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Rabaan AA, Al-Ahmed SH, Albayat H, Alwarthan S, Alhajri M, Najim MA, AlShehail BM, Al-Adsani W, Alghadeer A, Abduljabbar WA, Alotaibi N, Alsalman J, Gorab AH, Almaghrabi RS, Zaidan AA, Aldossary S, Alissa M, Alburaiky LM, Alsalim FM, Thakur N, Verma G, Dhawan M. Variants of SARS-CoV-2: Influences on the Vaccines' Effectiveness and Possible Strategies to Overcome Their Consequences. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:507. [PMID: 36984508 PMCID: PMC10051174 DOI: 10.3390/medicina59030507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 02/27/2023] [Accepted: 03/03/2023] [Indexed: 03/08/2023]
Abstract
The immune response elicited by the current COVID-19 vaccinations declines with time, especially among the immunocompromised population. Furthermore, the emergence of novel SARS-CoV-2 variants, particularly the Omicron variant, has raised serious concerns about the efficacy of currently available vaccines in protecting the most vulnerable people. Several studies have reported that vaccinated people get breakthrough infections amid COVID-19 cases. So far, five variants of concern (VOCs) have been reported, resulting in successive waves of infection. These variants have shown a variable amount of resistance towards the neutralising antibodies (nAbs) elicited either through natural infection or the vaccination. The spike (S) protein, membrane (M) protein, and envelope (E) protein on the viral surface envelope and the N-nucleocapsid protein in the core of the ribonucleoprotein are the major structural vaccine target proteins against COVID-19. Among these targets, S Protein has been extensively exploited to generate effective vaccines against COVID-19. Hence, amid the emergence of novel variants of SARS-CoV-2, we have discussed their impact on currently available vaccines. We have also discussed the potential roles of S Protein in the development of novel vaccination approaches to contain the negative consequences of the variants' emergence and acquisition of mutations in the S Protein of SARS-CoV-2. Moreover, the implications of SARS-CoV-2's structural proteins were also discussed in terms of their variable potential to elicit an effective amount of immune response.
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Affiliation(s)
- Ali A. Rabaan
- Molecular Diagnostic Laboratory, Johns Hopkins Aramco Healthcare, Dhahran 31311, Saudi Arabia
- College of Medicine, Alfaisal University, Riyadh 11533, Saudi Arabia
- Department of Public Health and Nutrition, The University of Haripur, Haripur 22610, Pakistan
| | - Shamsah H. Al-Ahmed
- Specialty Paediatric Medicine, Qatif Central Hospital, Qatif 32654, Saudi Arabia
| | - Hawra Albayat
- Infectious Disease Department, King Saud Medical City, Riyadh 7790, Saudi Arabia
| | - Sara Alwarthan
- Department of Internal Medicine, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam 34212, Saudi Arabia
| | - Mashael Alhajri
- Department of Internal Medicine, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam 34212, Saudi Arabia
| | - Mustafa A. Najim
- Department of Medical Laboratories Technology, College of Applied Medical Sciences, Taibah University, Madinah 41411, Saudi Arabia
| | - Bashayer M. AlShehail
- Pharmacy Practice Department, College of Clinical Pharmacy, Imam Abdulrahman Bin Faisal University, Dammam 31441, Saudi Arabia
| | - Wasl Al-Adsani
- Department of Medicine, Infectious Diseases Hospital, Kuwait City 63537, Kuwait
- Department of Infectious Diseases, Hampton Veterans Administration Medical Center, Hampton, VA 23667, USA
| | - Ali Alghadeer
- Department of Anesthesia, Dammam Medical Complex, Dammam 32245, Saudi Arabia
| | - Wesam A. Abduljabbar
- Department of Medical Laboratory Sciences, Fakeeh College for Medical Science, Jeddah 21134, Saudi Arabia
| | - Nouf Alotaibi
- Clinical Pharmacy Department, College of Pharmacy, Umm Al-Qura University, Makkah 21955, Saudi Arabia
| | - Jameela Alsalman
- Infection Disease Unit, Department of Internal Medicine, Salmaniya Medical Complex, Ministry of Health, Kingdom of Bahrain, Manama 435, Bahrain
| | - Ali H. Gorab
- Al Kuzama Primary Health Care Center, Al Khobar Health Network, Eastern Health Cluster, Al Khobar 34446, Saudi Arabia
| | - Reem S. Almaghrabi
- Organ Transplant Center of Excellence, King Faisal Specialist Hospital and Research Center, Riyadh 11211, Saudi Arabia
| | - Ali A. Zaidan
- Gastroenterology Department, King Fahad Armed Forces Hospital, Jeddah 23831, Saudi Arabia
| | - Sahar Aldossary
- Pediatric Infectious Diseases, Women and Children’s Health Institute, Johns Hopkins Aramco Healthcare, Dhahran 31311, Saudi Arabia
| | - Mohammed Alissa
- Department of Medical Laboratory Sciences, College of Applied Medical Sciences, Prince Sattam bin Abdulaziz University, Al-Kharj 11942, Saudi Arabia
| | - Lamees M. Alburaiky
- Pediatric Department, Safwa General Hospital, Eastern Health Cluster, Safwa 31921, Saudi Arabia
| | - Fatimah Mustafa Alsalim
- Department of Family Medicine, Primary Health Care, Qatif Health Cluster, Qatif 32434, Saudi Arabia
| | - Nanamika Thakur
- University Institute of Biotechnology, Department of Biotechnology, Chandigarh University, Mohali 140413, India
| | - Geetika Verma
- Department of Experimental Medicine and Biotechnology, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh 160012, India
| | - Manish Dhawan
- Department of Microbiology, Punjab Agricultural University, Ludhiana 141004, India
- Trafford College, Altrincham, Manchester WA14 5PQ, UK
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Ashique S, Kumar S, Kumar H, Roy J, Pal S, Pal S. A brief overview of various vaccines against nCOVID19, including safety, efficacy, reported cases, clinical trials, and progress. INDIAN JOURNAL OF HEALTH SCIENCES AND BIOMEDICAL RESEARCH (KLEU) 2023. [DOI: 10.4103/kleuhsj.kleuhsj_505_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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Sharma E, Revinipati S, Bhandari S, Thakur S, Goyal S, Ghose A, Bajpai S, Muhammad W, Boussios S. Efficacy and Safety of COVID-19 Vaccines-An Update. Diseases 2022; 10:112. [PMID: 36547198 PMCID: PMC9777372 DOI: 10.3390/diseases10040112] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 11/16/2022] [Accepted: 11/19/2022] [Indexed: 11/24/2022] Open
Abstract
A few centuries ago, the first vaccine vial was formulated, and since then, they have resulted in an eminent reduction in infectious diseases associated morbidity and mortality. The discovery of the novel SARS-CoV-2 virus and the COVID-19 disease and its steady progression to a global pandemic with 603,711,760 confirmed cases and 6,484,136 reported deaths according to the World Health Organization (WHO) on 7 September 2022 was exceedingly catastrophic. This brought about an unexpected need for preventative and cost-effective measures to curb the devastating impact of the virus, followed by accelerated competition within the pharma giants to manufacture and dispense vaccines at an exponential rate. Non-pharmaceutical medications such as mandated face mask policies, the imposition of travel limitations and generalized disinfectant use were somewhat successful in mitigating the catastrophic effect, but the onus fell upon vaccination strategies and other medical interventions to counteract and subdue this international health threat. The need to ensure current and future pandemic preparedness, however, presents multiple hurdles, among which are equitable vaccine access and the rising trend of vaccine hesitancy at an individual and international level, which are beyond the scope of this discussion. With this review article, we seek to draw perspective on current COVID-19 virus variants, in-hand vaccine types with their mechanism of action along with their effectiveness and safety profile. We also aim to discuss substantial side effects while adding a segment on the booster dose controversy.
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Affiliation(s)
- Eshani Sharma
- Department of Internal Medicine, Kasturba Medical College, Mangalore 575001, India
| | | | - Saisha Bhandari
- Department of Internal Medicine, Kasturba Medical College, Mangalore 575001, India
- Department of Internal Medicine, Post Graduate Institute of Medical Education and Research, Chandigarh 160012, India
| | - Sejal Thakur
- Department of Internal Medicine, Kasturba Medical College, Mangalore 575001, India
| | - Shubham Goyal
- Department of Infectious Diseases, Kasturba Medical College, Manipal 576104, India
| | - Aruni Ghose
- Department of Internal Medicine, Newham University Hospital, Barts Health NHS Trust, London E13 8SL, UK
- Department of Medical Oncology, Medway NHS Foundation Trust, Windmill Road, Gillingham ME7 5NY, UK
| | - Sukrit Bajpai
- Department of Respiratory Medicine, Queen Elizabeth Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham B15 2TH, UK
| | - Waleed Muhammad
- Department of Internal Medicine, Newham University Hospital, Barts Health NHS Trust, London E13 8SL, UK
| | - Stergios Boussios
- Department of Medical Oncology, Medway NHS Foundation Trust, Windmill Road, Gillingham ME7 5NY, UK
- Faculty of Life Sciences & Medicine, School of Cancer & Pharmaceutical Sciences, King’s College London, London SE1 9RT, UK
- AELIA Organization, 9th KM Thessaloniki—Thermi, 57001 Thessaloniki, Greece
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Patel RB, Patel BB. An Analysis of the COVID-19 Situation in India in Terms of Testing, Treatment, Vaccine Acceptance and National Economic Performance. Int J Public Health 2022; 67:1604975. [DOI: 10.3389/ijph.2022.1604975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 10/14/2022] [Indexed: 11/07/2022] Open
Abstract
Objectives: This study aims to provide a comprehensive review on the analysis of COVID-19 pandemic in India and address economic impact, diagnosis approaches, and vaccine acceptance and hesitation.Method: We retrieved articles published in 2020 and 2021 and current data from official websites that narrate the strategy for COVID-19 testing, issues, and challenges, healthcare system insufficiency, statistics of cases, deaths, vaccination, and vaccine acceptance barriers, and beliefs.Results: India being the 2nd largest populated country with a population of 1.4 billion faced massive difficulty in controlling the transmission of SARS-CoV-2. This crisis dramatically impeded the economy of the nation. India witnessed 2nd highest number (43,019,453) of confirmed cases and 3rd highest number of deaths (521,004) across the world.Conclusion: The major cause of the collapse of COVID-19 is the high population of India, pre-existing weak healthcare system, and the lack of awareness among the people. The fall, rise, and statistics provided in the review will help in comparing the current status with other countries and in making strong strategies to combat future calamities.
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Dotiwala F, Upadhyay AK. A comprehensive review of BBV152 vaccine development, effectiveness, safety, challenges, and prospects. Front Immunol 2022; 13:940715. [PMID: 36177016 PMCID: PMC9513542 DOI: 10.3389/fimmu.2022.940715] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Accepted: 08/08/2022] [Indexed: 11/13/2022] Open
Abstract
The world has responded to the COVID-19 pandemic with unprecedented speed and vigor in the mass vaccination campaigns, targeted to reduce COVID-19 severity and mortality, reduce the pressure on the healthcare system, re-open society, and reduction in disease mortality and morbidity. Here we review the preclinical and clinical development of BBV152, a whole virus inactivated vaccine and an important tool in the fight to control this pandemic. BBV152, formulated with a TLR7/8 agonist adjuvant generates a Th1-biased immune response that induces high neutralization efficacy against different SARS-CoV-2 variants of concern and robust long-term memory B- and T-cell responses. With seroconversion rates as high as 98.3% in vaccinated individuals, BBV152 shows 77.8% and 93.4% protection from symptomatic COVID-19 disease and severe symptomatic COVID-19 disease respectively. Studies in pediatric populations show superior immunogenicity (geometric mean titer ratio of 1.76 compared to an adult) with a seroconversion rate of >95%. The reactogenicity and safety profiles were comparable across all pediatric age groups between 2-18 yrs. as in adults. Like most approved vaccines, the BBV152 booster given 6 months after full vaccination, reverses a waning immunity, restores the neutralization efficacy, and shows synergy in a heterologous prime-boost study with about 3-fold or 300% increase in neutralization titers against multiple SARS-CoV-2 variants of concern. Based on the interim Phase III data, BBV152 received full authorization for adults and emergency use authorization for children from ages 6 to 18 years in India. It is also licensed for emergency use in 14 countries globally. Over 313 million vaccine doses have already been administered in India alone by April 18th, 2022.
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Ahmed TI, Rishi S, Irshad S, Aggarwal J, Happa K, Mansoor S. Inactivated vaccine Covaxin/BBV152: A systematic review. Front Immunol 2022; 13:863162. [PMID: 36016940 PMCID: PMC9395719 DOI: 10.3389/fimmu.2022.863162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Accepted: 06/27/2022] [Indexed: 11/13/2022] Open
Abstract
We systematically reviewed and summarized studies focusing on Bharat Biotech’s Whole Virion Inactivated Corona Virus Antigen BBV152 (Covaxin), which is India’s indigenous response to fighting the SARS-CoV-2 pandemic. Studies were searched for data on the efficacy, immunogenicity, and safety profile of BBV152. All relevant studies published up to March 22, 2022, were screened from major databases, and 25 studies were eventually inducted into the systematic review. The studies focused on the virus antigen (6 μg) adjuvanted with aluminium hydroxide gel and/or Imidazo quinolin gallamide (IMDG), aTLR7/8 agonist. Pre-clinical, phase I, and II clinical trials showed appreciable immunogenicity. Both neutralizing and binding antibody titers were significant and T cell responses were Th1-biased. Phase III trials on the 6 μg +Algel-IMDG formulation showed a 93.4% efficacy against severe COVID-19. Data from the trials revealed an acceptable safety profile with mostly mild-moderate local and systemic adverse events. No serious adverse events or fatalities were seen, and most studies reported milder and lesser adverse events with Covaxin when compared with other vaccines, especially Oxford-Astra Zeneca’s AZD1222 (Covishield). The immunogenicity performance of Covaxin, which provided significant protection only after the second dose, was mediocre and it was consistently surpassed by Covishield. One study reported adjusted effectiveness against symptomatic infection to be just 50% at 2 weeks after the second dose. Nonetheless, appreciable results were seen in previously infected individuals administered both doses. There was some evidence of coverage against the Alpha, Beta, and Delta variants. However, neither Covaxin nor Covishield showed sufficient protection against the Omicron variant. Two studies reported super-additive results on mixing Covaxin with Covishield. Further exploration of heterologous prime-boost vaccination with a combination of an inactivated vaccine and an adenoviral vector-based vaccine for tackling future variants may be beneficial.
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Affiliation(s)
- Tousief Irshad Ahmed
- Department of Clinical Biochemistry, Sher-I-Kashmir Institute of Medical Sciences, Srinagar, JK, India
| | - Saqib Rishi
- Department of Microbiology, Government Medical College, Srinagar, JK, India
| | - Summaiya Irshad
- Department of Ophthalmology, Government Medical College, Jammu, JK, India
| | - Jyoti Aggarwal
- Department of Biochemistry, Maharishi Markandeshwar Institute of Medical Sciences and Research (MMIMSR), Ambala, HR, India
| | - Karan Happa
- Department of General Medicine, Sher-I-Kashmir Institute of Medical Sciences, Srinagar, JK, India
| | - Sheikh Mansoor
- Advanced Centre for Human Genetics, Sher-I-Kashmir Institute of Medical Sciences, Srinagar, JK, India
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7
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Vadrevu KM, Ganneru B, Reddy S, Jogdand H, Raju D, Sapkal G, Yadav P, Reddy P, Verma S, Singh C, Redkar SV, Gillurkar CS, Kushwaha JS, Mohapatra S, Bhate A, Rai SK, Ella R, Abraham P, Prasad S, Ella K. Persistence of immunity and impact of third dose of inactivated COVID-19 vaccine against emerging variants. Sci Rep 2022; 12:12038. [PMID: 35835822 PMCID: PMC9281359 DOI: 10.1038/s41598-022-16097-3] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2022] [Accepted: 07/04/2022] [Indexed: 12/30/2022] Open
Abstract
This is a comprehensive report on immunogenicity of COVAXIN® booster dose against ancestral and Variants of Concern (VOCs) up to 12 months. It is well known that neutralizing antibodies induced by COVID-19 vaccines wane within 6 months of vaccination leading to questions on the effectiveness of two-dose vaccination against breakthrough infections. Therefore, we assessed the persistence of immunogenicity up to 6 months after a two or three-dose with BBV152 and the safety of a booster dose in an ongoing phase 2, double-blind, randomized controlled trial (ClinicalTrials.gov: NCT04471519). We report persistence of humoral and cell mediated immunity up to 12 months of vaccination, despite decline in the magnitude of antibody titers. Administration of a third dose of BBV152 increased neutralization titers against both homologous (D614G) and heterologous strains (Alpha, Beta, Delta, Delta Plus and Omicron) with a slight increase in B cell memory responses. Thus, seronversion rate remain high in boosted recipients compared to non-booster, even after 6 months, post third dose against variants. No serious adverse events observed, except pain at the injection site, itching and redness. Hence, these results indicate that a booster dose of BBV152 is safe and necessary to ensure persistent immunity to minimize breakthrough infections of COVID-19, due to newly emerging variants. Trial registration: Registered with the Clinical Trials Registry (India) No. CTRI/2021/04/032942, dated 19/04/2021 and on Clinicaltrials.gov: NCT04471519.
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Affiliation(s)
| | - Brunda Ganneru
- Bharat Biotech International Limited, Genome Valley, Hyderabad, 500 078, India
| | - Siddharth Reddy
- Bharat Biotech International Limited, Genome Valley, Hyderabad, 500 078, India
| | - Harsh Jogdand
- Bharat Biotech International Limited, Genome Valley, Hyderabad, 500 078, India
| | - Dugyala Raju
- Bharat Biotech International Limited, Genome Valley, Hyderabad, 500 078, India
| | - Gajanan Sapkal
- Indian Council of Medical Research-National Institute of Virology, Pune, India
| | - Pragya Yadav
- Indian Council of Medical Research-National Institute of Virology, Pune, India
| | | | - Savita Verma
- Pandit Bhagwat Dayal Sharma Post Graduate Institute of Medical Sciences, Rohtak, India
| | | | | | | | | | | | | | | | - Raches Ella
- Independent Clinical Development Consultant, Cambridge, USA
| | - Priya Abraham
- Indian Council of Medical Research-National Institute of Virology, Pune, India
| | - Sai Prasad
- Bharat Biotech International Limited, Genome Valley, Hyderabad, 500 078, India
| | - Krishna Ella
- Bharat Biotech International Limited, Genome Valley, Hyderabad, 500 078, India
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Short KK, Lathrop SK, Davison CJ, Partlow HA, Kaiser JA, Tee RD, Lorentz EB, Evans JT, Burkhart DJ. Using Dual Toll-like Receptor Agonism to Drive Th1-Biased Response in a Squalene- and α-Tocopherol-Containing Emulsion for a More Effective SARS-CoV-2 Vaccine. Pharmaceutics 2022; 14:pharmaceutics14071455. [PMID: 35890352 PMCID: PMC9318334 DOI: 10.3390/pharmaceutics14071455] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2022] [Revised: 06/29/2022] [Accepted: 06/30/2022] [Indexed: 11/18/2022] Open
Abstract
A diversity of vaccines is necessary to reduce the mortality and morbidity of SARS-CoV-2. Vaccines must be efficacious, easy to manufacture, and stable within the existing cold chain to improve their availability around the world. Recombinant protein subunit vaccines adjuvanted with squalene-based emulsions such as AS03™ and MF59™ have a long and robust history of safe, efficacious use with straightforward production and distribution. Here, subunit vaccines were made with squalene-based emulsions containing novel, synthetic toll-like receptor (TLR) agonists, INI-2002 (TLR4 agonist) and INI-4001 (TLR7/8 agonist), using the recombinant receptor-binding domain (RBD) of SARS-CoV-2 S protein as an antigen. The addition of the TLR4 and TLR7/8 agonists, alone or in combination, maintained the formulation characteristics of squalene-based emulsions, including a sterile filterable droplet size (<220 nm), high homogeneity, and colloidal stability after months of storage at 4, 25, and 40 °C. Furthermore, the addition of the TLR agonists skewed the immune response from Th2 towards Th1 in immunized C57BL/6 mice, resulting in an increased production of IgG2c antibodies and a lower antigen-specific production of IL-5 with a higher production of IFNγ by lymphocytes. As such, incorporating TLR4 and TLR7/8 agonists into emulsions leveraged the desirable formulation and stability characteristics of emulsions and can induce Th1-type humoral and cell-mediated immune responses to combat the continued threat of SARS-CoV-2.
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Affiliation(s)
- Kristopher K. Short
- Center for Translational Medicine, University of Montana, Missoula, MT 59812, USA; (K.K.S.); (S.K.L.); (C.J.D.); (H.A.P.); (J.A.K.); (R.D.T.); (E.B.L.); (J.T.E.)
- Department of Biomedical and Pharmaceutical Sciences, University of Montana, Missoula, MT 59812, USA
| | - Stephanie K. Lathrop
- Center for Translational Medicine, University of Montana, Missoula, MT 59812, USA; (K.K.S.); (S.K.L.); (C.J.D.); (H.A.P.); (J.A.K.); (R.D.T.); (E.B.L.); (J.T.E.)
- Department of Biomedical and Pharmaceutical Sciences, University of Montana, Missoula, MT 59812, USA
| | - Clara J. Davison
- Center for Translational Medicine, University of Montana, Missoula, MT 59812, USA; (K.K.S.); (S.K.L.); (C.J.D.); (H.A.P.); (J.A.K.); (R.D.T.); (E.B.L.); (J.T.E.)
- Department of Biomedical and Pharmaceutical Sciences, University of Montana, Missoula, MT 59812, USA
| | - Haley A. Partlow
- Center for Translational Medicine, University of Montana, Missoula, MT 59812, USA; (K.K.S.); (S.K.L.); (C.J.D.); (H.A.P.); (J.A.K.); (R.D.T.); (E.B.L.); (J.T.E.)
- Department of Biomedical and Pharmaceutical Sciences, University of Montana, Missoula, MT 59812, USA
| | - Johnathan A. Kaiser
- Center for Translational Medicine, University of Montana, Missoula, MT 59812, USA; (K.K.S.); (S.K.L.); (C.J.D.); (H.A.P.); (J.A.K.); (R.D.T.); (E.B.L.); (J.T.E.)
- Department of Biomedical and Pharmaceutical Sciences, University of Montana, Missoula, MT 59812, USA
| | - Rebekah D. Tee
- Center for Translational Medicine, University of Montana, Missoula, MT 59812, USA; (K.K.S.); (S.K.L.); (C.J.D.); (H.A.P.); (J.A.K.); (R.D.T.); (E.B.L.); (J.T.E.)
- Department of Biomedical and Pharmaceutical Sciences, University of Montana, Missoula, MT 59812, USA
| | - Elizabeth B. Lorentz
- Center for Translational Medicine, University of Montana, Missoula, MT 59812, USA; (K.K.S.); (S.K.L.); (C.J.D.); (H.A.P.); (J.A.K.); (R.D.T.); (E.B.L.); (J.T.E.)
- Department of Biomedical and Pharmaceutical Sciences, University of Montana, Missoula, MT 59812, USA
| | - Jay T. Evans
- Center for Translational Medicine, University of Montana, Missoula, MT 59812, USA; (K.K.S.); (S.K.L.); (C.J.D.); (H.A.P.); (J.A.K.); (R.D.T.); (E.B.L.); (J.T.E.)
- Department of Biomedical and Pharmaceutical Sciences, University of Montana, Missoula, MT 59812, USA
| | - David J. Burkhart
- Center for Translational Medicine, University of Montana, Missoula, MT 59812, USA; (K.K.S.); (S.K.L.); (C.J.D.); (H.A.P.); (J.A.K.); (R.D.T.); (E.B.L.); (J.T.E.)
- Department of Biomedical and Pharmaceutical Sciences, University of Montana, Missoula, MT 59812, USA
- Correspondence:
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Neil JA, Griffith M, Godfrey DI, Purcell DFJ, Deliyannis G, Jackson D, Rockman S, Subbarao K, Nolan T. Nonhuman primate models for evaluation of SARS-CoV-2 vaccines. Expert Rev Vaccines 2022; 21:1055-1070. [PMID: 35652289 DOI: 10.1080/14760584.2022.2071264] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
INTRODUCTION Evaluation of immunogenicity and efficacy in animal models provide critical data in vaccine development. Nonhuman primates (NHPs) have been used extensively in the evaluation of SARS-CoV-2 vaccines. AREAS COVERED A critical synthesis of SARS-CoV-2 vaccine development with a focus on challenge studies in NHPs is provided. The benefits and drawbacks of the NHP models are discussed. The citations were selected by the authors based on PubMed searches of the literature, summaries from national public health bodies, and press-release information provided by vaccine developers. EXPERT OPINION We identify several aspects of NHP models that limit their usefulness for vaccine-challenge studies and numerous variables that constrain comparisons across vaccine platforms. We propose that studies conducted in NHPs for vaccine development should use a standardized protocol and, where possible, be substituted with smaller animal models. This will ensure continued rapid progression of vaccines to clinical trials without compromising assessments of safety or efficacy.
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Affiliation(s)
- Jessica A Neil
- Department of Microbiology and Immunology, Peter Doherty Institute for Infection and Immunity, The University of Melbourne, Melbourne, Australia
| | - Maryanne Griffith
- Vaccine and Immunisation Research Group (VIRGo), Department of Infectious Diseases, Peter Doherty Institute for Infection and Immunity, the University of Melbourne, Melbourne, Australia
| | - Dale I Godfrey
- Department of Microbiology and Immunology, Peter Doherty Institute for Infection and Immunity, The University of Melbourne, Melbourne, Australia
| | - Damian F J Purcell
- Department of Microbiology and Immunology, Peter Doherty Institute for Infection and Immunity, The University of Melbourne, Melbourne, Australia
| | - Georgia Deliyannis
- Department of Microbiology and Immunology, Peter Doherty Institute for Infection and Immunity, The University of Melbourne, Melbourne, Australia
| | - David Jackson
- Department of Microbiology and Immunology, Peter Doherty Institute for Infection and Immunity, The University of Melbourne, Melbourne, Australia
| | - Steve Rockman
- Department of Microbiology and Immunology, Peter Doherty Institute for Infection and Immunity, The University of Melbourne, Melbourne, Australia.,Seqirus, Parkville, Australia
| | - Kanta Subbarao
- Department of Microbiology and Immunology, Peter Doherty Institute for Infection and Immunity, The University of Melbourne, Melbourne, Australia.,WHO Collaborating Centre for Reference and Research on Influenza, Melbourne, Australia
| | - Terry Nolan
- Vaccine and Immunisation Research Group (VIRGo), Department of Infectious Diseases, Peter Doherty Institute for Infection and Immunity, the University of Melbourne, Melbourne, Australia.,Murdoch Children's Research Institute, Melbourne, Australia
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10
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Zhang Z, Shen Q, Chang H. Vaccines for COVID-19: A Systematic Review of Immunogenicity, Current Development, and Future Prospects. Front Immunol 2022; 13:843928. [PMID: 35572592 PMCID: PMC9092649 DOI: 10.3389/fimmu.2022.843928] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Accepted: 03/21/2022] [Indexed: 01/09/2023] Open
Abstract
The persistent coronavirus disease 2019 (COVID-19), characterized by severe respiratory syndrome, is caused by coronavirus 2 (SARS-CoV-2), and it poses a major threat to public health all over the world. Currently, optimal COVID-19 management involves effective vaccination. Vaccination is known to greatly enhance immune response against viral infections and reduce public transmission of COVID-19. However, although current vaccines offer some benefits, viral variations and other factors demand the continuous development of vaccines to eliminate this virus from host. Hence, vaccine research and development is crucial and urgent to the elimination of this pandemic. Herein, we summarized the structural and replicatory features of SARS-CoV-2, and focused on vaccine-mediated disease prevention strategies like vaccine antigen selection, vaccine research, and vaccine application. We also evaluated the latest literature on COVID-19 and extensively reviewed action mechanisms, clinical trial (CT) progresses, advantages, as well as disadvantages of various vaccine candidates against SARS-CoV-2. Lastly, we discussed the current viral treatment, prevention trends, and future prospects.
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Affiliation(s)
- Zhan Zhang
- Ministry of Education (MOE) Key Laboratory of Laser Life Science & Institute of Laser Life Science, College of Biophotonics, South China Normal University, Guangzhou, China
| | - Qi Shen
- Ministry of Education (MOE) Key Laboratory of Laser Life Science & Institute of Laser Life Science, College of Biophotonics, South China Normal University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Laser Life Science, College of Biophotonics, South China Normal University, Guangzhou, China
| | - Haocai Chang
- Ministry of Education (MOE) Key Laboratory of Laser Life Science & Institute of Laser Life Science, College of Biophotonics, South China Normal University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Laser Life Science, College of Biophotonics, South China Normal University, Guangzhou, China
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11
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Zhou H, Ni WJ, Huang W, Wang Z, Cai M, Sun YC. Advances in Pathogenesis, Progression, Potential Targets and Targeted Therapeutic Strategies in SARS-CoV-2-Induced COVID-19. Front Immunol 2022; 13:834942. [PMID: 35450063 PMCID: PMC9016159 DOI: 10.3389/fimmu.2022.834942] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Accepted: 03/07/2022] [Indexed: 01/18/2023] Open
Abstract
As the new year of 2020 approaches, an acute respiratory disease quietly caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), also known as coronavirus disease 2019 (COVID-19) was reported in Wuhan, China. Subsequently, COVID-19 broke out on a global scale and formed a global public health emergency. To date, the destruction that has lasted for more than two years has not stopped and has caused the virus to continuously evolve new mutant strains. SARS-CoV-2 infection has been shown to cause multiple complications and lead to severe disability and death, which has dealt a heavy blow to global development, not only in the medical field but also in social security, economic development, global cooperation and communication. To date, studies on the epidemiology, pathogenic mechanism and pathological characteristics of SARS-CoV-2-induced COVID-19, as well as target confirmation, drug screening, and clinical intervention have achieved remarkable effects. With the continuous efforts of the WHO, governments of various countries, and scientific research and medical personnel, the public’s awareness of COVID-19 is gradually deepening, a variety of prevention methods and detection methods have been implemented, and multiple vaccines and drugs have been developed and urgently marketed. However, these do not appear to have completely stopped the pandemic and ravages of this virus. Meanwhile, research on SARS-CoV-2-induced COVID-19 has also seen some twists and controversies, such as potential drugs and the role of vaccines. In view of the fact that research on SARS-CoV-2 and COVID-19 has been extensive and in depth, this review will systematically update the current understanding of the epidemiology, transmission mechanism, pathological features, potential targets, promising drugs and ongoing clinical trials, which will provide important references and new directions for SARS-CoV-2 and COVID-19 research.
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Affiliation(s)
- Hong Zhou
- Department of Pharmacy, Anhui Provincial Cancer Hospital, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
| | - Wei-Jian Ni
- Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, The Key Laboratory of Anti-inflammatory of Immune Medicines, Ministry of Education, Anhui Institute of Innovative Drugs, School of Pharmacy, Anhui Medical University, Hefei, China.,Anhui Provincial Hospital, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
| | - Wei Huang
- The Third People's Hospital of Hefei, The Third Clinical College of Anhui Medical University, Hefei, China
| | - Zhen Wang
- Anhui Provincial Children's Hospital, Children's Hospital of Fudan University-Anhui Campus, Hefei, China
| | - Ming Cai
- Department of Pharmacy, The Second Affiliated Hospital of Anhui University of Chinese Medicine, Hefei, China.,School of Pharmacy, Anhui University of Chinese Medicine, Hefei, China
| | - Yan-Cai Sun
- Department of Pharmacy, Anhui Provincial Cancer Hospital, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
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12
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Hassan A, Prasad D, Rani S, Alhassan M. Gauging the Impact of Artificial Intelligence and Mathematical Modeling in Response to the COVID-19 Pandemic: A Systematic Review. BIOMED RESEARCH INTERNATIONAL 2022; 2022:7731618. [PMID: 35309167 PMCID: PMC8931177 DOI: 10.1155/2022/7731618] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/08/2022] [Accepted: 02/17/2022] [Indexed: 12/23/2022]
Abstract
While the world continues to grapple with the devastating effects of the SARS-nCoV-2 virus, different scientific groups, including researchers from different parts of the world, are trying to collaborate to discover solutions to prevent the spread of the COVID-19 virus permanently. Henceforth, the current study envisions the analysis of predictive models that employ machine learning techniques and mathematical modeling to mitigate the spread of COVID-19. A systematic literature review (SLR) has been conducted, wherein a search into different databases, viz., PubMed and IEEE Explore, fetched 1178 records initially. From an initial of 1178 records, only 50 articles were analyzed completely. Around (64%) of the studies employed data-driven mathematical models, whereas only (26%) used machine learning models. Hybrid and ARIMA models constituted about (5%) and (3%) of the selected articles. Various Quality Evaluation Metrics (QEM), including accuracy, precision, specificity, sensitivity, Brier-score, F1-score, RMSE, AUC, and prediction and validation cohort, were used to gauge the effectiveness of the studied models. The study also considered the impact of Pfizer-BioNTech (BNT162b2), AstraZeneca (ChAd0x1), and Moderna (mRNA-1273) on Beta (B.1.1.7) and Delta (B.1.617.2) viral variants and the impact of administering booster doses given the evolution of viral variants of the virus.
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Affiliation(s)
- Afshan Hassan
- Chitkara University Institute of Engineering and Technology, Chitkara University, Punjab, India
| | - Devendra Prasad
- Chitkara University Institute of Engineering and Technology, Chitkara University, Punjab, India
| | - Shalli Rani
- Chitkara University Institute of Engineering and Technology, Chitkara University, Punjab, India
| | - Musah Alhassan
- University of Development Studies, Electrical Engineering Department, School of Engineering, Nyankpala Campus, Ghana
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13
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Thakur S, Sasi S, Pillai SG, Nag A, Shukla D, Singhal R, Phalke S, Velu GSK. SARS-CoV-2 Mutations and Their Impact on Diagnostics, Therapeutics and Vaccines. Front Med (Lausanne) 2022; 9:815389. [PMID: 35273977 PMCID: PMC8902153 DOI: 10.3389/fmed.2022.815389] [Citation(s) in RCA: 73] [Impact Index Per Article: 36.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Accepted: 01/04/2022] [Indexed: 12/11/2022] Open
Abstract
With the high rate of COVID-19 infections worldwide, the emergence of SARS-CoV-2 variants was inevitable. Several mutations have been identified in the SARS-CoV-2 genome, with the spike protein as one of the mutational hot spots. Specific amino acid substitutions such as D614G and N501Y were found to alter the transmissibility and virulence of the virus. The WHO has classified the variants identified with fitness-enhancing mutations as variants of concern (VOC), variants of interest (VOI) or variants under monitoring (VUM). The VOCs pose an imminent threat as they exhibit higher transmissibility, disease severity and ability to evade vaccine-induced and natural immunity. Here we review the mutational landscape on the SARS-CoV-2 structural and non-structural proteins and their impact on diagnostics, therapeutics and vaccines. We also look at the effectiveness of approved vaccines, antibody therapy and convalescent plasma on the currently prevalent VOCs, which are B.1.17, B.1.351, P.1, B.1.617.2 and B.1.1.529. We further discuss the possible factors influencing mutation rates and future directions.
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Affiliation(s)
- Suresh Thakur
- Trivitron Healthcare Pvt., Ltd., Visakhapatnam, India
| | - Shalitha Sasi
- Blue Horizon International Therapeutic Sciences, Hackensack, NJ, United States
| | | | | | - Dhananjay Shukla
- Department of Biotechnology, Guru Ghasidas Vishwavidyalaya (A Central University), Bilaspur, India
| | - Ritu Singhal
- Department of Microbiology, National Institute of Tuberculosis and Respiratory Disease, New Delhi, India
| | - Sameer Phalke
- Trivitron Healthcare Pvt., Ltd., Visakhapatnam, India
| | - G. S. K. Velu
- Trivitron Healthcare Pvt., Ltd., Visakhapatnam, India
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14
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Incidence and severity of COVID-19 infection post-vaccination: a survey among Indian doctors. Infection 2022; 50:889-895. [PMID: 35129788 PMCID: PMC8819206 DOI: 10.1007/s15010-022-01758-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Accepted: 01/14/2022] [Indexed: 11/30/2022]
Abstract
Purpose The rollout of COVID-19 vaccines began in India in January 2021, with healthcare professionals being the first to receive vaccination. The purpose of this research was to study the incidence and severity of COVID-19 infections among Indian doctors, following vaccination with ChAdOx1 nCoV-19 or BBV152. Methods We conducted an online voluntary survey among Indian doctors who received one or two doses of ChAdOx1 nCoV-19 or BBV152. Questions pertaining to the incidence and severity of COVID-19 infection following vaccination were asked. Data thus obtained were analysed. Results 9146 doctors were included in this study. 8301 of these received ChAdOx1 nCoV-19, while 845 received BBV152. 2842 (31.07%) respondents reported having a COVID-19 infection following vaccination. Presence of pre-existing medical comorbidities was associated with a higher incidence, while prior COVID-19 infection and two doses of either vaccine were associated with a lower incidence of COVID-19 infection post-vaccination. Exposure to COVID-19 patients on a daily basis did not increase the incidence of COVID-19 infection among doctors who were vaccinated. Increasing age, male gender, presence of pre-existing medical comorbidities, and daily exposure to COVID-19 patients were associated with increased severity of COVID-19 infection after vaccination. Two doses of either vaccine resulted in less severity of disease compared to one dose. Conclusion ChAdOx1 nCoV-19 and BBV152 confer immunity against severe forms of COVID-19 infections. COVID-19 infections prior to vaccination result in a lower incidence of breakthrough infection. Presence of pre-existing medical comorbidities is associated with increased incidence and severity of breakthrough infections.
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15
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Yadav P, Mohandas S, Sarkale P, Nyayanit D, Shete A, Sahay R, Potdar V, Baradkar S, Gupta N, Sapkal G, Abraham P, Panda S, Bhargava B. Isolation of SARS-CoV-2 B.1.1.28.2 (P2) variant and pathogenicity comparison with D614G variant in hamster model. J Infect Public Health 2022; 15:164-171. [PMID: 34959053 PMCID: PMC8690136 DOI: 10.1016/j.jiph.2021.12.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Revised: 11/23/2021] [Accepted: 12/13/2021] [Indexed: 12/18/2022] Open
Abstract
Background Considering the potential threat from emerging Severe Acute Respiratory Syndrome-Corona Virus-2 (SARS-CoV-2) variants and the rising COVID-19 cases, SARS-CoV-2 genomic surveillance is ongoing in India. We report herewith the isolation of the P.2 variant (B.1.1.28.2) from international travelers and further its pathogenicity evaluation and comparison with D614G variant (B.1) in hamster model. Methods Virus isolation was performed in Vero CCL81 cells and genomic characterization by next generation sequencing. The pathogenicity and host immune response of the isolate was assessed in Syrian hamster model and compared with B.1 variant. Results B.1.1.28.2 variant was isolated from nasal/throat swabs of international travelers returned to India from United Kingdom and Brazil. The B.1.1.28.2 variant induced body weight loss, viral replication in the respiratory tract and caused severe lung pathology in infected Syrian hamster model in comparison, with B.1 variant infected hamsters. The sera from B.1.1.28.2 infected hamsters efficiently neutralized the D614G variant virus whereas 6-fold reduction in the neutralization was seen in case of D614G variant infected hamsters’ sera with the B.1.1.28.2 variant. Conclusions B.1.1.28.2 lineage variant could be successfully isolated and characterization could be performed. Pathogenicity of the isolate was demonstrated in Syrian hamster model and the findings of neutralization reduction is of great concern and point towards the need for screening the vaccines for efficacy.
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Affiliation(s)
- Pragya Yadav
- Indian Council of Medical Research-National Institute of Virology (ICMR-NIV), Pune, Maharashtra, 411021, India.
| | - Sreelekshmy Mohandas
- Indian Council of Medical Research-National Institute of Virology (ICMR-NIV), Pune, Maharashtra, 411021, India
| | - Prasad Sarkale
- Indian Council of Medical Research-National Institute of Virology (ICMR-NIV), Pune, Maharashtra, 411021, India
| | - Dimpal Nyayanit
- Indian Council of Medical Research-National Institute of Virology (ICMR-NIV), Pune, Maharashtra, 411021, India
| | - Anita Shete
- Indian Council of Medical Research-National Institute of Virology (ICMR-NIV), Pune, Maharashtra, 411021, India
| | - Rima Sahay
- Indian Council of Medical Research-National Institute of Virology (ICMR-NIV), Pune, Maharashtra, 411021, India
| | - Varsha Potdar
- Indian Council of Medical Research-National Institute of Virology (ICMR-NIV), Pune, Maharashtra, 411021, India
| | - Shrikant Baradkar
- Indian Council of Medical Research-National Institute of Virology (ICMR-NIV), Pune, Maharashtra, 411021, India
| | - Nivedita Gupta
- Indian Council of Medical Research, V. Ramalingaswami Bhawan, P.O. Box No. 4911, Ansari Nagar, New Delhi, 110029, India
| | - Gajanan Sapkal
- Indian Council of Medical Research-National Institute of Virology (ICMR-NIV), Pune, Maharashtra, 411021, India
| | - Priya Abraham
- Indian Council of Medical Research-National Institute of Virology (ICMR-NIV), Pune, Maharashtra, 411021, India
| | - Samiran Panda
- Indian Council of Medical Research, V. Ramalingaswami Bhawan, P.O. Box No. 4911, Ansari Nagar, New Delhi, 110029, India
| | - Balram Bhargava
- Indian Council of Medical Research, V. Ramalingaswami Bhawan, P.O. Box No. 4911, Ansari Nagar, New Delhi, 110029, India
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Malhotra S, Mani K, Lodha R, Bakhshi S, Mathur VP, Gupta P, Kedia S, Sankar J, Kumar P, Kumar A, Ahuja V, Sinha S, Guleria R. SARS-CoV-2 Reinfection Rate and Estimated Effectiveness of the Inactivated Whole Virion Vaccine BBV152 Against Reinfection Among Health Care Workers in New Delhi, India. JAMA Netw Open 2022; 5:e2142210. [PMID: 34994793 PMCID: PMC8742193 DOI: 10.1001/jamanetworkopen.2021.42210] [Citation(s) in RCA: 40] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 11/05/2021] [Indexed: 12/13/2022] Open
Abstract
Importance A surge of COVID-19 occurred from March to June 2021, in New Delhi, India, linked to the B.1.617.2 (Delta) variant of SARS-CoV-2. COVID-19 vaccines were rolled out for health care workers (HCWs) starting in January 2021. Objective To assess the incidence density of reinfection among a cohort of HCWs and estimate the effectiveness of the inactivated whole virion vaccine BBV152 against reinfection. Design, Setting, and Participants This was a retrospective cohort study among HCWs working at a tertiary care center in New Delhi, India. Exposures Vaccination with 0, 1, or 2 doses of BBV152. Main Outcomes and Measures The HCWs were categorized as fully vaccinated (with 2 doses and ≥15 days after the second dose), partially vaccinated (with 1 dose or 2 doses with <15 days after the second dose), or unvaccinated. The incidence density of COVID-19 reinfection per 100 person-years was computed, and events from March 3, 2020, to June 18, 2021, were included for analysis. Unadjusted and adjusted hazard ratios (HRs) were estimated using a Cox proportional hazards model. Estimated vaccine effectiveness (1 - adjusted HR) was reported. Results Among 15 244 HCWs who participated in the study, 4978 (32.7%) were diagnosed with COVID-19. The mean (SD) age was 36.6 (10.3) years, and 55.0% were male. The reinfection incidence density was 7.26 (95% CI: 6.09-8.66) per 100 person-years (124 HCWs [2.5%], total person follow-up period of 1696 person-years as time at risk). Fully vaccinated HCWs had lower risk of reinfection (HR, 0.14 [95% CI, 0.08-0.23]), symptomatic reinfection (HR, 0.13 [95% CI, 0.07-0.24]), and asymptomatic reinfection (HR, 0.16 [95% CI, 0.05-0.53]) compared with unvaccinated HCWs. Accordingly, among the 3 vaccine categories, reinfection was observed in 60 of 472 (12.7%) of unvaccinated (incidence density, 18.05 per 100 person-years; 95% CI, 14.02-23.25), 39 of 356 (11.0%) of partially vaccinated (incidence density 15.62 per 100 person-years; 95% CI, 11.42-21.38), and 17 of 1089 (1.6%) fully vaccinated (incidence density 2.18 per 100 person-years; 95% CI, 1.35-3.51) HCWs. The estimated effectiveness of BBV152 against reinfection was 86% (95% CI, 77%-92%); symptomatic reinfection, 87% (95% CI, 76%-93%); and asymptomatic reinfection, 84% (95% CI, 47%-95%) among fully vaccinated HCWs. Partial vaccination was not associated with reduced risk of reinfection. Conclusions and Relevance These findings suggest that BBV152 was associated with protection against both symptomatic and asymptomatic reinfection in HCWs after a complete vaccination schedule, when the predominant circulating variant was B.1.617.2.
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Affiliation(s)
- Sumit Malhotra
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Kalaivani Mani
- Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, India
| | - Rakesh Lodha
- Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India
| | - Sameer Bakhshi
- Department of Medical Oncology, Dr B.R.A Institute–Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India
| | - Vijay Prakash Mathur
- Division of Pedodontics and Preventive Dentistry, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India
| | - Pooja Gupta
- Department of Pharmacology, All India Institute of Medical Sciences, New Delhi, India
| | - Saurabh Kedia
- Department of Gastroenterology & Human Nutrition, All India Institute of Medical Sciences, New Delhi, India
| | - Jeeva Sankar
- Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India
| | - Parmeshwar Kumar
- Department of Hospital Administration, All India Institute of Medical Sciences, New Delhi, India
| | - Arvind Kumar
- Department of Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Vineet Ahuja
- Department of Gastroenterology & Human Nutrition, All India Institute of Medical Sciences, New Delhi, India
| | - Subrata Sinha
- Department of Biochemistry, All India Institute of Medical Sciences, New Delhi, India
| | - Randeep Guleria
- Department of Pulmonary Critical Care and Sleep Medicine, All India Institute of Medical Sciences, New Delhi, India
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Mukhopadhyay L, Gupta N, Yadav PD, Aggarwal N. Neutralization assays for SARS-CoV-2: Implications for assessment of protective efficacy of COVID-19 vaccines. Indian J Med Res 2022; 155:105-122. [PMID: 35859437 PMCID: PMC9552365 DOI: 10.4103/ijmr.ijmr_2544_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
The WHO emergency use-listed (EUL) COVID-19 vaccines were developed against early strains of SARS-CoV-2. With the emergence of SARS-CoV-2 variants of concern (VOCs) - Alpha, Beta, Gamma, Delta and Omicron, it is necessary to assess the neutralizing activity of these vaccines against the VOCs. PubMed and preprint platforms were searched for literature on neutralizing activity of serum from WHO EUL vaccine recipients, against the VOCs, using appropriate search terms till November 30, 2021. Our search yielded 91 studies meeting the inclusion criteria. The analysis revealed a drop of 0-8.9-fold against Alpha variant, 0.3-42.4-fold against Beta variant, 0-13.8-fold against Gamma variant and 1.35-20-fold against Delta variant in neutralization titres of serum from the WHO EUL COVID-19 vaccine recipients, as compared to early SARS-CoV-2 isolates. The wide range of variability was due to differences in the choice of virus strains selected for neutralization assays (pseudovirus or live virus), timing of serum sample collection after the final dose of vaccine (day 0 to 8 months) and sample size (ranging from 5 to 470 vaccinees). The reasons for this variation have been discussed and the possible way forward to have uniformity across neutralization assays in different laboratories have been described, which will generate reliable data. Though in vitro neutralization studies are a valuable tool to estimate the performance of vaccines against the backdrop of emerging variants, the results must be interpreted with caution and corroborated with field-effectiveness studies.
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Affiliation(s)
- Labanya Mukhopadhyay
- Virology Unit, Division of Epidemiology and Communicable Diseases, Indian Council of Medical Research, New Delhi, India
| | - Nivedita Gupta
- Virology Unit, Division of Epidemiology and Communicable Diseases, Indian Council of Medical Research, New Delhi, India
| | - Pragya D Yadav
- Maximum Containment Laboratory, Indian Council of Medical Research-National Institute of Virology, Pune, Maharashtra, India
| | - Neeraj Aggarwal
- Virology Unit, Division of Epidemiology and Communicable Diseases, Indian Council of Medical Research, New Delhi, India
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18
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Peng XL, Cheng JSY, Gong HL, Yuan MD, Zhao XH, Li Z, Wei DX. Advances in the design and development of SARS-CoV-2 vaccines. Mil Med Res 2021; 8:67. [PMID: 34911569 PMCID: PMC8674100 DOI: 10.1186/s40779-021-00360-1] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2021] [Accepted: 11/15/2021] [Indexed: 01/18/2023] Open
Abstract
Since the end of 2019, coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has spread worldwide. The RNA genome of SARS-CoV-2, which is highly infectious and prone to rapid mutation, encodes both structural and nonstructural proteins. Vaccination is currently the only effective method to prevent COVID-19, and structural proteins are critical targets for vaccine development. Currently, many vaccines are in clinical trials or are already on the market. This review highlights ongoing advances in the design of prophylactic or therapeutic vaccines against COVID-19, including viral vector vaccines, DNA vaccines, RNA vaccines, live-attenuated vaccines, inactivated virus vaccines, recombinant protein vaccines and bionic nanoparticle vaccines. In addition to traditional inactivated virus vaccines, some novel vaccines based on viral vectors, nanoscience and synthetic biology also play important roles in combating COVID-19. However, many challenges persist in ongoing clinical trials.
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Affiliation(s)
- Xue-Liang Peng
- Key Laboratory of Resource Biology and Biotechnology in Western China, Ministry of Education, School of Medicine, Department of Life Sciences and Medicine, Northwest University, Xi’an, 710069 China
| | - Ji-Si-Yu Cheng
- Key Laboratory of Resource Biology and Biotechnology in Western China, Ministry of Education, School of Medicine, Department of Life Sciences and Medicine, Northwest University, Xi’an, 710069 China
| | - Hai-Lun Gong
- Key Laboratory of Resource Biology and Biotechnology in Western China, Ministry of Education, School of Medicine, Department of Life Sciences and Medicine, Northwest University, Xi’an, 710069 China
| | - Meng-Di Yuan
- Key Laboratory of Resource Biology and Biotechnology in Western China, Ministry of Education, School of Medicine, Department of Life Sciences and Medicine, Northwest University, Xi’an, 710069 China
| | - Xiao-Hong Zhao
- Key Laboratory of Resource Biology and Biotechnology in Western China, Ministry of Education, School of Medicine, Department of Life Sciences and Medicine, Northwest University, Xi’an, 710069 China
| | - Zibiao Li
- Institute of Materials Research and Engineering, A*STAR (Agency for Science, Technology and Research), 2 Fusionopolis Way, Innovis, #08-03, Singapore, 138634 Singapore
| | - Dai-Xu Wei
- Key Laboratory of Resource Biology and Biotechnology in Western China, Ministry of Education, School of Medicine, Department of Life Sciences and Medicine, Northwest University, Xi’an, 710069 China
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Ella R, Reddy S, Blackwelder W, Potdar V, Yadav P, Sarangi V, Aileni VK, Kanungo S, Rai S, Reddy P, Verma S, Singh C, Redkar S, Mohapatra S, Pandey A, Ranganadin P, Gumashta R, Multani M, Mohammad S, Bhatt P, Kumari L, Sapkal G, Gupta N, Abraham P, Panda S, Prasad S, Bhargava B, Ella K, Vadrevu KM. Efficacy, safety, and lot-to-lot immunogenicity of an inactivated SARS-CoV-2 vaccine (BBV152): interim results of a randomised, double-blind, controlled, phase 3 trial. Lancet 2021; 398:2173-2184. [PMID: 34774196 PMCID: PMC8584828 DOI: 10.1016/s0140-6736(21)02000-6] [Citation(s) in RCA: 201] [Impact Index Per Article: 67.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 08/17/2021] [Accepted: 08/25/2021] [Indexed: 01/19/2023]
Abstract
BACKGROUND We report the clinical efficacy against COVID-19 infection of BBV152, a whole virion inactivated SARS-CoV-2 vaccine formulated with a toll-like receptor 7/8 agonist molecule adsorbed to alum (Algel-IMDG) in Indian adults. METHODS We did a randomised, double-blind, placebo-controlled, multicentre, phase 3 clinical trial in 25 Indian hospitals or medical clinics to evaluate the efficacy, safety, and immunological lot consistency of BBV152. Adults (age ≥18 years) who were healthy or had stable chronic medical conditions (not an immunocompromising condition or requiring treatment with immunosuppressive therapy) were randomised 1:1 with a computer-generated randomisation scheme (stratified for the presence or absence of chronic conditions) to receive two intramuscular doses of vaccine or placebo administered 4 weeks apart. Participants, investigators, study coordinators, study-related personnel, the sponsor, and nurses who administered the vaccines were masked to treatment group allocation; an unmasked contract research organisation and a masked expert adjudication panel assessed outcomes. The primary outcome was the efficacy of the BBV152 vaccine in preventing a first occurrence of laboratory-confirmed (RT-PCR-positive) symptomatic COVID-19 (any severity), occurring at least 14 days after the second dose in the per-protocol population. We also assessed safety and reactogenicity throughout the duration of the study in all participants who had received at least one dose of vaccine or placebo. This report contains interim results (data cutoff May 17, 2021) regarding immunogenicity and safety outcomes (captured on days 0 to 56) and efficacy results with a median of 99 days for the study population. The trial was registered on the Indian Clinical Trials Registry India, CTRI/2020/11/028976, and ClinicalTrials.gov, NCT04641481 (active, not recruiting). FINDINGS Between Nov 16, 2020, and Jan 7, 2021, we recruited 25 798 participants who were randomly assigned to receive BBV152 or placebo; 24 419 received two doses of BBV152 (n=12 221) or placebo (n=12 198). Efficacy analysis was dependent on having 130 cases of symptomatic COVID-19, which occurred when 16 973 initially seronegative participants had at least 14 days follow-up after the second dose. 24 (0·3%) cases occurred among 8471 vaccine recipients and 106 (1·2%) among 8502 placebo recipients, giving an overall estimated vaccine efficacy of 77·8% (95% CI 65·2-86·4). In the safety population (n=25 753), 5959 adverse events occurred in 3194 participants. BBV152 was well tolerated; the same proportion of participants reported adverse events in the vaccine group (1597 [12·4%] of 12 879) and placebo group (1597 [12·4%] of 12 874), with no clinically significant differences in the distributions of solicited, unsolicited, or serious adverse events between the groups, and no cases of anaphylaxis or vaccine-related deaths. INTERPRETATION BBV152 was highly efficacious against laboratory-confirmed symptomatic COVID-19 disease in adults. Vaccination was well tolerated with no safety concerns raised in this interim analysis. FUNDING Bharat Biotech International and Indian Council of Medical Research.
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Affiliation(s)
- Raches Ella
- Bharat Biotech International, Hyderabad, India
| | | | | | - Varsha Potdar
- National Institute of Virology, Indian Council of Medical Research, Pune, India
| | - Pragya Yadav
- National Institute of Virology, Indian Council of Medical Research, Pune, India
| | | | | | - Suman Kanungo
- National Institute of Cholera and Enteric Diseases, Indian Council of Medical Research, Kolkatta, India
| | - Sanjay Rai
- All India Institute of Medical Sciences, New Delhi, India
| | | | - Savita Verma
- Pandit Bhagwat Dayal Sharma Post Graduate Institute of Medical Sciences, Rohtak, India
| | | | | | | | - Anil Pandey
- ESIC Medical College and Hospital, Faridabad, India
| | | | - Raghavendra Gumashta
- Department of Community Medicine, People's College of Medical Sciences and Research Centre, People's University, Bhopal, India
| | | | | | - Parul Bhatt
- GMERS Medical College and Civil Hospital, Ahmedabad, India
| | | | - Gajanan Sapkal
- National Institute of Virology, Indian Council of Medical Research, Pune, India
| | | | - Priya Abraham
- National Institute of Virology, Indian Council of Medical Research, Pune, India
| | - Samiran Panda
- Indian Council of Medical Research, New Delhi, India
| | - Sai Prasad
- Bharat Biotech International, Hyderabad, India
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20
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Deb B, Vilvadrinath R, Goel S. COVID-19 variants that escape vaccine immunity: Global and Indian context—are more vaccines needed? J Biosci 2021. [PMID: 34857677 PMCID: PMC8633907 DOI: 10.1007/s12038-021-00226-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The COVID-19 pandemic that emerged around December 2019 claimed millions of lives. For vaccine development, S protein on viral envelope that binds to ACE2 receptor on cells for entry was identified as vaccine candidate. S protein consists of Receptor Binding Motif (RBM) in the S1 subunit followed by the S2 subunit with an intermediate furin cleavage site. A stabilized version of S protein with 2 proline residues was used as antigen. Overall, most vaccines exhibited efficacy between 80 and 95%. However, being a RNA virus that is prone to mutations along with selection pressure on S protein and frequent use of convalescent plasma led to evolution of variants. These variants are responsible for multiple waves of infection observed globally. In our review, we discuss current data on vaccines and its efficacy in neutralizing SARS-CoV-2 from Wuhan and its variants. Further, our docked mutations observed in variants on the ACE2-S complex cryo-EM structure show that mostly the S1 domain is under selection pressure where major mutations occur in the N terminal domain (NTD), RBM and junction near S1-S2 subunit. Therefore, this review would be a reference for development of new candidate antigen(s) with better efficacy against variants.
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Affiliation(s)
- Bijayeeta Deb
- Indian Institute of Science Education and Research (IISER) Tirupati, Tirupati, India
| | - Ramya Vilvadrinath
- Indian Institute of Science Education and Research (IISER) Tirupati, Tirupati, India
| | - Suchi Goel
- Indian Institute of Science Education and Research (IISER) Tirupati, Tirupati, India
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21
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Tatsi EB, Filippatos F, Michos A. SARS-CoV-2 variants and effectiveness of vaccines: a review of current evidence. Epidemiol Infect 2021; 149:e237. [PMID: 34732275 PMCID: PMC8632374 DOI: 10.1017/s0950268821002430] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 10/29/2021] [Accepted: 10/31/2021] [Indexed: 12/23/2022] Open
Abstract
The SARS-CoV-2 virus is rapidly evolving via mutagenesis, lengthening the pandemic, and threatening the public health. Until August 2021, 12 variants of SARS-CoV-2 named as variants of concern (VOC; Alpha to Delta) or variants of interest (VOI; Epsilon to Mu), with significant impact on transmissibility, morbidity, possible reinfection and mortality, have been identified. The VOC Delta (B.1.617.2) of Indian origin is now the dominant and the most contagious variant worldwide as it provokes a strong binding to the human ACE2 receptor, increases transmissibility and manifests considerable immune escape strategies after natural infection or vaccination. Although the development and administration of SARS-CoV-2 vaccines, based on different technologies (mRNA, adenovirus carrier, recombinant protein, etc.), are very promising for the control of the pandemic, their effectiveness and neutralizing activity against VOCs varies significantly. In this review, we describe the most significant circulating variants of SARS-CoV-2, and the known effectiveness of currently available vaccines against them.
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Affiliation(s)
- Elizabeth-Barbara Tatsi
- First Department of Pediatrics, Infectious Diseases and Chemotherapy Research Laboratory, Medical School, National and Kapodistrian University of Athens, ‘Aghia Sophia’ Children's Hospital, 11527Athens, Greece
| | - Filippos Filippatos
- First Department of Pediatrics, Infectious Diseases and Chemotherapy Research Laboratory, Medical School, National and Kapodistrian University of Athens, ‘Aghia Sophia’ Children's Hospital, 11527Athens, Greece
| | - Athanasios Michos
- First Department of Pediatrics, Infectious Diseases and Chemotherapy Research Laboratory, Medical School, National and Kapodistrian University of Athens, ‘Aghia Sophia’ Children's Hospital, 11527Athens, Greece
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22
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Sharma R, Tiwari S, Dixit A. Covaxin: An overview of its immunogenicity and safety trials in India. Bioinformation 2021; 17:840-845. [PMID: 35574502 PMCID: PMC9070630 DOI: 10.6026/97320630017840] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Revised: 09/18/2021] [Accepted: 09/19/2021] [Indexed: 11/23/2022] Open
Abstract
The spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has led to a global coronavirus disease-19 (COVID-19) pandemic. Several vaccine types, such as inactivated, viral vector-, or mRNA-based, have received approval against SARS-CoV-2. The ability to induceT-helper-1 cell (Th1) responses is desirable from an effective vaccine against this virus. Covaxin (BBV152) is a wholevirion inactivated SARS-CoV-2 vaccine adjuvanted with Algel-Imidazoquinoline (IMDG) molecule, a toll-like receptor (TLR) 7/8 agonist. The mRNA-based vaccine use is hindered because of cold storage requirement, whereas covaxin is stored between 2°C and 8°C, making it suitable for countries with limited resources. The Drug Controller General of India (DCGI) has approved the BBV152 vaccine. Therefore, it is of interest to document known data on BBV152 vaccine phase I, phase II and phase III human clinical trials to evaluate the safety, reactogenicity, tolerance, and immunogenicity of the whole-virion inactivated SARS-CoV-2 vaccine (BBV152).
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Affiliation(s)
- Rohit Sharma
- School of Biotechnology, Jawaharlal Nehru University, New Delhi - 110067, India
| | - Swati Tiwari
- School of Biotechnology, Jawaharlal Nehru University, New Delhi - 110067, India
| | - Aparna Dixit
- School of Biotechnology, Jawaharlal Nehru University, New Delhi - 110067, India
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23
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Yadav PD, Sapkal GN, Ella R, Sahay RR, Nyayanit DA, Patil DY, Deshpande G, Shete AM, Gupta N, Mohan VK, Abraham P, Panda S, Bhargava B. Neutralization of Beta and Delta variant with sera of COVID-19 recovered cases and vaccinees of inactivated COVID-19 vaccine BBV152/Covaxin. J Travel Med 2021; 28:6316247. [PMID: 34230972 PMCID: PMC8344909 DOI: 10.1093/jtm/taab104] [Citation(s) in RCA: 65] [Impact Index Per Article: 21.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 06/29/2021] [Accepted: 06/29/2021] [Indexed: 11/25/2022]
Abstract
SARS-CoV-2 variant of concern mainly Delta and Beta is global public health concern due to its impact on existing vaccines. Here, we assessed the neutralization of sera from COVID-19 recovered cases and BBV152 vaccinees against Beta and Delta variants. BBV152 vaccine found to confer significant protection against both the variants.
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Affiliation(s)
- Pragya D Yadav
- Indian Council of Medical Research-National Institute of Virology, Pune, India
| | - Gajanan N Sapkal
- Indian Council of Medical Research-National Institute of Virology, Pune, India
| | - Raches Ella
- Bharat Biotech International Limited, Genome Valley, Hyderabad, Telangana, India
| | - Rima R Sahay
- Indian Council of Medical Research-National Institute of Virology, Pune, India
| | - Dimpal A Nyayanit
- Indian Council of Medical Research-National Institute of Virology, Pune, India
| | - Deepak Y Patil
- Indian Council of Medical Research-National Institute of Virology, Pune, India
| | - Gururaj Deshpande
- Indian Council of Medical Research-National Institute of Virology, Pune, India
| | - Anita M Shete
- Indian Council of Medical Research-National Institute of Virology, Pune, India
| | - Nivedita Gupta
- Indian Council of Medical Research, V. Ramalingaswami Bhawan, Ansari Nagar, New Delhi, India
| | - V Krishna Mohan
- Bharat Biotech International Limited, Genome Valley, Hyderabad, Telangana, India
| | - Priya Abraham
- Indian Council of Medical Research-National Institute of Virology, Pune, India
| | - Samiran Panda
- Indian Council of Medical Research, V. Ramalingaswami Bhawan, Ansari Nagar, New Delhi, India
| | - Balram Bhargava
- Indian Council of Medical Research, V. Ramalingaswami Bhawan, Ansari Nagar, New Delhi, India
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24
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Gupta N, Kaur H, Yadav PD, Mukhopadhyay L, Sahay RR, Kumar A, Nyayanit DA, Shete AM, Patil S, Majumdar T, Rana S, Gupta S, Narayan J, Vijay N, Barde P, Nataraj G, B. AK, Kumari MP, Biswas D, Iravane J, Raut S, Dutta S, Devi S, Barua P, Gupta P, Borkakoty B, Kalita D, Dhingra K, Fomda B, Joshi Y, Goyal K, John R, Munivenkatappa A, Dhodapkar R, Pandit P, Devi S, Dudhmal M, Kinariwala D, Khandelwal N, Tiwari YK, Khatri PK, Gupta A, Khatri H, Malhotra B, Nagasundaram M, Dar L, Sheikh N, Shastri J, Aggarwal N, Abraham P. Clinical Characterization and Genomic Analysis of Samples from COVID-19 Breakthrough Infections during the Second Wave among the Various States of India. Viruses 2021; 13:v13091782. [PMID: 34578363 PMCID: PMC8472862 DOI: 10.3390/v13091782] [Citation(s) in RCA: 45] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Revised: 08/27/2021] [Accepted: 08/29/2021] [Indexed: 02/04/2023] Open
Abstract
From March to June 2021, India experienced a deadly second wave of COVID-19, with an increased number of post-vaccination breakthrough infections reported across the country. To understand the possible reason for these breakthroughs, we collected 677 clinical samples (throat swab/nasal swabs) of individuals from 17 states/Union Territories of the country who had received two doses (n = 592) and one dose (n = 85) of vaccines and tested positive for COVID-19. These cases were telephonically interviewed and clinical data were analyzed. A total of 511 SARS-CoV-2 genomes were recovered with genome coverage of higher than 98% from both groups. Analysis of both groups determined that 86.69% (n = 443) of them belonged to the Delta variant, along with Alpha, Kappa, Delta AY.1, and Delta AY.2. The Delta variant clustered into four distinct sub-lineages. Sub-lineage I had mutations in ORF1ab A1306S, P2046L, P2287S, V2930L, T3255I, T3446A, G5063S, P5401L, and A6319V, and in N G215C; Sub-lineage II had mutations in ORF1ab P309L, A3209V, V3718A, G5063S, P5401L, and ORF7a L116F; Sub-lineage III had mutations in ORF1ab A3209V, V3718A, T3750I, G5063S, and P5401L and in spike A222V; Sub-lineage IV had mutations in ORF1ab P309L, D2980N, and F3138S and spike K77T. This study indicates that majority of the breakthrough COVID-19 clinical cases were infected with the Delta variant, and only 9.8% cases required hospitalization, while fatality was observed in only 0.4% cases. This clearly suggests that the vaccination does provide reduction in hospital admission and mortality.
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Affiliation(s)
- Nivedita Gupta
- Indian Council of Medical Research, V. Ramalingaswami Bhawan, Ansari Nagar, New Delhi 110029, India; (N.G.); (H.K.); (L.M.); (S.R.); (S.G.); (J.N.); (N.V.); (N.A.)
| | - Harmanmeet Kaur
- Indian Council of Medical Research, V. Ramalingaswami Bhawan, Ansari Nagar, New Delhi 110029, India; (N.G.); (H.K.); (L.M.); (S.R.); (S.G.); (J.N.); (N.V.); (N.A.)
| | - Pragya Dhruv Yadav
- Indian Council of Medical Research-National Institute of Virology, Pune 411021, India; (R.R.S.); (A.K.); (D.A.N.); (A.M.S.); (S.P.); (T.M.); (Y.J.); (P.P.); (M.D.); (P.A.)
- Correspondence: ; Tel.: +91-20-2600-6111; Fax: +91-20-2612-2669
| | - Labanya Mukhopadhyay
- Indian Council of Medical Research, V. Ramalingaswami Bhawan, Ansari Nagar, New Delhi 110029, India; (N.G.); (H.K.); (L.M.); (S.R.); (S.G.); (J.N.); (N.V.); (N.A.)
| | - Rima R. Sahay
- Indian Council of Medical Research-National Institute of Virology, Pune 411021, India; (R.R.S.); (A.K.); (D.A.N.); (A.M.S.); (S.P.); (T.M.); (Y.J.); (P.P.); (M.D.); (P.A.)
| | - Abhinendra Kumar
- Indian Council of Medical Research-National Institute of Virology, Pune 411021, India; (R.R.S.); (A.K.); (D.A.N.); (A.M.S.); (S.P.); (T.M.); (Y.J.); (P.P.); (M.D.); (P.A.)
| | - Dimpal A. Nyayanit
- Indian Council of Medical Research-National Institute of Virology, Pune 411021, India; (R.R.S.); (A.K.); (D.A.N.); (A.M.S.); (S.P.); (T.M.); (Y.J.); (P.P.); (M.D.); (P.A.)
| | - Anita M. Shete
- Indian Council of Medical Research-National Institute of Virology, Pune 411021, India; (R.R.S.); (A.K.); (D.A.N.); (A.M.S.); (S.P.); (T.M.); (Y.J.); (P.P.); (M.D.); (P.A.)
| | - Savita Patil
- Indian Council of Medical Research-National Institute of Virology, Pune 411021, India; (R.R.S.); (A.K.); (D.A.N.); (A.M.S.); (S.P.); (T.M.); (Y.J.); (P.P.); (M.D.); (P.A.)
| | - Triparna Majumdar
- Indian Council of Medical Research-National Institute of Virology, Pune 411021, India; (R.R.S.); (A.K.); (D.A.N.); (A.M.S.); (S.P.); (T.M.); (Y.J.); (P.P.); (M.D.); (P.A.)
| | - Salaj Rana
- Indian Council of Medical Research, V. Ramalingaswami Bhawan, Ansari Nagar, New Delhi 110029, India; (N.G.); (H.K.); (L.M.); (S.R.); (S.G.); (J.N.); (N.V.); (N.A.)
| | - Swati Gupta
- Indian Council of Medical Research, V. Ramalingaswami Bhawan, Ansari Nagar, New Delhi 110029, India; (N.G.); (H.K.); (L.M.); (S.R.); (S.G.); (J.N.); (N.V.); (N.A.)
| | - Jitendra Narayan
- Indian Council of Medical Research, V. Ramalingaswami Bhawan, Ansari Nagar, New Delhi 110029, India; (N.G.); (H.K.); (L.M.); (S.R.); (S.G.); (J.N.); (N.V.); (N.A.)
| | - Neetu Vijay
- Indian Council of Medical Research, V. Ramalingaswami Bhawan, Ansari Nagar, New Delhi 110029, India; (N.G.); (H.K.); (L.M.); (S.R.); (S.G.); (J.N.); (N.V.); (N.A.)
| | - Pradip Barde
- Viral Research and Diagnostic Laboratory, National Institute of Research in Tribal Health (NIRTH), Jabalpur 482003, India;
| | - Gita Nataraj
- Viral Research and Diagnostic Laboratory, Department of Microbiology, KEM Medical College, Mumbai 400012, India;
| | - Amrutha Kumari B.
- Viral Research and Diagnostic Laboratory, Department of Microbiology, Mysore Medical College, Mysore 570015, India; (A.K.B.); (M.P.K.)
| | - Manasa P. Kumari
- Viral Research and Diagnostic Laboratory, Department of Microbiology, Mysore Medical College, Mysore 570015, India; (A.K.B.); (M.P.K.)
| | - Debasis Biswas
- Viral Research and Diagnostic Laboratory, Department of Microbiology, All India Institute of Medical Sciences, Bhopal 462020, India;
| | - Jyoti Iravane
- Viral Research and Diagnostic Laboratory, Government Medical College, Aurangabad 431001, India;
| | - Sharmila Raut
- Viral Research and Diagnostic Laboratory, Indira Gandhi Government Medical College, Nagpur 440012, India;
| | - Shanta Dutta
- Viral Research and Diagnostic Laboratory, National Institute of Cholera and Enteric Diseases, Kolkata 700010, India;
| | - Sulochana Devi
- Viral Research and Diagnostic Laboratory, Regional Institute of Medical Sciences, Imphal 795004, India;
| | - Purnima Barua
- Viral Research and Diagnostic Laboratory, Jorhat Medical College, Jorhat 785001, India;
| | - Piyali Gupta
- Viral Research and Diagnostic Laboratory, Mahatma Gandhi Memorial Medical College, Jamshedpur 831020, India;
| | - Biswa Borkakoty
- Viral Research and Diagnostic Laboratory, ICMR-Regional Medical Research Centre, Dibrugarh 786001, India;
| | - Deepjyoti Kalita
- Viral Research and Diagnostic Laboratory, All India Institutes of Medical Sciences, Rishikesh 249203, India;
| | - Kanwardeep Dhingra
- Viral Research and Diagnostic Laboratory, Government Medical College, Amritsar 143001, India;
| | - Bashir Fomda
- Viral Research and Diagnostic Laboratory, Sher-i-Kashmir Institute of Medical Sciences, Srinagar 190011, India;
| | - Yash Joshi
- Indian Council of Medical Research-National Institute of Virology, Pune 411021, India; (R.R.S.); (A.K.); (D.A.N.); (A.M.S.); (S.P.); (T.M.); (Y.J.); (P.P.); (M.D.); (P.A.)
| | - Kapil Goyal
- Department of Virology, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, India;
| | - Reena John
- Viral Research and Diagnostic Laboratory, Government Medical College, Thrissur 680596, India;
| | | | - Rahul Dhodapkar
- Viral Research and Diagnostic Laboratory, Jawaharlal Institute of Postgraduate Medical Education & Research, Puducherry 605006, India;
| | - Priyanka Pandit
- Indian Council of Medical Research-National Institute of Virology, Pune 411021, India; (R.R.S.); (A.K.); (D.A.N.); (A.M.S.); (S.P.); (T.M.); (Y.J.); (P.P.); (M.D.); (P.A.)
| | - Sarada Devi
- Viral Research and Diagnostic Laboratory, Government Medical College, Thiruvanthapuram 695011, India;
| | - Manisha Dudhmal
- Indian Council of Medical Research-National Institute of Virology, Pune 411021, India; (R.R.S.); (A.K.); (D.A.N.); (A.M.S.); (S.P.); (T.M.); (Y.J.); (P.P.); (M.D.); (P.A.)
| | - Deepa Kinariwala
- Viral Research and Diagnostic Laboratory, B. J. Medical College, Ahmedabad 380016, India;
| | - Neeta Khandelwal
- Viral Research and Diagnostic Laboratory, Government Medical College, Surat 395001, India;
| | - Yogendra Kumar Tiwari
- Viral Research and Diagnostic Laboratory, Jhalawar Medical College, Jhalawar 326001, India;
| | - Prabhat Kiran Khatri
- Viral Research and Diagnostic Laboratory, Dr. Sampurnanand Medical College, Jodhpur 342003, India;
| | - Anjli Gupta
- Viral Research and Diagnostic Laboratory, Sarder Patel Medical College, Bikaner 334001, India;
| | - Himanshu Khatri
- Viral Research and Diagnostic Laboratory, Department of Microbiology, GMERS Medical College, Himmatnagar 383001, India;
| | - Bharti Malhotra
- Viral Research and Diagnostic Laboratory, Sawai Man Singh Medical College, Jaipur 302004, India;
| | - Mythily Nagasundaram
- Viral Research and Diagnostic Laboratory, Coimbatore Medical College, Coimbatore 641018, India;
| | - Lalit Dar
- Viral Research and Diagnostic Laboratory, All India Institute of Medical Sciences, Delhi 110029, India;
| | - Nazira Sheikh
- Viral Research and Diagnostic Laboratory, Dr. V.M Government Medical College, Solapur 413003, India;
| | - Jayanthi Shastri
- Viral Research and Diagnostic Laboratory, Kasturba Hospital for Infectious Diseases, Mumbai 400011, India;
| | - Neeraj Aggarwal
- Indian Council of Medical Research, V. Ramalingaswami Bhawan, Ansari Nagar, New Delhi 110029, India; (N.G.); (H.K.); (L.M.); (S.R.); (S.G.); (J.N.); (N.V.); (N.A.)
| | - Priya Abraham
- Indian Council of Medical Research-National Institute of Virology, Pune 411021, India; (R.R.S.); (A.K.); (D.A.N.); (A.M.S.); (S.P.); (T.M.); (Y.J.); (P.P.); (M.D.); (P.A.)
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25
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Gupta N, Kaur H, Yadav PD, Mukhopadhyay L, Sahay RR, Kumar A, Nyayanit DA, Shete AM, Patil S, Majumdar T, Rana S, Gupta S, Narayan J, Vijay N, Barde P, Nataraj G, B AK, Kumari MP, Biswas D, Iravane J, Raut S, Dutta S, Devi S, Barua P, Gupta P, Borkakoty B, Kalita D, Dhingra K, Fomda B, Joshi Y, Goyal K, John R, Munivenkatappa A, Dhodapkar R, Pandit P, Devi S, Dudhmal M, Kinariwala D, Khandelwal N, Tiwari YK, Khatri PK, Gupta A, Khatri H, Malhotra B, Nagasundaram M, Dar L, Sheikh N, Shastri J, Aggarwal N, Abraham P. Clinical Characterization and Genomic Analysis of Samples from COVID-19 Breakthrough Infections during the Second Wave among the Various States of India. Viruses 2021. [PMID: 34578363 DOI: 10.1101/2021.07.13.21260273v1.full-text] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/16/2023] Open
Abstract
From March to June 2021, India experienced a deadly second wave of COVID-19, with an increased number of post-vaccination breakthrough infections reported across the country. To understand the possible reason for these breakthroughs, we collected 677 clinical samples (throat swab/nasal swabs) of individuals from 17 states/Union Territories of the country who had received two doses (n = 592) and one dose (n = 85) of vaccines and tested positive for COVID-19. These cases were telephonically interviewed and clinical data were analyzed. A total of 511 SARS-CoV-2 genomes were recovered with genome coverage of higher than 98% from both groups. Analysis of both groups determined that 86.69% (n = 443) of them belonged to the Delta variant, along with Alpha, Kappa, Delta AY.1, and Delta AY.2. The Delta variant clustered into four distinct sub-lineages. Sub-lineage I had mutations in ORF1ab A1306S, P2046L, P2287S, V2930L, T3255I, T3446A, G5063S, P5401L, and A6319V, and in N G215C; Sub-lineage II had mutations in ORF1ab P309L, A3209V, V3718A, G5063S, P5401L, and ORF7a L116F; Sub-lineage III had mutations in ORF1ab A3209V, V3718A, T3750I, G5063S, and P5401L and in spike A222V; Sub-lineage IV had mutations in ORF1ab P309L, D2980N, and F3138S and spike K77T. This study indicates that majority of the breakthrough COVID-19 clinical cases were infected with the Delta variant, and only 9.8% cases required hospitalization, while fatality was observed in only 0.4% cases. This clearly suggests that the vaccination does provide reduction in hospital admission and mortality.
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Affiliation(s)
- Nivedita Gupta
- Indian Council of Medical Research, V. Ramalingaswami Bhawan, Ansari Nagar, New Delhi 110029, India
| | - Harmanmeet Kaur
- Indian Council of Medical Research, V. Ramalingaswami Bhawan, Ansari Nagar, New Delhi 110029, India
| | - Pragya Dhruv Yadav
- Indian Council of Medical Research-National Institute of Virology, Pune 411021, India
| | - Labanya Mukhopadhyay
- Indian Council of Medical Research, V. Ramalingaswami Bhawan, Ansari Nagar, New Delhi 110029, India
| | - Rima R Sahay
- Indian Council of Medical Research-National Institute of Virology, Pune 411021, India
| | - Abhinendra Kumar
- Indian Council of Medical Research-National Institute of Virology, Pune 411021, India
| | - Dimpal A Nyayanit
- Indian Council of Medical Research-National Institute of Virology, Pune 411021, India
| | - Anita M Shete
- Indian Council of Medical Research-National Institute of Virology, Pune 411021, India
| | - Savita Patil
- Indian Council of Medical Research-National Institute of Virology, Pune 411021, India
| | - Triparna Majumdar
- Indian Council of Medical Research-National Institute of Virology, Pune 411021, India
| | - Salaj Rana
- Indian Council of Medical Research, V. Ramalingaswami Bhawan, Ansari Nagar, New Delhi 110029, India
| | - Swati Gupta
- Indian Council of Medical Research, V. Ramalingaswami Bhawan, Ansari Nagar, New Delhi 110029, India
| | - Jitendra Narayan
- Indian Council of Medical Research, V. Ramalingaswami Bhawan, Ansari Nagar, New Delhi 110029, India
| | - Neetu Vijay
- Indian Council of Medical Research, V. Ramalingaswami Bhawan, Ansari Nagar, New Delhi 110029, India
| | - Pradip Barde
- Viral Research and Diagnostic Laboratory, National Institute of Research in Tribal Health (NIRTH), Jabalpur 482003, India
| | - Gita Nataraj
- Viral Research and Diagnostic Laboratory, Department of Microbiology, KEM Medical College, Mumbai 400012, India
| | - Amrutha Kumari B
- Viral Research and Diagnostic Laboratory, Department of Microbiology, Mysore Medical College, Mysore 570015, India
| | - Manasa P Kumari
- Viral Research and Diagnostic Laboratory, Department of Microbiology, Mysore Medical College, Mysore 570015, India
| | - Debasis Biswas
- Viral Research and Diagnostic Laboratory, Department of Microbiology, All India Institute of Medical Sciences, Bhopal 462020, India
| | - Jyoti Iravane
- Viral Research and Diagnostic Laboratory, Government Medical College, Aurangabad 431001, India
| | - Sharmila Raut
- Viral Research and Diagnostic Laboratory, Indira Gandhi Government Medical College, Nagpur 440012, India
| | - Shanta Dutta
- Viral Research and Diagnostic Laboratory, National Institute of Cholera and Enteric Diseases, Kolkata 700010, India
| | - Sulochana Devi
- Viral Research and Diagnostic Laboratory, Regional Institute of Medical Sciences, Imphal 795004, India
| | - Purnima Barua
- Viral Research and Diagnostic Laboratory, Jorhat Medical College, Jorhat 785001, India
| | - Piyali Gupta
- Viral Research and Diagnostic Laboratory, Mahatma Gandhi Memorial Medical College, Jamshedpur 831020, India
| | - Biswa Borkakoty
- Viral Research and Diagnostic Laboratory, ICMR-Regional Medical Research Centre, Dibrugarh 786001, India
| | - Deepjyoti Kalita
- Viral Research and Diagnostic Laboratory, All India Institutes of Medical Sciences, Rishikesh 249203, India
| | - Kanwardeep Dhingra
- Viral Research and Diagnostic Laboratory, Government Medical College, Amritsar 143001, India
| | - Bashir Fomda
- Viral Research and Diagnostic Laboratory, Sher-i-Kashmir Institute of Medical Sciences, Srinagar 190011, India
| | - Yash Joshi
- Indian Council of Medical Research-National Institute of Virology, Pune 411021, India
| | - Kapil Goyal
- Department of Virology, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, India
| | - Reena John
- Viral Research and Diagnostic Laboratory, Government Medical College, Thrissur 680596, India
| | | | - Rahul Dhodapkar
- Viral Research and Diagnostic Laboratory, Jawaharlal Institute of Postgraduate Medical Education & Research, Puducherry 605006, India
| | - Priyanka Pandit
- Indian Council of Medical Research-National Institute of Virology, Pune 411021, India
| | - Sarada Devi
- Viral Research and Diagnostic Laboratory, Government Medical College, Thiruvanthapuram 695011, India
| | - Manisha Dudhmal
- Indian Council of Medical Research-National Institute of Virology, Pune 411021, India
| | - Deepa Kinariwala
- Viral Research and Diagnostic Laboratory, B. J. Medical College, Ahmedabad 380016, India
| | - Neeta Khandelwal
- Viral Research and Diagnostic Laboratory, Government Medical College, Surat 395001, India
| | - Yogendra Kumar Tiwari
- Viral Research and Diagnostic Laboratory, Jhalawar Medical College, Jhalawar 326001, India
| | - Prabhat Kiran Khatri
- Viral Research and Diagnostic Laboratory, Dr. Sampurnanand Medical College, Jodhpur 342003, India
| | - Anjli Gupta
- Viral Research and Diagnostic Laboratory, Sarder Patel Medical College, Bikaner 334001, India
| | - Himanshu Khatri
- Viral Research and Diagnostic Laboratory, Department of Microbiology, GMERS Medical College, Himmatnagar 383001, India
| | - Bharti Malhotra
- Viral Research and Diagnostic Laboratory, Sawai Man Singh Medical College, Jaipur 302004, India
| | - Mythily Nagasundaram
- Viral Research and Diagnostic Laboratory, Coimbatore Medical College, Coimbatore 641018, India
| | - Lalit Dar
- Viral Research and Diagnostic Laboratory, All India Institute of Medical Sciences, Delhi 110029, India
| | - Nazira Sheikh
- Viral Research and Diagnostic Laboratory, Dr. V.M Government Medical College, Solapur 413003, India
| | - Jayanthi Shastri
- Viral Research and Diagnostic Laboratory, Kasturba Hospital for Infectious Diseases, Mumbai 400011, India
| | - Neeraj Aggarwal
- Indian Council of Medical Research, V. Ramalingaswami Bhawan, Ansari Nagar, New Delhi 110029, India
| | - Priya Abraham
- Indian Council of Medical Research-National Institute of Virology, Pune 411021, India
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A Comprehensive Review of COVID-19 Virology, Vaccines, Variants, and Therapeutics. Curr Med Sci 2021; 41:1037-1051. [PMID: 34241776 PMCID: PMC8267225 DOI: 10.1007/s11596-021-2395-1] [Citation(s) in RCA: 110] [Impact Index Per Article: 36.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Accepted: 06/25/2021] [Indexed: 02/08/2023]
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the causative pathogen of the coronavirus disease 2019 (COVID-19), has caused more than 179 million infections and 3.8 million deaths worldwide. Throughout the past year, multiple vaccines have already been developed and used, while some others are in the process of being developed. However, the emergence of new mutant strains of SARS-CoV-2 that have demonstrated immune-evading characteristics and an increase in infective capabilities leads to potential ineffectiveness of the vaccines against these variants. The purpose of this review article is to highlight the current understanding of the immunological mechanisms of the virus and vaccines, as well as to investigate some key variants and mutations of the virus driving the current pandemic and their impacts on current management guidelines. We also discussed new technologies being developed for the prevention, treatment, and detection of SARS-CoV-2. In this paper, we thoroughly reviewed and provided crucial information on SARS-CoV-2 virology, vaccines and drugs being used and developed for its prevention and treatment, as well as important variant strains. Our review paper will be beneficial to health care professionals and researchers so they can have a better understanding of the basic sciences, prevention, and clinical treatment of COVID-19 during the pandemic. This paper consists of the most updated information that has been available as of June 21, 2021.
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Focosi D, Tuccori M, Baj A, Maggi F. SARS-CoV-2 Variants: A Synopsis of In Vitro Efficacy Data of Convalescent Plasma, Currently Marketed Vaccines, and Monoclonal Antibodies. Viruses 2021; 13:1211. [PMID: 34201767 PMCID: PMC8310233 DOI: 10.3390/v13071211] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 06/01/2021] [Accepted: 06/02/2021] [Indexed: 12/24/2022] Open
Abstract
We summarize here in vitro evidences of efficacy for convalescent plasma, currently approved vaccines and monoclonal antibodies against SARS-CoV-2 variants of concern (VOC: B.1.1.7, B.1.351, P.1, and B.1.617.2), variants of interest (VOI: B.1.427/B.1.429, P.2, B.1.525, P.3, B.1.526, and B.1.671.1), and other strains (B.1.1.298 and B.1.258delta). While waiting from real world clinical efficacy, these data provide guidance for the treating physician.
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Affiliation(s)
- Daniele Focosi
- North-Western Tuscany Blood Bank, Pisa University Hospital, Via Paraisa 2, 56124 Pisa, Italy
| | - Marco Tuccori
- Division of Pharmacovigilance, Pisa University Hospital, Via Paradisa 2, 56124 Pisa, Italy
| | - Andreina Baj
- Department of Medicine and Surgery, University of Insubria, 21100 Varese, Italy
| | - Fabrizio Maggi
- Department of Medicine and Surgery, University of Insubria, 21100 Varese, Italy
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Deb B, Vilvadrinath R, Goel S. COVID-19 variants that escape vaccine immunity: Global and Indian context-are more vaccines needed? J Biosci 2021; 46:112. [PMID: 34857677 PMCID: PMC8633907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Accepted: 09/28/2021] [Indexed: 04/05/2024]
Abstract
The COVID-19 pandemic that emerged around December 2019 claimed millions of lives. For vaccine development, S protein on viral envelope that binds to ACE2 receptor on cells for entry was identified as vaccine candidate. S protein consists of Receptor Binding Motif (RBM) in the S1 subunit followed by the S2 subunit with an intermediate furin cleavage site. A stabilized version of S protein with 2 proline residues was used as antigen. Overall, most vaccines exhibited efficacy between 80 and 95%. However, being a RNA virus that is prone to mutations along with selection pressure on S protein and frequent use of convalescent plasma led to evolution of variants. These variants are responsible for multiple waves of infection observed globally. In our review, we discuss current data on vaccines and its efficacy in neutralizing SARS-CoV-2 from Wuhan and its variants. Further, our docked mutations observed in variants on the ACE2-S complex cryo-EM structure show that mostly the S1 domain is under selection pressure where major mutations occur in the N terminal domain (NTD), RBM and junction near S1-S2 subunit. Therefore, this review would be a reference for development of new candidate antigen(s) with better efficacy against variants.
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Affiliation(s)
- Bijayeeta Deb
- Indian Institute of Science Education and Research (IISER) Tirupati, Tirupati, India
| | - Ramya Vilvadrinath
- Indian Institute of Science Education and Research (IISER) Tirupati, Tirupati, India
| | - Suchi Goel
- Indian Institute of Science Education and Research (IISER) Tirupati, Tirupati, India
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