SARS-CoV-2 emerging Omicron subvariants with a special focus on BF.7 and XBB.1.5 recently posing fears of rising cases amid ongoing COVID-19 pandemic

Kuldeep Dhama; Deepak Chandran; Hitesh Chopra; Md. Aminul Islam; Talha Bin Emran; Mohammad Ebad Ur Rehman; Abhijit Dey; Ranjan K. Mohapatra; Praveen SV; Pran Mohankumar; Anil Kumar Sharma; Prosun Bhattacharya

doi:10.18006/2022.10(6).1215.1221

Authors

Kuldeep Dhama Division of Pathology, ICAR-Indian Veterinary Research Institute, Bareilly, Uttar Pradesh - 243122, India https://orcid.org/0000-0001-7469-4752
Deepak Chandran Department of Veterinary Sciences and Animal Husbandry, Amrita School of Agricultural Sciences, Amrita Vishwa Vidyapeetham University, Coimbatore, Tamil Nadu, India – 642109 https://orcid.org/0000-0002-9873-6969
Hitesh Chopra Chitkara College of Pharmacy, Chitkara University, Punjab, India-140401 https://orcid.org/0000-0001-8867-7603
Md. Aminul Islam COVID-19 Diagnostic Lab, Department of Microbiology, Noakhali Science and Technology University, Noakhali-3814, Bangladesh https://orcid.org/0000-0003-1091-9726
Talha Bin Emran Department of Pharmacy, BGC Trust University Bangladesh, Chittagong 4381, Bangladesh https://orcid.org/0000-0003-3188-2272
Mohammad Ebad Ur Rehman Department of Medicine, Rawalpindi Medical University, Rawalpindi - 46000, Pakistan https://orcid.org/0000-0001-8118-4849
Abhijit Dey Department of Life Sciences, Presidency University, 86/1 College Street, Kolkata-700073, West Bengal, India https://orcid.org/0000-0002-5750-0802
Ranjan K. Mohapatra Department of Chemistry, Government College of Engineering, Keonjhar – 758 002, Odisha, India https://orcid.org/0000-0001-7623-3343
Praveen SV National Institute of Technology, Tiruchirappalli – 620015, Tamil Nadu, India https://orcid.org/0000-0002-1450-8839
Pran Mohankumar School of Agricultural Sciences, Karunya Institute of Technology and Sciences, Coimbatore, Tamil Nadu, India - 641114. https://orcid.org/0000-0001-8952-7893
Anil Kumar Sharma Department of Biotechnology, Maharishi Markandeshwar University (Deemed to be University) Mullana-Ambala-133207, Haryana, India https://orcid.org/0000-0002-9768-1644
Prosun Bhattacharya COVID-19 Research, Department of Sustainable Development, Environmental Science and Engineering, KTH Royal Institute of Technology, Teknikringen 10B, SE 10044 Stockholm, Sweden https://orcid.org/0000-0003-4350-9950

DOI:

https://doi.org/10.18006/2022.10(6).1215.1221

Keywords:

SARS-CoV-2, COVID-19, Variants, Omicron subvariants, Pandemic, Rising cases, Mitigation strategies

Abstract

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Omicron versions have been the sole one circulating for quite some time. Subvariants BA.1, BA.2, BA.3, BA.4, and BA.5 of the Omicron emerged over time and through mutation, with BA.1 responsible for the most severe global pandemic between December 2021 and January 2022. Other Omicron subvariants such as BQ.1, BQ.1.1, BA.4.6, BF.7, BA.2.75.2, XBB.1 appeared recently and could cause a new wave of increased cases amid the ongoing COVID-19 pandemic. There is evidence that certain Omicron subvariants have increased transmissibility, extra spike mutations, and ability to overcome protective effects of COVID-19 neutralizing antibodies through immunological evasion. In recent months, the Omicron BF.7 subvariant has been in the news due to its spread in China and a small number of other countries, raising concerns about a possible rebound in COVID-19 cases. More recently, the Omicron XBB.1.5 subvariant has captured international attention due to an increase in cases in the United States. As a highly transmissible sublineage of Omicron BA.5, as well as having a shorter incubation time and the potential to reinfect or infect immune population, BF.7 has stronger infection ability. It appears that the regional immunological landscape is affected by the amount and timing of previous Omicron waves, as well as the COVID-19 vaccination coverage, which in turn determines whether the increased immune escape of BF.7 and XBB.1.5 subvariants is sufficient to drive new infection waves. Expanding our understanding of the transmission and efficacy of vaccines, immunotherapeutics, and antiviral drugs against newly emerging Omicron subvariants and lineages, as well as bolstering genomic facilities for tracking their spread and maintaining a constant vigilance, and shedding more light on their evolution and mutational events, would help in the development of effective mitigation strategies. Importantly, reducing the occurrence of mutations and recombination in the virus can be aided by bolstering One health approach and emphasizing its significance in combating zoonosis and reversal zoonosis linked with COVID-19. This article provides a brief overview on Omicron variant, its recently emerging lineages and subvairants with a special focus on BF.7 and XBB.1.5 as much more infectious and highly transmissible variations that may once again threaten a sharp increase in COVID-19 cases globally amid the currently ongoing pandemic, along with presenting salient mitigation measures.

References

Ai, J., Wang, X., He, X., Zhao, X., et al. (2022). Antibody evasion of SARS-CoV-2 Omicron BA.1, BA.1.1, BA.2, and BA.3 sub-lineages. Cell Host Microbe, 30(8):1077-1083.e4. doi: 10.1016/j.chom.2022.05.001. DOI: https://doi.org/10.1016/j.chom.2022.05.001

Akkız, H. (2022). The biological functions and clinical significance of SARS-CoV-2 variants of concern. Frontiers in Medicine (Lausanne), 9, 849217. doi: 10.3389/fmed.2022.849217. DOI: https://doi.org/10.3389/fmed.2022.849217

Aleem, A., Akbar Samad, A.B., & Slenker, A.K. (2022). Emerging variants of SARS-CoV-2 and novel therapeutics against coronavirus (COVID-19). In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing.

Arora, P., Zhang, L., Nehlmeier, I., Kempf, A., et al. (2022). The effect of cilgavimab and neutralisation by vaccine-induced antibodies in emerging SARS-CoV-2 BA.4 and BA.5 sublineages. Lancet Infectious Diseases, 22(12):1665-1666. doi: 10.1016/S1473-3099(22)00693-4. DOI: https://doi.org/10.1016/S1473-3099(22)00693-4

Balint, G., Voros-Horvath, B., & Szechenyi, A. (2022). Omicron: increased transmissibility and decreased pathogenicity. Signal Transduction and Target Therapeutics, 7(1), 151. DOI: https://doi.org/10.1038/s41392-022-01009-8

Björk, J., Bonander, C., Moghaddassi, M., Rasmussen, M., Malmqvist, U., Inghammar, M., & Kahn, F. (2022). COVID-19 vaccine effectiveness against severe disease from SARS-CoV-2 Omicron BA.1 and BA.2 subvariants – surveillance results from southern Sweden, December 2021 to March 2022. European Surveillance, 27(18), 2200322. doi: 10.2807/1560-7917.ES.2022.27.18.2200322. DOI: https://doi.org/10.2807/1560-7917.ES.2022.27.18.2200322

Chakraborty, C., Bhattacharya, M., Sharma, A.R., Dhama, K., & Lee, S.S. (2022). The rapid emergence of multiple sublineages of Omicron (B.1.1.529) variant: Dynamic profiling via molecular phylogenetics and mutational landscape studies. Journal of Infection and Public Health, 15(11), 1234-1258. doi: 10.1016/j.jiph.2022.10.004. DOI: https://doi.org/10.1016/j.jiph.2022.10.004

Chen, J., Wang, R., Gilby, N.B., & Wei, G.W. (2022). Omicron Variant (B.1.1.529): Infectivity, vaccine breakthrough, and antibody resistance. Journal of Chemistry and Infection Modelling, 24, 62(2):412-422. Doi: 10.1021/acs.jcim.1c01451. DOI: https://doi.org/10.1021/acs.jcim.1c01451

CNBC. (2023b). https://www.cnbc.com/2022/12/14/covid-news-bq-xbb-omicron-subvariants-pose-serious-threat-to-boosters.html

CNBC. (2023a). https://www.cnbc.com/2023/01/04/xbbpoint1 point5-omicron-subvariant-is-the-most-transmissible-version-of-covid-yet-who-says.html

CNN. (2023). https://edition.cnn.com/2023/01/04/health/public-health-concerned-xbb/index.html

Cui, Z., Liu, P., Wang, N., Wang, L., et al. (2022). Structural and functional characterizations of infectivity and immune evasion of SARS-CoV-2 Omicron. Cells, 185(5), 860-871.e13. doi: 10.1016/j.cell.2022.01.019. DOI: https://doi.org/10.1016/j.cell.2022.01.019

Dhama, K., Khan, S., Tiwari, R., Sircar, S., et al. (2020). Coronavirus disease 2019-COVID-19. Clinical Microbiology Reviews, 33(4), e00028-20. doi: 10.1128/CMR.00028-20. DOI: https://doi.org/10.1128/CMR.00028-20

Dhama, K., Nainu, F., Frediansyah, A., Yatoo, M.I., et al. (2023). Global emerging Omicron variant of SARS-CoV-2: Impacts, challenges and strategies. Journal of Infection and Public Health, 16(1), 4-14. doi: 10.1016/j.jiph.2022.11.024. DOI: https://doi.org/10.1016/j.jiph.2022.11.024

Du, P., Gao, G.F., & Wang, Q. (2022). The mysterious origins of the Omicron variant of SARS-CoV-2. Innovation (Cambridge), 3(2), 100206. doi: 10.1016/j.xinn.2022.100206. DOI: https://doi.org/10.1016/j.xinn.2022.100206

Elliott, P., Eales, O., Steyn, N., Tang, D., et al. (2022) Twin peaks: The Omicron SARS-CoV-2 BA.1 and BA.2 epidemics in England. Science, 376(6600), eabq4411. doi: 10.1126/science.abq4411. DOI: https://doi.org/10.1126/science.abq4411

Evans, J.P., Zeng, C., Qu, P., Faraone, J., et al. (2022). Neutralization of SARS-CoV-2 Omicron sub-lineages BA.1, BA.1.1, and BA.2. Cell Host Microbe, 30(8), 1093-1102.e3. doi: 10.1016/j.chom.2022.04.014. DOI: https://doi.org/10.1016/j.chom.2022.04.014

Farahat, R.A., Baklola, M., & Umar, T.P. (2022). Omicron B.1.1.529 subvariant: Brief evidence and future prospects. Annals in Medicine and Surgery (London), 83, 104808. doi: 10.1016/j.amsu.2022.104808. DOI: https://doi.org/10.1016/j.amsu.2022.104808

Fernandes, Q., Inchakalody, V.P., Merhi, M., Mestiri, S., et al. (2022). Emerging COVID-19 variants and their impact on SARS-CoV-2 diagnosis, therapeutics and vaccines. Annals in Medicine, 54(1), 524-540. doi: 10.1080/07853890.2022.2031274. DOI: https://doi.org/10.1080/07853890.2022.2031274

Ferré, V.M., Peiffer-Smadja, N., Visseaux, B., Descamps, D., Ghosn, J., & Charpentier, C. (2022). Omicron SARS-CoV-2 variant: What we know and what we don’t. Anesthesia, Critical Care and Pain Medicine. 41(1), 100998. doi: 10.1016/j.accpm.2021.100998. DOI: https://doi.org/10.1016/j.accpm.2021.100998

Forbes. (2023). https://www.forbes.com/sites/ariannajohnson/ 2023/01/04/omicron-subvariant-xbb15-the-dominant-covid-strain-in-the-us-surges-in-major-metro-areas-with-slightly-different-symptoms/?sh=7d2c58a0af2c

Graham F. (2022). Daily briefing: China's COVID wave could kill one million people. Nature, 10.1038/d41586-022-04541-3. Advance online publication. https://doi.org/10.1038/d41586-022-04541-3. DOI: https://doi.org/10.1038/d41586-022-04541-3

Hachmann, N.P., Miller, J., Collier, A.Y., & Barouch, D.H. (2022). Neutralization escape by SARS-CoV-2 Omicron Subvariant BA.4.6. New England Journal of Medicine, 17, 387(20), 1904-1906. doi: 10.1056/NEJMc2212117. DOI: https://doi.org/10.1056/NEJMc2212117

Hanai, T. (2022). Further quantitative in silico analysis of SARS-CoV-2 S-RBD Omicron BA.4, BA.5, BA.2.75, BQ.1, and BQ.1.1 transmissibility. Talanta, 254, 124127. doi: 10.1016/j.talanta.2022.124127. DOI: https://doi.org/10.1016/j.talanta.2022.124127

Hossain, A., Akter, S., Rashid, A.A., Khair, S., & Alam, A.S.M.R.U. (2022). Unique mutations in SARS-CoV-2 Omicron subvariants’ non-spike proteins: Potential impacts on viral pathogenesis and host immune evasion. Microbial Pathogenesis, 170, 105699. doi: 10.1016/j.micpath.2022.105699. DOI: https://doi.org/10.1016/j.micpath.2022.105699

Imai, M., Ito, M., Kiso, M., Yamayoshi, S., et al. (2022). Efficacy of antiviral agents against Omicron subvariants BQ.1.1 and XBB. New England Journal of Medicine, 7, NEJMc2214302. doi: 10.1056/NEJMc2214302. DOI: https://doi.org/10.1056/NEJMc2214302

Kandeel, M., Mohamed, M.E.M., Abd El-Lateef, H.M., Venugopala, K.N., & El-Beltagi, H.S. (2022). Omicron variant genome evolution and phylogenetics. Journal of Medical Virology, 94(4), 1627-1632. doi: 10.1002/jmv.27515. DOI: https://doi.org/10.1002/jmv.27515

Kannan, S., Shaik Syed, A.P, & Sheeza, A. (2021). Omicron (B.1.1.529) – variant of concern – molecular profile and epidemiology: a mini review. European Reviews in Medical and Pharmacological Science, 25(24), 8019-8022. doi: 10.26355/eurrev_202112_27653.

Ke, H., Chang, M.R., & Marasco, W.A. (2022). Immune Evasion of SARS-CoV-2 Omicron Subvariants. Vaccines (Basel), 10(9), 1545. doi: 10.3390/vaccines10091545. DOI: https://doi.org/10.3390/vaccines10091545

Khandia, R., Singhal, S., Alqahtani, T., Kamal, M.A., et al. (2022). Emergence of SARS-CoV-2 Omicron (B.1.1.529) variant, salient features, high global health concerns and strategies to counter it amid ongoing COVID-19 pandemic. Environmental Research, 209, 112816. doi: 10.1016/j.envres.2022.112816. DOI: https://doi.org/10.1016/j.envres.2022.112816

Kopsidas, I., Karagiannidou, S., Kostaki, E.G., Kousi, D., et al. (2022). Global distribution, dispersal patterns, and trend of several Omicron subvariants of SARS-CoV-2 across the globe. Tropical Medicine and Infectious Diseases, 7(11), 373. doi: 10.3390/tropicalmed7110373. DOI: https://doi.org/10.3390/tropicalmed7110373

Kurhade, C., Zou, J., Xia, H., Liu, M., et al. (2022). Low neutralization of SARS-CoV-2 Omicron BA.2.75.2, BQ.1.1, and XBB.1 by parental mRNA vaccine or a BA.5-bivalent booster. Natural Medicine. doi: 10.1038/s41591-022-02162-x. DOI: https://doi.org/10.1038/s41591-022-02162-x

Livemint. (2023). https://www.livemint.com/science/health/ omicrons-xbb-1-5-sub-variant-explained-should-india-be-worried-of-this-strain-11672789266832.html

Mohapatra, R.K., El-Shall, N.A., Tiwari, R., Nainu, F., et al. (2022c). Need of booster vaccine doses to counteract the emergence of SARS-CoV-2 variants in the context of the Omicron variant and increasing COVID-19 cases: An update. Human Vaccines and Immunotherapeutics, 18(5), 2065824. doi: 10.1080/21645515.2022.2065824. DOI: https://doi.org/10.1080/21645515.2022.2065824

Mohapatra, R.K., Kandi, V., Sarangi, A.K., Verma, S., et al. (2022a). The recently emerged BA.4 and BA.5 lineages of Omicron and their global health concerns amid the ongoing wave of COVID-19 pandemic – Correspondence. International Journal of Surgery, 103, 106698. doi: 10.1016/j.ijsu.2022.106698. DOI: https://doi.org/10.1016/j.ijsu.2022.106698

Mohapatra, R.K., Tiwari, R., Sarangi, A.K., Sharma, S.K., Khandia, R., Saikumar, G., & Dhama, K. (2022b). Twin combination of Omicron and Delta variants triggering a tsunami wave of ever high surges in COVID-19 cases: A challenging global threat with a special focus on the Indian subcontinent. Journal of Medical Virology, 94(5), 1761-1765. doi: 10.1002/jmv.27585. DOI: https://doi.org/10.1002/jmv.27585

News18. (2022). https://www.news18.com/news/explainers/what-is-bf7-covid-omicron-variant-china-india-coronavirus-explained-6668959.html. (Accessed on 23 December, 2022).

Planas, D., Bruel, T., Staropoli, I., Guivel-Benhassine, F., et al. (2022). Resistance of Omicron subvariants BA.2.75.2, BA.4.6 and BQ.1.1 to neutralizing antibodies. bioRxiv, 21, 2022.11.17.516888. doi: 10.1101/2022.11.17.516888. DOI: https://doi.org/10.1101/2022.11.17.516888

Qu, P., Evans, J.P., Faraone, J.N., Zheng, Y.M., et al. (2022). Enhanced neutralization resistance of SARS-CoV-2 Omicron subvariants BQ.1, BQ.1.1, BA.4.6, BF.7, and BA.2.75.2. Cell Host Microbe, 2S1931-3128(22)00568-6. doi: 10.1016/ j.chom.2022.11.012 DOI: https://doi.org/10.1016/j.chom.2022.11.012

Reynolds, C.J., Pade, C., Gibbons, J.M., Otter, A.D., et al. (2022). Immune boosting by B. 1.1. 529 (Omicron) depends on previous SARS-CoV-2 exposure. Science, 377(6603), eabq1841.

Sagar, V. (2022). What is BF.7, Covid Variant Spreading in China & Does India Need to Worry? Symptoms, Infection Rate EXPLAINED, in NEWS182022:

Saito, A., Tamura, T., Zahradnik, J., Deguchi, S., et al. (2022). Virological characteristics of the SARS-CoV-2 Omicron BA.2.75 variant. Cell Host Microbe, 30(11), 1540-1555.e15. doi: 10.1016/j.chom.2022.10.003. DOI: https://doi.org/10.1016/j.chom.2022.10.003

Thakur, V., & Ratho, R.K. (2022). OMICRON (B.1.1.529): A new SARS-CoV-2 variant of concern mounting worldwide fear. DOI: https://doi.org/10.1002/jmv.27541

Journal of Medical Virology, 94(5), 1821-1824. doi: 10.1002/jmv.27541.

Tian, D., Sun, Y., Xu, H., & Ye, Q. (2022). The emergence and epidemic characteristics of the highly mutated SARS-CoV-2 Omicron variant. Journal of Medical Virology, 94(6), 2376-2383. doi: 10.1002/jmv.27643. DOI: https://doi.org/10.1002/jmv.27643

Tuekprakhon, A., Nutalai, R., Dijokaite-Guraliuc, A., Zhou, D., et al. (2022). Antibody escape of SARS-CoV-2 Omicron BA.4 and BA.5 from vaccine and BA.1 serum. Cell, 185(14), 2422-2433.e13. doi: 10.1016/j.cell.2022.06.005. DOI: https://doi.org/10.1016/j.cell.2022.06.005

Uraki, R., Ito, M., Furusawa, Y., Yamayoshi, S., et al. (2022). Humoral immune evasion of the omicron subvariants BQ.1.1 and XBB. Lancet Infectious Diseases, 23(1), 30–32. doi: 10.1016/S1473-3099(22)00816-7. DOI: https://doi.org/10.1016/S1473-3099(22)00816-7

Wang, X.J., Yao, L., Zhang, H.Y., Zhu, K.L., et al. (2022). Neutralization sensitivity, fusogenicity, and infectivity of Omicron subvariants. Genome Medicine, 14(1), 146. doi: 10.1186/s13073-022-01151-6. DOI: https://doi.org/10.1186/s13073-022-01151-6

WFLA. (2023). https://www.wfla.com/hill-politics/white-house-cautions-against-panic-as-xbb-1-5-omicron-subvariant-spreads/.

WHO, Enhancing readiness for Omicron (B.1.1.529): technical brief and priority actions for member states. (2022). https://www.who.int/docs/default-source/coronaviruse/technical-brief-and-priority-action-on-omicron.pdf?sfvrsn=50732953_3〉 Accessed on 23 December, 2022.

WHO. (2023a). WHO Coronavirus (COVID-19) Dashboard. https://covid19.who.int/ Accessed on January 6, 2023.

WHO. (2023b). World Health Organization. Tracking SARS-CoV-2 variants. https://www.who.int/en/activities/tracking-SARS-CoV-2-variants Accessed on January 2, 2023.

Wong, C. (2022). Subvariant ‘soup’ may drive wave. New Science, 256(3411), 11. doi: 10.1016/S0262-4079(22)01970-4. DOI: https://doi.org/10.1016/S0262-4079(22)01970-4

Xia, S., Wang, L., Zhu, Y., Lu, L., & Jiang, S. (2022). Origin, virological features, immune evasion and intervention of SARS-CoV-2 Omicron sublineages. Signal Transduction and Target Therapeutics, 7(1):241. doi: 10.1038/s41392-022-01105-9. DOI: https://doi.org/10.1038/s41392-022-01105-9

Zhou, H., Møhlenberg, M., Thakor, J.C., Tuli, H.S., et al. (2022). Sensitivity to vaccines, therapeutic antibodies, and viral entry inhibitors and advances to counter the SARS-CoV-2 Omicron variant. Clinical Microbiology Reviews, 35(3), e0001422. doi: 10.1128/cmr.00014-22. DOI: https://doi.org/10.1128/cmr.00014-22