Comparison of the Clinical and Virological Characteristics of SARS-COV-2 Omicron BA.1/BA.2 and Omicron BA.5 Variants: A Prospective Cohort Study

Kang, Sang‐Wook; Park, H.; Kim, J.Y.; Lim, Sung-Eun; Lee, S.; Bae, Joon-Hyup; Kim, J.; Chang, Eunmi; Bae, Seongman; Jung, Jiwon; Kim, M.J.; Chong, Yong Pil; Lee, S.-O.; Choi, Sehoon; Kim, Y.S.; Park, M.-S.; Kim, S.-H.

doi:10.1164/ajrccm-conference.2023.207.1_meetingabstracts.a3840

Cited by 2 publications

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“…Some hamster studies have suggest increased lung infection/pathology for BA.5 (Kimura et al, 2022;Ong et al, 2023), whereas other studies using hamsters and/or K18-hACE2 mice argued that the reduced pathogenicity seen for the early omicron variants (Shuai et al, 2022) was retained by BA.5 (Rizvi et al, 2022;Uraki et al, 2022) and XBB (Tamura et al, 2023). Similarly, while some human studies report increased pathogenicity for BA.5 (Hansen et al, 2023;Kang et al, 2023;Kouamen et al, 2022;Russell et al, 2023), others report no significant changes (Davies et al, 2023;Wolter et al, 2022). XBB variants appear to have increased transmission potential (Islam et al, 2023), as well as enhanced receptor binding affinity, although the implications for pathogenicity remain to be established (Yue et al, 2023).…”

Section: Introductionmentioning

confidence: 99%

Increased neurovirulence of omicron BA.5 and XBB variants over BA.1 in K18-hACE2 mice and human brain organoids

Stewart

Ellis

Yan

et al. 2022

Preprint

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A frequently repeated premise is that viruses evolve to become less pathogenic. This appears also to be true for SARS-CoV-2, although the increased level of immunity in human populations makes it difficult to distinguish between reduced intrinsic pathogenicity and increasing protective immunity. The reduced pathogenicity of the omicron BA.1 sub-lineage compared to earlier variants is well described and appears to be due to reduced utilization of TMPRRS2. That this reduced pathogenicity remains true for omicron BA.5 was recently reported. In sharp contrast, we show that a BA.5 isolate was significantly more pathogenic in K18-hACE2 mice than a BA.1 isolate, with BA.5 infection showing increased neurovirulence, encephalitis and mortality, similar to that seen for an original strain isolate. BA.5 also infected human cortical brain organoids to a greater extent than a BA.1 and original strain isolate. Neurons were the target of infection, with increasing evidence of neuron infection in COVID-19 patients. These results argue that while omicron virus may be associated with reduced respiratory symptoms, BA.5 shows increased neurovirulence compared to earlier omicron sub-variants.

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