % geführt. Die Wirksamkeit der in Deutschland verfügbaren Impfungen gegen SARS-CoV‑2 scheint durch diese Mutationen jedoch nur geringfügig beeinträchtigt zu sein. Bei der Beta-Variante (B.1.351), die zuerst in Südafrika beschrieben wurde, ist die Fähigkeit von Antikörpern, SARS-CoV‑2 zu neutralisieren, vermindert. Die therapeutisch verwendeten monoklonalen Antikörper Bamlanivimab und Etesivimab sind unwirksam. Der Impfstoff von AstraZeneca hat gegenüber leichten und mittelschweren Erkrankungen durch die Beta-Variante fast keine Schutzwirkung. Die Gamma-Variante (P.1 oder B.1.1.28.1), die zuerst in Brasilien gefunden wurde, ist wahrscheinlich um den Faktor 1,7 bis 2,6 stärker übertragbar als zuvor in Brasilien zirkulierende Virusstämme. Neben der Infektiosität scheint auch das Sterberisiko bei der Gamma-Variante um den Faktor 1,2 bis 1,9 bei Erwachsenen und bei jüngeren Patienten um den Faktor 5 bis 8 erhöht zu sein. Die Delta-Variante (B.1.617), die zuerst in Indien beschrieben wurde, ist inzwischen in den meisten Ländern dominierend. Ihre Infektiosität ist gegenüber der zuvor dominierenden Alpha-Variante um etwa 50 % erhöht, die Schutzwirkung der verfügbaren Impfungen vor symptomatischen Erkrankungen kann vermindert sein (BioNTech: Delta-Variante 88 %, Alpha-Variante 93,7 %; AstraZeneca: Delta-Variante 67 %, Alpha-Variante 74,5 %). Ferner ist der Krankheitsverlauf bei der Delta-Variante oft schwerer als beim Wildtyp. Erkrankungen durch die Delta-Variante verlaufen bei Geimpften leichter als bei Ungeimpften, und tödliche Verläufe sind wesentlich seltener. Eine hohe Impfquote ist unerlässlich, um einer Herdenimmunität möglichst nahezukommen und die Pandemie unter Kontrolle zu bringen. Selbst bei verminderter Schutzwirkung gegenüber leichten und mittelschweren Erkrankungen bieten Impfungen in der Regel einen ausgezeichneten Schutz gegenüber lebensbedrohlichen und tödlichen Krankheitsverläufen.

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“…This is supported by previous studies that show patients who have had a wild-type infection subsequently acquire Alpha or Beta infections only very rarely ( 41 ). Moreover, such reinfections generally associate with non-severe illness ( 42 ). However, it should be noted that because the serological status of each patient before their admission into the ICU was not known, we could not formally prove the absence of reinfection.…”

Section: Discussionmentioning

confidence: 99%

“…The majority of patients were treated in Center 2 (50%); the remaining three ICUs each accounted for 15-18% of the patients. The median SOFA and SAPS 2 scores were 5 (3-7) and 36 (29)(30)(31)(32)(33)(34)(35)(36)(37)(38)(39)(40)(41)(42)(43)(44)(45), respectively. Approximately half of the patients had AKI (43%) and a CT chest impairment of ≥50% (56%), 5% had pulmonary embolism, and 2% were pregnant.…”

Section: Characteristics Management and Outcomes Of The Total Cohortmentioning

confidence: 99%

Comparison of SARS-CoV-2 Variants of Concern Alpha (B.1.1.7) vs. Beta (B.1.351) in Critically Ill Patients: A Multicenter Cohort Study

et al. 2022

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ObjectivesThe clinical outcomes of the Beta (B.1.351) variant of concern (VOC) of the SARS-CoV-2 virus remain poorly understood. In early 2021, northeastern France experienced an outbreak of Beta that was not observed elsewhere. This outbreak slightly preceded and then overlapped with a second outbreak of the better understood VOC Alpha (B.1.1.7) in the region. This situation allowed us to contemporaneously compare Alpha and Beta in terms of the characteristics, management, and outcomes of critically ill patients.MethodsA multicenter prospective cohort study was conducted on all consecutive adult patients who had laboratory confirmed SARS CoV-2 infection, underwent variant screening, and were admitted to one of four intensive care units (ICU) for acute respiratory failure between January 9th and May 15th, 2021. Primary outcome was 60-day mortality. Differences between Alpha and Beta in terms of other outcomes, patient variables, management, and vaccination characteristics were also explored by univariate analysis. The factors that associated with 60-day death in Alpha- and Beta-infected patients were examined with logistic regression analysis.ResultsIn total, 333 patients (median age, 63 years; 68% male) were enrolled. Of these, 174 and 159 had Alpha and Beta, respectively. The two groups did not differ significantly in terms of 60-day mortality (19 vs. 23%), 28-day mortality (17 vs. 20%), need for mechanical ventilation (60 vs. 61%), mechanical ventilation duration (14 vs. 15 days), other management variables, patient demographic variables, comorbidities, or clinical variables on ICU admission. The vast majority of patients were unvaccinated (94%). The remaining 18 patients had received a partial vaccine course and 2 were fully vaccinated. The vaccinated patients were equally likely to have Alpha and Beta.ConclusionsBeta did not differ from Alpha in terms of patient characteristics, management, or outcomes in critically ill patients.Trial RegistrationClinicalTrials.gov, identifier: NCT04906850.

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Case series of four re-infections with a SARS-CoV-2 B.1.351 variant, Luxembourg, February 2021

Cited by 17 publications

References 8 publications

SARS-COV-2 Variants: Differences and Potential of Immune Evasion

SARS-COV-2 Variants: Differences and Potential of Immune Evasion

COVID-19: Epidemiologie und Mutationen

Comparison of SARS-CoV-2 Variants of Concern Alpha (B.1.1.7) vs. Beta (B.1.351) in Critically Ill Patients: A Multicenter Cohort Study

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