COVID-19 Variants of Concern

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] ; Associate Editor(s)-in-Chief: Mohamed Riad, M.D.[2]

Overview

As a result of mutations occurring in COVID-19 virus, new variants of COVID-19 emerge and most of them are being tracked in the United States. The "variants of concern" refer to those COVID-19 variants with clear evidence of an increased rate of transmission, severe illness and death, marked decrease in neutralization by antibodies produced as a result of previous infection or vaccination, decreased effectiveness of vaccines or treatments, or failure of diagnostic detection.

Variants of Concern

As in all viruses, COVID-19 virus continuously undergo spontaneous mutations followed by emergence of new variants of COVID-19. Some of these variants appear then disappear; however, others persist causing global pandemic. The best way to fight against the appearance of new variants is commitment to the protective measures.

The "variants of concern" refer to those COVID-19 variants with clear evidence of an increased rate of transmission, severe illness and death, marked decrease in neutralization by antibodies produced as a result of previous infection or vaccination, decreased effectiveness of vaccines or treatments, or failure of diagnostic detection. The genomic and epidemiological as well as other properties of these variants are summarized in the table below.

WHO Label Name Countries of Earlier Detection Time of First Detection Spike Protein Substitutions BEI Reference Isolate Properties Rate of Spread Severe Illness and Mortality Vaccine Treatments
Alpha B.1.1.7 20I/501Y.V1 United Kingdom September 2020 69del, 70del, 144del, (E484K*), (S494P*), N501Y, A570D, D614G, P681H, T716I, S982A, D1118H (K1191N*) NR-54000external icon
  • Approximately 50% increased transmissibility
  • Increased severity according to hospitalizations and case fatality rates
  • Little effect on neutralization by convalescent and post-vaccination sera
High Occur
  • Effective
  • Rarely, breakthrough infections in vaccinated individuals may occur
Effective
Beta B.1.357 20H/501.V2 South Africa September 2020 D80A, D215G, 241del, 242del, 243del, K417N, E484K, N501Y, D614G, A701V NR-55282
  • Approximately 50% increased transmissibility
  • A marked decrease in the susceptibility to the combination of bamlanivimab and etesevimab monoclonal antibody treatment; however, other EUA monoclonal antibody treatments are available
  • Decreased neutralization by convalescent and post-vaccination sera
High Not common
  • Effective
  • Rarely, breakthrough infections in vaccinated individuals may occur
Less effective
Gamma P.1 20J/501Y.V3 Brazil and Japan December 2020 L18F, T20N, P26S, D138Y, R190S, K417T, E484K, N501Y, D614G, H655Y, T1027I NR-54982
  • A marked decrease in the susceptibility to the combination of bamlanivimab and etesevimab monoclonal antibody treatment; however, other EUA monoclonal antibody treatments are available
  • Decreased neutralization by convalescent and post-vaccination sera
High Not common
  • Effective
  • Rarely, breakthrough infections in vaccinated individuals may occur
Less effective
Delta B.1.617.2 21A/S:478K India December 2020 T19R, (V70F*), T95I, G142D, E156-, F157-, R158G, (A222V*), (W258L*), (K417N*), L452R, T478K, D614G, P681R, D950N
  • Increased transmissibility
  • Decreased neutralization by some EUA monoclonal antibody treatments 
  • Significant decrease in neutralization by post-vaccination sera
Characterized by the highest rate of spread among these variants Characterized by higher rates of hospitalizations, severe illness, and death than other variants
  • Effective
  • Rarely, breakthrough infections in vaccinated individuals may occur
Less effective

BEI Resources: refer to the "Biodefense and Emerging Infections Research Resources" that is a NIAID-funded repository to provide reagents, tools, and information to the research community.

References