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What to know about the New immune escape COVID-19 variant

As the COVID-19 pandemic continues to spread in various parts of the world, the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is evolving to evade our immune system. At the end of 2020, several new variants labeled as variants of concern were reported from the United Kingdom, South Africa, and Brazil, all of which appear to be more infectious than the original strain.

With record-breaking daily cases and a rising death toll, India's fight against the second wave of COVID-19 is making headlines. In a single day, the country recorded more than 4,12,095 new COVID-19 cases, the highest total ever recorded since the pandemic began. The country saw the highest single-day death toll of 3,971 people. Even as the United States achieves promising vaccination milestones, it's a sobering reminder that the pandemic is far from over.

One possible reason for the increase in cases in India is the "triple mutant strain" or "triple mutant variant" of coronavirus, according to some experts. While the term may be frightening, it refers to one of many strains that have been identified as part of the COVID-19 pandemic. Viruses are constantly evolving as a result of mutations, and variants have emerged since the outbreak began. As per the Centers for Disease Control and Prevention, the World Health Organization (WHO) has classified this B.1.617 variant as a "variant of concern" and a "variant of interest”.

According to infectious disease experts, here's what you need to know about the triple mutant variant and how you can help India combat the new wave of coronavirus cases.

What is a Mutant Strain?

In simple terms, the coronavirus, like all viruses, evolves as it spreads from one person to the next. Since its discovery, the Covid-19 virus has been mutating. Viruses frequently undergo genetic mutations during replication, which can result in different variants. A strain is a group of variants with distinctly different physical characteristics.

What Is Triple Mutation?

Simply put, a triple mutation is a variant that contains three different strains that have merged to form a new variant.

Identifying mutations

The team discovered 47 G lineages after analyzing 598 whole viral genomes. The B.1.617 was the most common, appearing in nearly half of the genomes sequenced. They discovered four clusters within the B.1.617 clade that were linked to specific spike protein mutations. They discovered that starting in January 2021, mutations L452R and E484Q in the receptor-binding domain (RBD) of the spike protein, as well as mutations G142D and P681R outside the RBD, increased in frequency. H1101D and T95I were two other mutations discovered. Only a small percentage of sequences, especially in December 2020, revealed the B.1.1.7 variant. T19R and D950N mutations in the spike protein were found in one cluster of mutations that did not include E484Q. Another mutation, D111D, was found in the cluster with the RBD mutations L452R and E484Q, but not without the E484Q mutation. Since February 2021, the frequency of non-synonymous mutations (those that change protein sequences) has increased, according to the analysis.

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Why is a mutant strain dangerous and necessitates careful surveillance?

These variants could be more contagious, cause more serious diseases, or evade vaccines. The following are some of the potential consequences of emerging variants, according to the CDC:

  • Transmissibility (Can spread more quickly in humans): One virus mutation, D614G, confers a greater ability to spread in humans than SARS-CoV-2. In the laboratory, 614G variants proliferate faster in human respiratory epithelial cells than 614D viruses. There's also evidence that the 614G variant spreads faster than viruses that don't have the mutation.
  • Severity (can cause people to have a milder or more severe disease): According to experts in the United Kingdom, the B.1.1.7 variant may be linked to a higher risk of death than other variants. B.1.618 is a new SARS-CoV-2 lineage distinguished by a distinct set of genetic variants, including E484K, a major immune escape variant.
  • Detection by specific viral diagnostic tests is not possible: Most commercial reverse-transcription polymerase chain reaction (RT-PCR)-based tests have multiple targets for detecting the virus, so even if one of the targets is affected by a mutation, the remaining RT-PCR targets will still work.
  • Implications for vaccination: These strains can get around the immunity that immunizations are supposed to provide. SARS-CoV-2 causes a polyclonal response that targets several parts of the spike protein in both vaccination and natural infection. To evade immunity induced by vaccines or natural infection, the virus would most likely need to accumulate multiple mutations in the spike protein.
  • Susceptibility: It can be susceptible to therapeutic agents like monoclonal antibodies.

What makes this variant unique?

It's actually not that different. There are a few notable mutations in this strain that have already been identified in other variants. One of them is E484K, which is referred to as a "major immune escape variant." It means that those mutations have evolved in order to evade antibodies formed as a result of natural infection with previous strains. This variant appears to be gaining traction at a time when these factors are increasing. Although the variant is thought to be more contagious than the original SARS-CoV-2 virus, there is no evidence that it causes more severe diseases or deaths. Experts say that the same public health measures that can prevent the spread of the virus variant — masks and social distancing — can also prevent the spread of the virus variant. While it may have an effect on vaccines, research suggests that its mutations are unlikely to be enough to compromise protection against serious illness.

As the virus changes, it is highly likely that down the road we may need to get a booster, just as we do with flu vaccines. The good news is that modern technology makes changing vaccines simple and quick.

How can PatientMD help you in this pandemic situation?

At PatientMD, we can connect you with an array of board-certified physicians to help and empower you with information; assist you to deal with fear or confusion while you sort through the conflicting information in these times. We are dedicated to being your dependable and invaluable source of COVID-19 information. Our mobile platform gives patients access to and control over their clinical data, laying the groundwork for healthcare transformation. We want to provide patients with digital tools that allow them to get the most cost-effective healthcare from their doctors and other healthcare providers.

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