XBB.1.5 Omicron subvariant: Questions patients may have

While it may be a new year, the problem still exists: Covid-19. At this time, however, the dominant strain in parts of the United States is the Omicron variant of COVID-19 known as XBB.1.5.

The addition of the Covid-19 Omicron sub-variant XBB.1.5 is the result of a combination of potent mutations that make it easier for the virus to spread widely, including those previously infected or vaccinated. This means there are higher chances of re-infection or developing an infection.

Some questions patients may have about XBB.1.5 Covid-19 subtype, including answers that physicians should share.

Since the Covid-19 Omicron variant became the world’s dominant strain, it has mutated into several sub-variants. First it was the BA.1, then the BA.5 was the Omicron sub variant. Eventually changed to BQ.1 and BQ.1.1.

Now there’s the XBB.1.5 – nicknamed the Kraken – which is derived from the BA.2 Omicron sub-variant. It is part of the XBB family of variants that appeared a few months ago and has attracted the attention of virologists because it has more mutations to evade the immune system than any other variant seen so far. A change in the XBB.1.5 subunit is believed to help the virus bind to cells and be transmitted further.

“It’s a really unusual name. ‘Kraken’ is the name of a mythical sea monster and XBB was given this name by a Canadian biology professor who was trying to identify the variants of Covid by giving them mythical names,” said Sandra Adamson Freihofer, MD, an Atlanta general internist and chair of the AMA Board of Trustees, in ” He said on the AMA Update” show.

“Now it’s a bit easier to say than XBB.1.5. But the name sounds scary,” Dr. Freihofer said.

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The number of Covid-19 cases in the US at XBB.1.5 rose rapidly from 1% to 40%. In fact, scientists are finding that this subunit “is more likely to stick to cells in the human body than its predecessors,” said Andrea Garcia, vice president of science, medicine and public health at the AMA.

“Also, the immune system appears to be more resistant to antibodies than earlier variants,” he said.

In December, the XBB.1.5 variant accounted for less than 10% of Covid-19 cases in the US in the first week of January, while XBB.1.5 was reported to account for 40% of cases. But there were delays in reporting the data from the states because of the holidays, so it was only an estimate.

Now the Centers for Disease Control and Prevention (CDC) has a clearer picture of the impact of the XBB.1.5 sub-variant. As of January 13, the CDC now estimates that XBB.1.5 accounts for 43% of cases, making it the highest burden in the country. BQ.1.1 is now the second highest prevalence of 29% of Covid-19 cases. But this can change quickly.

Currently, XBB.1.5 is the predominant type of Covid-19 in the Northeast, accounting for more than 80% of cases in New York and New Jersey. It is also found in at least 28 other countries, but it is not the main species.

The XBB.1.5 symbols are similar to previous Omicron sub-variables. Those can range from cold symptoms like coughing and congestion to shortness of breath and low oxygen levels that require emergency medical attention.

But as XBB.1.5 continues to spread, the signs and symptoms of Covid-19 may look different than those previously seen with alpha or delta variants. Symptoms such as transient taste and smell may still occur in some cases, but with micron variations and sub-variants it has become less common.

Other symptoms may include fever, chills, fatigue, muscle or body aches, sore throat, nausea or vomiting, and diarrhea. The symptoms can last from five to seven days but vary from person to person.

“The experts generally believe that the symptoms of COVID have been decreasing over time,” Garcia explained. “This may be because they tend to stay in the upper respiratory tract and do not damage the lungs like earlier variants.”

“But it may be because people in the US have some level of immunity before the vaccine or the disease,” she said, adding that “many people who are infected now are reporting mild symptoms such as cough, congestion and headache.” Confusion with cold or flu symptoms.

“While XBB.1.5 is one of the most antibody-resistant variants, it does not appear to harbor any mutations known to be associated with weight change. However, studies of disease severity are now underway,” said Dr. Freihofer, AMA liaison to the CDC’s Advisory Committee on Immunization Practices (ACIP) and a member of the ACP’s Covid-19 Vaccine Workgroup.

Many people infected with SARS-CoV-2 have been reporting mild symptoms such as cough, congestion and headache. These symptoms can often be confused with a cold or flu. But if you notice any of these symptoms, it’s important to get tested for Covid-19. This will help to know the difference between covid-19, cold and flu and what treatments to follow.

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Although researchers are still compiling data, it is estimated that those infected with the previous Omicron strain may still be susceptible to recontamination with XBB.1.5. This is because the XBB.1.5 sub-variant is more immunosuppressive.

In addition, a person’s natural immune response gradually declines after infection. The same can be said for vaccines. Even if it provides some protection, the immune response will decrease over time.

The short answer is yes. With each variant of Covid-19, the risk of prolonged Covid or post-Covid conditions remains. This can include extensive ongoing health problems that may last for weeks, months, or longer.

While prolonged covid is often reported in people with severe illness, it can affect anyone infected with SARS-CoV-2, people with mild illness or no symptoms. However, a new study has found that long-term covid symptoms disappear after a year for those with mild illness.

Getting vaccinated and up-to-date on Covid-19 boosters remains the best way to prevent serious illness, hospitalization and death. The updated covid-19 bivalent booster provides additional protection against the currently circulating variants because half Omicron BA is half the original strain. 4 and BA.5 subvariants.

While there is still confusion about the importance of dual stimulation, a new study from Israel — which is pre-published and not yet peer-reviewed — tested its effectiveness in preventing serious outcomes in those 65 or older. The study found an 81% reduction in hospitalizations among people 65 and older compared to those who received two doses of the Covid-19 vaccine, but not the improved rate.

“The bottom line is that there are times when you don’t get your bivalent booster, but you have to get it soon or you could be hospitalized,” says AMA member Peter Hotez, MD, PhD, of the N.Y. D. executive director of the National School of Tropical Medicine at Baylor College of Medicine and the Vaccine Development Center at Texas Children’s Hospital in Houston; Houston Chronicle Interview “With the new XBB1.5 sub variant, the goalposts have been moved. This is the reality.

“From November, pre-XBB.1.5, data from the CDC showed that people who received a double boost were 18.6 times less likely to be hospitalized,” he said. “Not as good as for XBB.1.5, but should be useful there.”

Yes, treatments are still expected to be effective in treating Covid-19 infections caused by XBB.1.5. These treatments help to reduce the severity of the disease. Oral antiviral drugs such as paxlovide and molnupiravir are expected to be effective against XBB.1.5 because they do not work by developing antibodies, which makes this strain seem to be able to be eliminated. Instead, these oral antiviral drugs work by interfering with the virus’s ability to replicate itself.

However, the Food and Drug Administration (FDA) indicated that they do not expect Evushield to eliminate XBB.1.5. This means that individuals receiving the drug for pre-exposure prophylaxis may not be protected from developing COVID-19. The FDA is currently awaiting additional data to confirm that Evusheld is not active against XBB.1.5.

This advice may sound like a broken record, but the best way to protect yourself against XBB.1.5 Omicron’s suboptimal immune system is to get vaccinated and stay up-to-date on Covid-19 vaccines. Beyond vaccination, it’s important to assess your risk level and keep that in mind. If you will be with others in an indoor setting, consider wearing a mask. But not just any mask will do. It is important to wear an N95 or KN95 mask for better protection.

XBB.1.5 “Maybe it’s spreading so fast because a lot of people don’t have masks,” Dr. Frihofer said. … I would say I see a lot more people wearing masks at the airport.

On top of vaccination and wearing a mask, avoid poorly ventilated areas and maintain physical distance from others. And if you feel sick, stay home and get tested to determine the best course of action.