Under the Microscope with David Weber: SARS-CoV-2 variants – Any Cause for Concern?

Author: David Weber, MD, MPH

Categories: Clinical Pathogens/Alerts January 8, 2021
Microscope in a lab

This Week’s Review:

COG-UK update on SARS-CoV-2 Spike mutations of special interest Report 1, prepared by COVID-19 Genomics UK (COG-UK), addresses the emergence of the new SARS-CoV-2 variants.

SARS-CoV-2 is an enveloped RNA virus.  RNA viruses, such as SARS-CoV-2 and influenza A, may undergo mutations (i.e., a change of a nucleotide in the virus RNA genome, a subset of which results in a change in amino acid) which  can result in a deletion or insertion in the virus genome.  Mutation in the viral genome of SARS-CoV-2 can lead to virus variants (i.e., a distinct virus).

The possible implications of a new SARS-CoV-2 variants are as follows:

  • ability to spread more rapidly in humans
  • ability to cause either milder or more severe disease in humans
  • ability to evade detection by some diagnostic tests
  • decreased susceptibility to therapeutic agents such as monoclonal antibodies
  • ability to evade vaccine-induced immunity.

Recently, a variant with increased transmissibility has been reported to be common in the United Kingdom, and a few patients with this variant have been reported in the United States.  Variants have been reported with the ability to evade detection by some diagnostic tests; variants have also been reported with likely decreased susceptibility therapeutic agents such as monoclonal antibodies.  No variants have been reported that lead to milder or more severe disease.

To date, it appears that current variants will NOT impair the vaccine response which is polyclonal, but further research is underway.  It is NOT expected that any of the mutations will alter the basic nature of SARS-CoV-2 and hence it is expected all SARS-CoV-2 will remain susceptible to currently recommended antiseptics and disinfectants.  Furthermore, it is unlikely that variants would be more environmentally stable.  The Centers for Disease Control is planning to enhance its surveillance of SARS-CoV-2 variants.

 

Under the Microscope with Dr. David Weber explores what’s new in industry literature and provides a synopsis, along with key takeaways.

Reference:  COG-UK update on SARS-CoV-2 Spike mutations of special interest Report 1 Prepared by COG-UK, 20thDecember 2020.  Available at:  https://www.cogconsortium.uk/wp-content/uploads/2020/12/Report-1_COG-UK_20-December-2020_SARS-CoV-2-Mutations_final_updated2.pdf

Author

David Weber MD, MPH
Dr. David Weber, Associate Chief Medical Officer for UNC Medical Center Associate Chief Medical Officer for UNC Medical Center

Profile

Dr. David Jay Weber received his Bachelors of Arts (B.A.) degree from Wesleyan University in 1973, his Medical Degree (M.D.) from the University of California, San Diego in 1977, a Master’s in Public Health (M.P.H.) from Harvard University in 1985, and completed his medicine residency and infectious disease fellowship at the Massachusetts General Hospital in 1985.

He is Board Certified in Internal Medicine, Infectious Disease, Critical Care Medicine, and Preventive Medicine.  Dr. Weber has been on the faculty of the University of North Carolina at Chapel Hill since 1985 where he is currently the Charles Addison and Elizabeth Ann Sanders Distinguished Professor of Medicine, Pediatrics and Epidemiology in the UNC School of Medicine, and UNC Gillings School of Global Public Health.

He serves as an Associate Chief Medical Officer for UNC Medical Center.  He also serves as Medical Director of the Department of Infection Prevention UNC Medical Center.  He is the Medical Director of the North Carolina Statewide Infection Control Program (SPICE), a Chair of UNC Biomedical IRB, and serves as the UNC Principle Investigator on the CDC sponsored Duke-UNC Epicenter.  Dr. Weber is an Associate Editor of Infection Control Hospital Epidemiology and the Secretary of the SHEA Board.

Dr. Weber has published more than 450 scientific papers in the peer-reviewed literature and more than 600 total papers and chapters.  His research interests include the epidemiology of healthcare-associated infections, disinfection and sterilization, new and emerging infectious diseases (novel influenza, SARS-coV-2, MERS-coV, Ebola, Candida auris), response to biothreats, nontuberculous mycobacteria, control of drug resistant pathogens, immunization practices (especially of healthcare personnel), zoonotic diseases, and epidemiology of tuberculosis.

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