Outcomes of laboratory-confirmed SARS-CoV-2 infection during resurgence driven by Omicron lineages BA.4 and BA.5 compared with previous waves in the Western Cape Province, South Africa

Davies, Mary‐Ann; Morden, Erna; Rosseau, Petro; Arendse, Juanita; Bam, Jamy-Lee; Boloko, Linda; Cloete, Keith; Cohen, Cheryl; Chetty, Nicole; Dane, Pierre; Heekes, Alexa; Hsiao, Nei-yuan; Hunter, Mehreen; Hussey, Hannah; Jacobs, Theuns; Jassat, Waasila; Kariem, Saadiq; Kassanjee, Reshma; Laenen, Inneke; Roux, Sue Le; Lessells, Richard; Mahomed, Hassan; Maughan, Deborah; Meintjes, Graeme; Mendelson, Marc; Mnguni, Ayanda Trevor; Moodley, Melvin; Murie, Katy; Naudé, Jonathan; Ntusi, Ntobeko; Paleker, Masudah; Parker, Arifa; Pienaar, David; Preiser, Wolfgang; Prozesky, Hans; Raubenheimer, Peter; Rossouw, Laura; Schrueder, Neshaad; Smith, Barry; Smith, Melissa; Solomon, Wesley; Symons, Greg; Taljaard, Jantjie; Wasserman, Sean; Wilkinson, Robert J.; Wolmarans, Milani; Wolter, Nicole; Boulle, Andrew

doi:10.1016/j.ijid.2022.11.024

Cited by 45 publications

(28 citation statements)

References 23 publications

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“…Also, Omicron waves showed a reduced risk of hospitalization and death than earlier waves. In this case, mass vaccination and prior infections were protective against developing severe COVID‐19 symptoms 24 . Outside South Africa, the COVID‐19 vaccination rate is very high in Portugal.…”

Section: Antibody Escaping By New Variants and Impact On Public Healthmentioning

confidence: 70%

“…In this case, mass vaccination and prior infections were protective against developing severe COVID-19 symptoms. 24 Outside South Africa, the COVID-19 vaccination rate is very high in Portugal. However, the hospitalization and death rates associated with BA.4 and BA.5 subvariants are similar to their first Omicron wave.…”

Section: Antibody Escaping By New Variants and Impact On Public Healthmentioning

confidence: 99%

“…Epidemiologic studies suggest that consecutive COVID-19 waves are converting to milder. 24 However, viruses do not automatically change to become less lethal. [26][27][28][29] Therefore, healthcare authorities across the globe need to be more careful about viral mutations and their impact on human health.…”

Section: Antibody Escaping By New Variants and Impact On Public Healthmentioning

confidence: 99%

“…Therefore, all countries will not face similar prevalence and disease burden due to Omicron BA.4 and BA.5 subvariants. Epidemiologic studies suggest that consecutive COVID‐19 waves are converting to milder 24 . However, viruses do not automatically change to become less lethal 26–29 .…”

Section: Antibody Escaping By New Variants and Impact On Public Healthmentioning

confidence: 99%

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The latest Omicron BA.4 and BA.5 lineages are frowning toward COVID‐19 preventive measures: A threat to global public health

Islam

Shahriar

Bhuiyan

2022

Health Science Reports

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BACKGROUND A cluster of pneumonia cases was reported by the Wuhan Municipal Health Commission, China, Hubei Province, resulting in the identification of a novel coronavirus (SARS-CoV-2). 1 As of September 19, 2022, more than 609 million cases and 6.5 million deaths have been recorded worldwide. The highest number of COVID-19 cases have been recorded in Europe, followed by the Americas, Western Pacific, South-East Asia, Eastern Mediterranean, and Africa regions. 2 As a country, the US contributed the highest number of COVID-19 cases and deaths. 2 SARS-CoV-2 is constantly mutating and dodging antibodies to infect more people. Epidemiologists in South Africa detected the fifth and the latest "variant of concern" (VOC) of SARS-CoV-2. They reported this new variant to the World Health Organization (WHO) on November 24, 2021. This fifth VOC of SARS-CoV-2 contains more than 30 mutations in its viral spike proteins to allow it more transmissibility and infection rates. 1 The WHO named this fifth VOC of SARS-CoV-2 as the Omicron variant (B.1.1.529) on November 26, 2021. 2 Omicron became the leading variant in COVID-19 after its inception. At present, Omicron is the only circulating VOC. Initially, Omicron had three subvariants (e.g., BA.1, BA.2, and BA.3). BA.1 was predominant during the fourth wave of the pandemic in South Africa. However, the global pattern was inconsistent in some other countries. BA.2 variant was responsible for hospitalizations and deaths in most cases during the Omicron wave in South Africa. 3 Currently, the Omicron variant includes five lineages and some other descendant subvariants. 4 Omicron subvariants that have rapidly spread across the globe. 5,6 Initially, BA.1 and BA.2 were predominant Omicron subvariant worldwide. However, BA.4 and BA.5 variants are now leading in Europe and the United States. 7 The WHO classified BA.4, BA.5, BA.2.12.1, and BA.2.75 as VOC-subvariants under monitoring. 4 The European Centre for Disease Prevention and Control categorized BA.4 and BA.5 as VOC from VOI on May 12, 2022. 8 Therefore, we recommend prioritized monitoring of epidemiology of the COVID-19 pandemic due to Omicron BA.4 and BA.5 subvariants. This article aims to present an update on Omicron BA.4 and BA.5 subvariants of SARS-CoV-2 and their potential impact on global public health. Scientists detected the BA.4 and BA.5 variants from a sample collected from South Africa in early 2022. 9 BA.4 and BA.5 have similarities with parent variants based on their genotype and phenotype as both are subvariants of Omicron. These subvariants have all mutations that Omicron had. The spike proteins of the latest Omicron BA.4 and BA.5 subvariants are identical and more similar to BA.2 than BA.1. 10 The Omicron BA.4 and BA.5 subvariants fueled a surge of cases in South Africa in the spring despite having widespread pre-existing immunity to the virus. The COVID-19 wave due to BA.4 and BA.5 subvariants was not as high as earlier waves, and deaths did not rise as sharply in South

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Section: Antibody Escaping By New Variants and Impact On Public Healthmentioning

confidence: 70%

Section: Antibody Escaping By New Variants and Impact On Public Healthmentioning

confidence: 99%

Section: Antibody Escaping By New Variants and Impact On Public Healthmentioning

confidence: 99%

Section: Antibody Escaping By New Variants and Impact On Public Healthmentioning

confidence: 99%

See 2 more Smart Citations

The latest Omicron BA.4 and BA.5 lineages are frowning toward COVID‐19 preventive measures: A threat to global public health

Islam

Shahriar

Bhuiyan

2022

Health Science Reports

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“…9 Consistent with this finding, risk of hospital admission during the BA.4/BA.5 and BA.1 waves in South Africa did not differ within analyses of all diagnosed cases. 23 Whereas a populationbased study in Denmark suggested moderately increased risk of hospital admission among BA.5 cases as compared to BA.2 cases, 21 this analysis did not include adjustment for potentially relevant confounders including individuals' healthcare-seeking behavior and calendar time. Our analyses sought to adjust for these variables based on the observed association of prior vaccination or infection with heightened risk of BA.4/BA.5 breakthrough infection, and because patient and provider demand for clinical SARS-CoV-2 testing changed markedly over the course of the BA.2 and BA.4/BA.5 waves, as public health mitigation measures were relaxed and access to home antigen testing expanded.…”

Section: Discussionmentioning

confidence: 99%

Association of SARS-CoV-2 BA.4/BA.5 Omicron lineages with immune escape and clinical outcome

Lewnard¹,

Hong²,

Tartof³

2022

Preprint

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Expansion of the SARS-CoV-2 BA.4/BA.5 Omicron lineages in populations with prevalent immunity from prior infection and vaccination has raised concerns about the association of these lineages with immune escape. Here we show that COVID-19 vaccination and documented prior infection are associated with reduced protection against infection with BA.4/BA.5. Compared to time-matched BA.2 cases, BA.4/BA.5 cases had 9% (95% confidence interval: 2-17%) and 27% (15-41%) higher adjusted odds of having received 3 and 4 COVID-19 vaccine doses, respectively, and 55% (39-71%) higher adjusted odds of documented infection ≥90 days previously. However, BA.4/BA.5 infection was not associated with differential risk of emergency department presentation, hospital admission, or intensive care unit admission following an initial outpatient diagnosis. This finding held after correcting for potential exposure misclassification resulting from unascertained prior infections. Despite increased risk of BA.4/BA.5 breakthrough infection observed among previously vaccinated or infected individuals, the reduced severity associated with prior (BA.1 and BA.2) Omicron lineages has persisted with BA.4/BA.5.

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Clinical characteristics of COVID‐19 patients infected by the Omicron variants in Macao, China: A cross‐sectional study

Cheong,

Sio,

Chan

et al. 2023

Health Science Reports

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Background and Aims: The evolving mutants of SARS-CoV-2 have made the COVID-19 pandemic sustained for over 3 years. In 2022, BA.4 and BA.5 were the Omicron variants dominating the spread globally. Although COVID-19 was no longer a Public Health Emergency of International Concern (PHEIC) as announced by WHO, the SARS-CoV-2 variants remain a challenge to global healthcare under the circumstances of withdrawal and loosening of personal protective behavior in the post-quarantine era. This study aims to acknowledge the clinical characteristics caused by Omicron BA.4/BA.5 in COVID-19 naive people and analyze possible factors affecting disease severities. Methods: In this retrospective study, we report and analyze the clinical features of 1820 COVID-19 patients infected with the BA.4/BA.5 Omicron variants of SARS-CoV-2 during a local outbreak that occurred in Macao SAR, China, from June to July 2022.Results: A total of 83.5% of patients were symptomatic eventually. The most common symptoms were fever, cough, and sore throat. Hypertension, dyslipidemia, and diabetes mellitus were the leading comorbidities. There were significantly more elderly patients (p < 0.001), more patients with comorbidity (p < 0.001) and more patients without vaccination or not completing the series (p < 0.001) in the "Severe to Critical" group. All deceased patients were elderly with at least three comorbidities and were partial to totally dependent in their daily lives. Conclusion:Our data are consistent with a milder disease caused by BA.4/5 Omicron variants in the general population, while patients with old age and comorbidities have developed severe to critical diseases. Complete vaccination series and booster doses are effective strategies to reinforce protection against severe diseases and avoid mortality.

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Outcomes of laboratory-confirmed SARS-CoV-2 infection during resurgence driven by Omicron lineages BA.4 and BA.5 compared with previous waves in the Western Cape Province, South Africa

Cited by 45 publications

References 23 publications

The latest Omicron BA.4 and BA.5 lineages are frowning toward COVID‐19 preventive measures: A threat to global public health

The latest Omicron BA.4 and BA.5 lineages are frowning toward COVID‐19 preventive measures: A threat to global public health

Association of SARS-CoV-2 BA.4/BA.5 Omicron lineages with immune escape and clinical outcome

Clinical characteristics of COVID‐19 patients infected by the Omicron variants in Macao, China: A cross‐sectional study

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