Division of Infectious Diseases, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
AIDS Research Institute, Yonsei University College of Medicine, Seoul, Korea.
Yonsei Med J. 2021 Nov;62(11):961-968. doi: 10.3349/ymj.2021.62.11.961.
Since the COVID-19 pandemic first began in December 2019, the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus has continuously evolved with many variants emerging across the world. These variants are categorized as the variant of interest (VOI), variant of concern (VOC), and variant under monitoring (VUM). As of September 15, 2021, there are four SARS-CoV-2 lineages designated as the VOC (alpha, beta, gamma, and delta variants). VOCs have increased transmissibility compared to the original virus, and have the potential for increasing disease severity. In addition, VOCs exhibit decreased susceptibility to vaccine-induced and infection-induced immune responses, and thus possess the ability to reinfect previously infected and recovered individuals. Given their ability to evade immune responses, VOC are less susceptible to monoclonal antibody treatments. VOCs can also impact the effectiveness of mRNA and adenovirus vector vaccines, although the currently authorized COVID-19 vaccines are still effective in preventing infection and severe disease. Current measures to reduce transmission as well as efforts to monitor and understand the impact of variants should be continued. Here, we review the molecular features, epidemiology, impact on transmissibility, disease severity, and vaccine effectiveness of VOCs.
自 2019 年 12 月 COVID-19 大流行首次开始以来,严重急性呼吸系统综合征冠状病毒 2(SARS-CoV-2)病毒不断进化,全球出现了许多变体。这些变体被归类为关注变体(VOI)、关注变体(VOC)和监测变体(VUM)。截至 2021 年 9 月 15 日,有四种 SARS-CoV-2 谱系被指定为 VOC(alpha、beta、gamma 和 delta 变体)。与原始病毒相比,VOC 的传染性更强,并且有可能增加疾病的严重程度。此外,VOC 对疫苗诱导和感染诱导的免疫反应的敏感性降低,因此具有重新感染先前感染和康复个体的能力。鉴于它们逃避免疫反应的能力,VOC 对单克隆抗体治疗的敏感性降低。VOC 还会影响 mRNA 和腺病毒载体疫苗的有效性,尽管目前授权的 COVID-19 疫苗仍然有效预防感染和严重疾病。应继续采取当前的传播减少措施以及监测和了解变体影响的努力。在这里,我们回顾了 VOC 的分子特征、流行病学、对传染性、疾病严重程度和疫苗有效性的影响。