Different SARS-CoV-2 variants may give rise to different long COVID symptoms, study suggests

Italian study of long-COVID patients suggests those infected with the Alpha variant experienced different neurological and emotional symptoms compared to those who contracted the original form of SARS-CoV-2



New research to be presented at this year’s European Congress of Clinical Microbiology & Infectious Diseases (ECCMID) in Lisbon, Portugal (23-26 April), suggests that the symptoms connected to long COVID could be different in people who are infected with different variants. The study is by Dr Michele Spinicci and colleagues from the University of Florence and Careggi University Hospital in Italy.

Estimates suggest that over half of survivors of SARS-CoV-2 infection experience post-acute sequelae of COVID-19 (PASC), more commonly known as ‘long COVID’ [1]. The condition can affect anyone—old and young, otherwise healthy, and those with underlying conditions. It has been seen in people who were hospitalised with COVID-19 and those with mild symptoms. But despite an increasing body of literature, long COVID remains poorly understood.

In this study, researchers did a retrospective observational study of 428 patients—254 (59%) men and 174 (41%) women—treated at the Careggi University Hospital’s post-COVID outpatient service between June 2020 and June 2021, when the original form of SARS-CoV-2 and the Alpha variant were circulating in the population. The patients had been hospitalised with COVID-19 and discharged 4-12 weeks before attending a clinical visit at the outpatient service and completing a questionnaire on persistent symptoms (an average [median] of 53 days after hospital discharge). In addition, data on medical history, microbiological and clinical COVID-19 course, and patient demographics were obtained from electronic medical records.

At least three-quarters 325/428 (76%) of patients reported at least one persistent symptom. The most common reported symptoms were shortness of breath (157/428; 37%) and chronic fatigue (156/428; 36%) followed by sleep problems (68/428; 16%), visual problems (55/428; 13%), and brain fog (54/428; 13%).

Analyses suggest that people with more severe forms, who required immunosuppressant drugs such as tocilizumab, were six times as likely to report long COVID symptoms, while those who received high flow oxygen support were 40% more likely to experience ongoing problems. Women were almost twice as likely to report symptoms of long COVID compared with men. However, patients with type 2 diabetes seemed to have a lower risk of developing long COVID symptoms. The authors say that further studies are needed to better understand this unexpected finding.

Researchers performed a more detailed evaluation comparing the symptoms reported by patients infected between March and December 2020 (when the original SARS-COV-2 was dominant) with those reported by patients infected between January and April 2021 (when Alpha was the dominant variant) and discovered a substantial change in the pattern of neurological and cognitive/emotional problems.

They found that when the Alpha variant was the dominant strain, the prevalence of myalgia (muscle aches and pain), insomnia, brain fog and anxiety/depression significantly increased, while anosmia (loss of smell), dysgeusia (difficulty in swallowing), ad impaired hearing were less common (figure 2 in notes to editors).

“Many of the symptoms reported in this study have been measured, but this is the first time they have been linked to different COVID-19 variants”, says Dr Spinicci. “The long duration and broad range of symptoms reminds us that the problem is not going away, and we need to do more to support and protect these patients in the long term. Future research should focus on the potential impacts of variants of concern and vaccination status on ongoing symptoms.”

The authors acknowledge that the study was observational and does not prove cause and effect, and they could not confirm which variant of the virus caused the infection in different patients—which may limit the conclusions that can be drawn.

Delta is surging, but is another variant on the way? Here’s what to know about lambda

Ben Sessoms, The Charlotte Observer  

The delta variant is by far the dominant strain of the coronavirus in North Carolina and the rest of the country, but experts say there are also other variants to watch.

Before delta, there was alpha, beta and gamma.

Now there is another, lambda, which is primarily spreading in South America.

Some cases of lambda were found at a Houston hospital last month, according to KHOU11.

Other cases were found in Dallas earlier this week, according to The Dallas Morning News.

But is it spreading in North Carolina? And does the vaccine protect against it?

Here is what you need to know about the lambda variant.

What is lambda?

The lambda variant, or C.37, is a mutation of the original strain of SARS-CoV-2, the virus that causes COVID-19.

It first emerged in Peru back in December. Since then, over 1,200 cases of it have been found there. In Chile, over 1,400 have been reported.

The World Health Organization recognizes it as a variant of interest, meaning that it’s capable of causing significant community transmission.

It’s a step below a variant of concern which includes alpha, beta, gamma and delta, which have been shown to increase transmissibility and have had a significant effect on public health, according to WHO.

Is it spreading in NC?

Among all the sequenced coronavirus samples nationwide, only 810 have been found to be lambda.

By comparison, over 86,000 have been found to be delta.

Due to testing limitations, only a fraction of viruses are sequenced, but officials are still confident they’re an accurate overall representation of variants among infections, The News & Observer previously reported.

The latest data from the Centers for Disease Control and Prevention doesn’t list lambda as a variant of concern in North Carolina.

Is it vaccine resistant?

Dr. David Wohl, infectious disease specialist at the UNC-Chapel Hill, said the lambda variant is potentially concerning because in theory, the COVID-19 vaccines are not as effective against it.

“There’s indications that the antibodies from people who’ve been vaccinated do not neutralize lambda as well as they neutralize other variants,” Wohl said. “That’s the concern with lambda is that in laboratory tests, there may be diminished activity. It still works but not as avidly.”

But some lab tests also show diminished vaccine effectiveness with delta, he said, yet in people, where delta is spreading much more rapidly than lambda, it’s a different story.

“If [the vaccine] didn’t work against delta, we would have our hospital and ICU filled with people who got Moderna, Pfizer and J&J,” Wohl said. “And we’re not seeing that.”

According to state officials, over 90% of people hospitalized with COVID-19, and almost all ICU patients, are unvaccinated.

Dr. Mandy Cohen, secretary of the N.C. Department of Health and Human Services, said at a press conference Wednesday that those who are unvaccinated are four times more likely to get COVID.

“We know that the vaccine works against all these variants. It does. It’s all relative, though,” Wohl said. “Compared to other variants we’re seeing in some of these lab tests, there are some concerns that maybe the antibodies produced by the vaccine aren’t as good against some of these newer variants.”

How does lambda compare to delta?

Cohen said at a press conference late last month that delta is three times as contagious as the original strain.

Wohl said data is limited

but given how much delta has spread in the past month, he’s not sure if lambda is as transmissible right now.

“In order for lambda to become the predominant virus, it has to outpace delta. It has to have some advantage over delta,” he explained. “Otherwise, you won’t be able to continue to spread because there’s no niche for it.”

“I think we would have seen lambda spread already, if it really was able to be fitter than delta,” he said.

Is a vaccine resistant variant coming?

Given that so many remain unvaccinated, there hasn’t been an evolutionary need for a variant to evolve that’s able to cause severe illness in those vaccinated, Wohl said.

“You really need a pressure to be applied to a virus in order to see it mutate,” he said.

The delta variant is spreading because of low vaccination rates and because it can infect vaccinated people, though a vast majority of cases are mild.

“Right now in our country, given how many people are unvaccinated, there’s a little bit less pressure actually on the virus to become resistant to the vaccines because there’s plenty of easy pickings of people who are not vaccinated,” Wohl explained.

“Maybe that’s kind of a silver lining. That it prevents us from getting infected — and this is all theoretical — with a variant that could be worse,” he said.

Still, Wohl urged the unvaccinated to get their shots because the vaccine protects against severe disease and death.

And even in countries with higher vaccination rates, vaccinations are still working and vaccine-resistant variants are not emerging, he said.

If a vaccine-resistant variant does emerge, Wohl said the mRNA technology in the Pfizer and Moderna vaccines can be adjusted quickly to compensate for such a mutation in the virus.

“I don’t think we’re going to see a truly vaccine-resistant variant for a long time, and by that time, I think we’re going to be better prepared,” Wohl said.

Deadly Lambda variant could be vaccine-resistant, new study says

Authors: By Hannah Sparks

As the US struggles to suppress the rapidly advancing coronavirus Delta variant, new evidence has emerged that the latest Lambda mutation — ravaging parts of South America — won’t be slowed by vaccines.

In a July 28 report appearing on bioRxiv, where the study awaits peer review prior to getting published, researchers in Japan are sounding the alarm on the C.37 variant, dubbed Lambda. And it’s proven just as virulent as Delta thanks to a similar mutation making them even more contagious.

The strain has been contained in 26 countries, including substantial outbreaks in Chile, Peru, Argentina and Ecuador.

“Notably, the vaccination rate in Chile is relatively high; the percentage of the people who received at least one dose of COVID-19 vaccine was [about] 60%,” the authors write.

“Nevertheless, a big COVID-19 surge has occurred in Chile in Spring 2021, suggesting that the Lambda variant is proficient in escaping from the antiviral immunity elicited by vaccination,” they warn.

The Lambda variant is thought to have emerged somewhere in South America between November and December 2020, and has since turned up in countries throughout Europe, North America and a few more isolated cases in Asia, according to GISAID data.

For More Information: https://nypost.com/2021/08/12/deadly-lambda-covid-19-variant-could-be-vaccine-resistant/amp/