Wednesday, September 20, 2023

Eris (E.G5) –The Current Variant of Interest

The new SARS-CoV-2 subvariant EG.5, also called Eris, is responsible for the increase in COVID-19 infections and is currently causing concern. The Centers for Disease Control and Prevention (CDC) estimates that about 24.5% of the total number of cases in the United States reported from Feb 2023 up until September 2023 are due to EG.5. Researchers are trying to update the COVID-19 vaccines to target the new variants. TrialSite previously reported on the World Health Organization’s (WHO) concerns about this strain.

Eris is a sub-variant of the Omicron variant. The first case of EG.5 was reported on Feb 17, 2023. Similar to other variants, it shows symptoms like fever, nausea, headache, sore throat, etc. It also demonstrates high transmissibility, which is concerning for researchers. Additionally, the variant can evade the immune response generated by antibodies that were developed either by vaccination or previous infection with other variants.

How concerning is this new variant?

EG.5 has one mutation in its spike protein that makes it different from the Omicron variant. This genetic change helps it to escape the immune response, which makes it more contagious. The World Health Organization (WHO) has declared it a “variant of interest” which means there is a need to focus on it because its transmissibility may cause a rapid increase in hospitalization.

Stanley Martin, MD., the Director of Infectious Diseases at Geisinger Medical Centre said that there is no need to worry about this variant unless you are above 65 or immunocompromised. However, you should be aware of this variant and take precautionary measures if you live around immunocompromised or elderly people because there is a risk of passing this variant on to them.

Dr. Brett Osborn, a board-certified neurosurgeon, said that in most cases, it is a self-limiting variant, so there is nothing to be concerned about.

Will the updated vaccine protect against EG.5?

There is currently no specific vaccine against EG.5; however, an updated version of the COVID-19 vaccine is expected to be released in September 2023. The vaccine manufacturing companies Pfizer/BioNTech, Moderna and Novavax are creating COVID-19 booster vaccines that will target XBB.1.5 (a subvariant of Omicron), but they expect that this booster will also provide some level of protection against EG.5 because they are closely related strains. The U.S. Food and Drug Administration (FDA) has recommended these booster vaccines and explained that they will continue to monitor the safety and effectiveness of COVID-19 vaccines. Anyone above the age of two is eligible for this booster vaccine.

Moderna’s clinical trials have confirmed that the booster vaccine will effectively target EG.5 and FL.1.5.1 (another subvariant of Omicron). The antiviral medicine, Paxlovid, also provides protection and works well against EG.5.

Experts' opinions on COVID-19 variants and vaccines
Osborn said that SARS-CoV-2 and its variants are here to stay, and we have to live with them because their mutation rate is high, like the influenza virus. Mostly, RNA viruses (those containing RNA as genetic material) become less harmful with time and pose less threat to lives, but there is also a chance that one of the strains will become virulent, which may lead to an increase in the death rate.

Scott Roberts, MD, an infectious diseases specialist, said that the vaccine takes about three months to provide high efficacy. The people who get vaccinated immediately after the vaccine release in September will have the maximum protection in the upcoming year.

Updated vaccine or booster shot?

The FDA and other health authorities have shifted in language from “booster” to “updated COVID-19 vaccine” because the booster only reinforces the immunity obtained from the previous vaccines, while the updated COVID-19 vaccine is designed to induce a new immune response against the existing variants. The term “updated COVID-19 vaccine” helps to normalize the idea of getting the COVID-19 vaccine on a regular basis, just like annual flu shots.

Bottom line

The current death rate associated with the Eris variant appears low. On the other hand, since many medical experts are warning the public about its high contagiousness, preventive measures such as mask-wearing, handwashing and maintaining appropriate distance remain important.

Current evidence suggests that updated COVID-19 booster shots can be an effective tool for prevention, especially for high-risk people such as the elderly or those suffering from severe health conditions. Still, vaccine hesitancy might affect the vaccination rates. This emphasizes the importance of transparent sharing of information with the public about COVID-19 vaccines.


Viral RNA Can Persist for 2 Years After COVID-19: Preprint Study

A new study may explain why some people who get COVID-19 never return to normal and instead experience new medical conditions like cardiovascular disease, clotting dysfunction, activation of latent viruses, diabetes mellitus, or what’s known as “long COVID” after SARS-CoV-2 infection.

In a recent preprint study published on medRxiv, researchers conducted the first positron emission tomography (PET) imaging study of T cell activation in individuals who previously recovered from COVID-19 and found that SARS-CoV-2 infection may result in persistent T cell activation in a variety of body tissues for years following initial symptoms.
Even in clinically mild cases of COVID-19, this phenomenon could explain the systemic changes observed in the immune system and in those with long COVID symptoms.

However, most of the participants were vaccinated and the study didn't investigate the link between the existence of viral RNA and vaccination.

To carry out the study, researchers conducted whole-body PET scans of 24 participants who were previously infected with SARS-CoV-2 and recovered from acute infection at time points ranging from 27 to 910 days following COVID-19 symptom onset.
A PET scan is an imaging test that uses a radioactive drug called a tracer to assess the metabolic or biochemical function of tissues and organs and can reveal both normal and abnormal metabolic activity. The tracer is usually injected into the hand or vein in the arm and collects in areas of the body with higher levels of metabolic or biochemical activity, which can reveal the location of the disease.

Using a novel radiopharmaceutical agent that detects specific molecules associated with a type of white blood cell called T lymphocytes, researchers found uptake of the tracer was significantly higher in post-acute COVID-19 participants compared to pre-pandemic controls in the brain stem, spinal cord, bone marrow, nasopharyngeal and hilar lymphoid tissue, cardiopulmonary tissues, and gut wall. Among males and females, male participants tended to have higher uptake in the pharyngeal tonsils, rectal wall, and hilar lymphoid tissue compared to female participants.

Researchers specifically identified cellular SARS-CoV-2 RNA in the gut tissue of all participants with long COVID symptoms who underwent biopsy—in the absence of reinfection—ranging from 158 to 676 days following initial COVID-19 illness, suggesting that tissue viral persistence could be associated with long-term immunological concerns. Although the uptake of the tracer in some tissues appeared to decline with time, the levels still remained elevated compared to the control group of healthy pre-pandemic volunteers.

"These data significantly extend prior observations of a durable and dysfunctional cellular immune response to SARS-CoV-2 and suggest that SARS-CoV-2 infection could result in a new immunologic steady state in the years following COVID-19," the researchers wrote.

To determine the association between T cell activation and long COVID symptoms, researchers compared post-acute COVID-19 participants with and without long COVID symptoms at the time of PET imaging. Those with long COVID symptoms reported a median of 5.5 symptoms at the time of imaging. Findings showed a “modestly higher uptake” of the agent in the spinal cord, hilar lymph nodes, and colon/rectal wall in those with long COVID symptoms.

In participants with long COVID who reported five or more symptoms at the time of imaging, researchers observed higher levels of inflammatory markers, “including proteins involved in immune responses, chemokine signaling, inflammation responses, and nervous system development.” Compared to both pre-pandemic controls and those participants who had COVID-19 and completely recovered, people with long COVID showed higher T cell activation in the spinal cord and gut wall.

All But 1 Participant Was Vaccinated

Researchers attribute their findings to SARS-CoV-2 infection, although all but one participant had received at least one COVID-19 vaccination prior to PET imaging.

To minimize the impact of vaccination on T cell activation, PET imaging was performed more than 60 days from any vaccine dose, except for the one participant who received a booster vaccine dose six days prior to imaging. Others who had received a COVID-19 vaccine within four weeks of imaging were excluded.

Researchers also grouped participants by receipt of a COVID-19 dose greater than or less than 180 days prior to PET imaging.

The researchers said their study had several other limitations, including small sample size, limited correlative studies, evolving variants, rapid and inconsistent rollout of COVID-19 vaccines, which required them to shift their imaging protocols, using pre-pandemic individuals as controls, and the extreme difficulty of finding people who had never been infected with SARS-CoV-2.

"In summary, our results provide provocative evidence of long-term immune system activation in several specific tissues following SARS-CoV-2 infection, including in those experiencing Long COVID symptoms," the researchers concluded. "We identified that SARS-CoV-2 persistence is one potential driver of this ongoing activated immune state, and we show that SARS-CoV-2 RNA may persist in gut tissue for nearly 2 years after the initial infection."


CDC Director Responds to COVID-19 Mask Mandate Speculation

The director of the U.S. Centers for Disease Control and Prevention (CDC) responded to speculation that COVID-19-related mask mandates or lockdowns could return, coming after the agency recommended new vaccine boosters for nearly all Americans.

CDC Director Mandy Cohen was asked on Sept. 12 whether she feels confident that there won't be widespread lockdowns, school closures, and a reversion to mask mandates.

"Right now, we have all the tools we need to keep this virus at bay if we use the vaccines and we use testing and treatment," Ms. Cohen told WCNC, a Charlotte, North Carolina, TV station.

"What I see is I don’t see any need for mandates or those kinds of things right now. But we have to keep watching this virus, seeing how it changes, and if we need to make other recommendations, we will," the CDC head said.

Her comment comes as the CDC issued a recommendation that people should receive the updated COVID-19 booster shot that targets the XBB1.5 subvariant. The U.S. Food and Drug Administration similarly authorized and approved the new mRNA-based shots, made by Pfizer and Moderna.

Meanwhile, since mid-August, there has been widespread speculation that the CDC and other federal agencies may attempt to recommend or push lockdowns, vaccine mandates, or masking mandates because of a small upswing in COVID-19 cases across the United States. A small number of schools, colleges, hospitals, and private businesses have implemented masking mandates, sparking alarm among some GOP officials and candidates.

CDC Advisory Committee on Immunization Practices Meet on COVID-19 and Vaccines

Several weeks ago, meanwhile, the Transportation Security Administration told The Epoch Times that claims that the agency held discussions that it would be reimplementing mandates or lockdowns are incorrect. Meanwhile, a spokesman for the CDC told the Associated Press around the same time that reports of pending lockdowns are "utterly false."
When asked by The Epoch Times about discussions around a possible federal mask mandate recommendation, a spokesperson said late last month that COVID-19 hospital admission levels "are currently low for 96 percent" of the United States. A separate spokesperson told other outlets that there were no agency discussions about bringing mask mandates back, and no new masking guidelines have been issued on the CDC's website in recent days.




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