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Variant BA.2 Covid: 92% in France, what symptoms? – The Women’s Journal

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NEW VARIANT. This sub-variant of Omicron is the majority in France. It accounts for 92% of positive covid tests. Monoclonal antibodies Ronapreve and Evusheld could be used in preventive treatments against BA.2 What are its symptoms? How dangerous is it? Is it possible to be re-infected? Summary

[Mis à jour le 11 avril 2022 à 15h40] BA.2 is a subvariant of Omicron, itself a variant of Sars-CoV-2. BA.2 and responsible for the recent resumption of the epidemic. The symptoms of a BA.2 infection are the same as those caused by Omicron: fatigue, cough, fever… The BA.2 sub-lineage is the majority in France, representing 92% of the positive covid tests analyzed by Health Public France according to the epidemiological point of April 7. It is more contagious than the BA1 Omicron subvariant which first appeared in France. But it does not present more danger. French researchers from the Institut Pasteur studied the effectiveness of the monoclonal antibodies Ronapreve® (combination of two antibodies developed by Roche/Regeneron) and Evusheld® (combination of two antibodies developed by AstraZeneca) against the Omicron variant (BA.1 and BA.2) of the coronavirus. Ultimately, BA.1, and to a lesser extent BA.2, is less sensitive to Evusheld® and Ronapreve® than Delta. “The antibodies and the corresponding sera are little or not active against BA.1, but are more active against BA.2. Compared to Delta, the neutralizing activity is more severely reduced against BA.1: it takes 344 times more d antibodies to neutralize BA.1, and 9 times more to neutralize BA.2”, explains Timothée Bruel, first author of the study published on March 23. What is this new mutation of Covid-19? Is it more contagious, more dangerous, than Omicron? Is the vaccine effective against this new variant? What are the symptoms of BA.2? Update. Definition: what is the new BA.2 variant? “The BA.2 is a sub-variant of Omicron. It is a “little cousin” of the Omicron variant” explained Jean-François Delfraissy, president of the Covid Scientific Council, at the microphone of Franceinfo in January. Named BA.2, it is a sub-lineage of Omicron like BA.1 (which circulated until now) or BA.3. “The genetic sequence of the BA.2 subvariant differs from that of BA.1 and notably presents amino acid differences in the Spike protein and other proteins” indicated the WHO in February 2022. “The most recent studies seem to confirm that BA.1 and BA.2 present similar severity and escape from the immune response, and BA.2 is therefore not considered as a distinct variant but as included in the Omicron VOC” specifies Santé Publique France . However BA.2 “is the most contagious variant of the SARS-CoV-2 virus that we have seen so far”, alerted Maria Van Kerkhove of the WHO, on March 19 at a press conference. What is the rate of the BA.2 variant in France? The BA.2 Omicron variant is now more present than the BA.1 variant, which has been circulating mainly since the end of 2021 in France. As of April 7, according to Santé Publique France, BA.2 represents 92% of the Omicron sequences analyzed over the week of March 21 to 27. “The progression of BA.2 to the detriment of BA.1 is observed throughout the metropolitan territory, but at different levels depending on the region. In the DROMs, BA.2 also seems to be increasing but the data needs to be consolidated” adds the organization. What are the symptoms of the BA.2 variant? For the moment, there are no specific symptoms listed on the cases of sub-variants BA.2. On the other hand for the Omicron variant “the epidemiological investigations indicate a specific clinical presentation with more high respiratory symptoms and less loss of taste and smell, as well as a lower severity (risk of hospitalization and admission to intensive care up to 80% lower)” reported Santé Publique France on January 26. Symptoms of the BA.2 variant (like Omicron in general) can be: Extreme fatigue; Cough ; Fever ; Headache Muscle aches or body aches; Sore throat ; Runny nose ; Nausea and vomiting Unpleasant breathing (more rarely) Loss of taste and smell (more rarely) Is the BA.2 variant more contagious than Omicron? “BA.2 is more transmissible than BA.1 (secondary attack rate of 39% for BA.2 against 29% for BA.1). A study also estimates that the generation interval (time between two cases) of BA.2 is 15% lower than that of BA.1. These differences in transmissibility explain the gradual replacement of BA.1 by BA.2 observed on a global scale” emphasizes Public Health France on March 25. BA.2 “is the most contagious variant of the SARS-CoV-2 virus that we have seen so far,” WHO epidemiologist Maria Van Kerkhove said on March 19. Proportion of BA.2 cases among the total number of sequences deposited on GISAID, by country as of February 21, 2022 © Santé Publique France What are the risks of reinfection with BA2? The frequency of possible reinfections with SARS-CoV-2 has increased significantly since the introduction and distribution in France of the Omicron variant, at the beginning of December 2021, notes Public Health France. “The upward resumption of the circulation of SARS-CoV-2 observed for several weeks in France and the emergence of the Omicron BA.2 sub-lineage, which has dominated since week 09-2022, are two factors that may play a role in the current trend of an increase in the number of reinfections” confirms the agency. Several recent studies have demonstrated the possibility of occurrence of reinfection with BA.2 following infection with BA.1, including within a very short period of time (less than 60 days). “Nevertheless they agree on the fact that these are probably rare events.” Is the BA.2 variant more dangerous than Omicron? “Omicron’s BA2 subvariant does not ’cause a more severe form’ of Covid than BA1, according to Maria Van Kerkhove, epidemiologist in charge of the emerging diseases unit at WHO, on March 19. However, with a large number of cases, you will see an increase in hospitalizations and that will turn into an increase in deaths…”. She clarified that there is “no difference in terms of severity between BA1 and BA2”. “In France, the screening strategy makes it possible to detect all Omicron without distinction, whether they are BA.1 or BA.2 and therefore to know in a reactive way the level of circulation of the variant” indicates Public Health France. In a second step, sequencing makes it possible to differentiate between the sub-variants, BA.1 and BA.2 “The screening makes it possible to reactively follow the Omicron as a whole and the sequencing allows a finer analysis of the different sub-variants. -lineages [BA.1 ou BA.2]”. Are the vaccines effective against the BA.2 variant? “The efficacy of the vaccine against symptomatic disease caused by BA.1 and BA.2 is similar: after two doses the efficacy is 10% for BA. 1 and 18% for BA.2, after three doses the efficacy against symptomatic disease is 69% for BA.1 and 74% for BA.2. Efficacy drops to almost 50% two and a half months after the 3rd dose for BA.1 and BA.2” according to the British health agency study published on February 25. “This suggests that vaccination is at least effective in preventing acquisition of BA.2 and may be more effective in preventing transmission of BA.2 than BA.1,” the WHO noted. “Vaccine efficacy is retained against Omicron after administration a booster dose, in particular against severe forms” confirmed Public Health France on January 26. What treatments to prevent infection with the BA.2 variant? Several monoclonal antibody treatments are available to prevent infection with Covid – 19. Researchers from the Institut Pasteur, the CNRS, the Vaccine Research Institute (VRI), in collaboration with the CHR of Orléans, the AP-HP, KU Leuven (Catholic University of Louvain) and Paris Cité University have studied the efficacy of two combinations of therapeutic monoclonal antibodies Ronapreve (combination of two antibodies developed by Roche/Regeneron) or Evusheld (combination of two antibodies developed by AstraZeneca) against the Omicron variant (BA.1 and BA.2) of the coronavirus. “We show that the antibodies and the corresponding sera have little or no activity against BA.1, but are more active against BA.2. Compared to Delta, the neutralizing activity is more severely reduced against BA.1: it takes 344 times more antibodies to neutralize BA.1, and 9 times more to neutralize BA.2”, explains Timothée Bruel, first author of the study published on March 23 in Nature Medicine and researcher in the Virus and Immunity Unit at the Institut Pasteur (mixed CNRS research unit). Four Omicron infections were described among the 29 patients treated with antibodies (including one severe case). “This indicates that, in this case, the treatment does not completely protect either against infection or against severe forms” explains Thierry Prazuck, co-lead author of the study and head of the infectious diseases department at the CHR d’Orléans . Sources: – “Serum neutralization of SARS-CoV-2 Omicron BA.1 and BA.2 sublines in patients receiving monoclonal antibodies”, Nature Medicine, March 23, 2022 – “SARS-CoV-2 variants of concern and variants under investigation in England”, British Health Agency, February 25, 2022 – “Coronavirus: circulation of SARS-CoV-2 variants’, updated February 25, 2022, Public Health France – “BA.2 is more transmissible than BA. 1 but vaccinated people are less likely to be infected and to transmit the infection”, January 31, Statens Serum Institut. – COVID-19: epidemiological update of January 27, 2022, Public Health France – “Risk analysis on the variants of SARS-CoV-2”, January 26, 2022, Public Health France. -“Now a variant of Omicron, BA.2, accounts for almost half of all Danish Omicron cases” January 20, 2022, Statens Serum Institute.

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