Some pretty bad news on the XBB.1 Covid Variant. [View all]
My fully vaccinated wife has Covid and was pretty sick, although she seems to be improving. My son is also not feeling well. I have a slight cough.
This situation motivated me to look into the XBB.1.5 variant that seems to be circulating, which I suspect my wife has.
I accessed this paper this morning: Qian Wang, Sho Iketani, Zhiteng Li, Liyuan Liu, Yicheng Guo, Yiming Huang, Anthony D. Bowen, Michael Liu, Maple Wang, Jian Yu, Riccardo Valdez, Adam S. Lauring, Zizhang Sheng, Harris H. Wang, Aubree Gordon, Lihong Liu, David D. Ho, Alarming antibody evasion properties of rising SARS-CoV-2 BQ and XBB subvariants, Cell, 2022, a corrected proof in press.
The paper is fully open sourced, anyone can read it, but I'll produce the opening paragraphs and a pretty depressing graphic from the paper as well.
The intro:
I added the bold.
The XBB virus has been fully sequenced, and the sites of the mutations are known. "K444T" refers to the substitution at the 444th residue in the spike protein of a threonine for a lysine. "N460K" refers to a substitution at the 460th residue of a lysine for an asparagine.
The following graphic shows the evolutionary history of variants of Covid:
The caption:
(A) Frequencies of Omicron subvariants from the Global Initiative on Sharing All Influenza Data (GISAID). Variants were designated according to their Pango dynamic lineage classification.12 Minor sublineages of each subvariant were grouped together with their parental variant. The values in the upper left corner of each box denote the cumulative number of sequences for all circulating viruses in the denoted time period.
(B) Unrooted phylogenetic tree of Omicron subvariants along with other main SARS-CoV-2 variants. The scale bar indicates the genetic distance.
(C) Key spike mutations found in XBB and XBB.1 in the background of BA.2 and in BQ.1 and BQ.1.1 in the background of BA.4/5. Del, deletion. The positions of these mutations on the spike trimer are shown in Figure S1.
This graphic shows the location of the mutations on the spike protein:
The caption:
(A and B) Key mutations of BQ.1 and BQ.1.1 in the context of BA.4/5 (A), and key mutations of XBB and XBB.1 in the context of BA.2 (B).
See also Figure 1.
And now for the real depressing graphic, showing the decreased neutralization capacity of antibodies:
The caption:
(A) Footprints of NTD- and RBD-directed antibodies tested are outlined, and mutations within BQ.1, BQ.1.1, XBB, and XBB.1 are highlighted in red.
(B) The fold changes in neutralization IC50 values of BQ.1, BQ.1.1, XBB, XBB.1, and the individual mutants compared with BA.4/5 or BA.2, with resistance colored red and sensitization colored green. The raw IC50 values are shown in Figure S2.
See also Figure S2.
The good news, as I understand it, is that this variant does not seem as severe in terms of illness, and there is some protective effect with vaccination status, although how much is on clear.
The authors make the comforting statement I will put in bold:
But it's also clear from my perspective, we're going to need another vaccine. We do have the machinery to do this now, so that is also good news.
The authors conclusions:
I have heard, peripherally, I will now look into it more deeply, that a "master" vaccine that may work against all or most corona viruses, including those responsible for the common cold, is under development.
My wife is suffering from nausea and diarrhea, before taking Paxlovid, and these are side effects of the drug, so she's reluctant to take it.
I'm going to work from home until it becomes clear what the situation is.
The bottom line: Be careful, keep your Covid supplies handy.
Update: My son just tested positive. The historical test kits seem to respond to this variant. He's sick, but not as sick as my wife.