印度流行的新冠病毒特點(diǎn)

印度流行的新冠病毒特點(diǎn)：1（SARS-CoV-2

Delta

variant）—主要變異位點(diǎn)有哪些—能否導(dǎo)致已有的疫苗失敗？？2一、全球新冠病毒不同變異及分類匯總3不同變異新冠病毒株重視程度：VOI

有意義的變異株variant

of

interestVUIVOC需要進(jìn)一步觀察株值得關(guān)注變異株variant

under

investigationvariant

of

concern4全球主要的SARS-CoV-2的“4大”突變株：原始病毒株2020-01

WIV04

/

2019（SARS-CoV-2）B.1.1.7

（20B/501Y.V1）

英國(guó)株B.1.351（501.V2,20C/501Y.V2）

南非株B.1.617.1、2、3（VOC

20I/484K/Q） 印度株P(guān)1

variant

巴西株5全球14個(gè)Notable（顯著）變異株？1.

Cluster52.

Lineage

B.1.1.7

/

Variant

of

Concern

20DEC-01-VOC-

21FEB-023.

Lineage

B.1.1.2074.

Lineage

B.1.1.3175.

Lineage

B.1.1.3186.

Lineage

B.1.3517.

Lineage

B.1.429

/

CAL.20C8.

Lineage

B.1.5259.

Lineage

B.1.526滅絕的丹麥株英國(guó)尼日尼亞澳大利亞昆士蘭英國(guó)南非毒株美國(guó)加利福利亞英國(guó)變異較多美國(guó)印度Lineage

B.1.617（

B.1.617,

B.1.617.1,

B.1.617.2,

and

B.1.617.3）Lineage

B.1.61812.Lineage

B.1.62013.Lineage

P.114.Lineage

P.3南非立陶宛巴西-英國(guó)，日本發(fā)現(xiàn)菲律賓6全球主要10大Notable

missense（錯(cuò)義）突變位點(diǎn)：N440K

傳染性增加L452R

雙突變，增加了ACE

的親和力，抵抗T

細(xì)胞免疫S477G/N

最多交換的氨基酸位點(diǎn)E484K

英國(guó)The

P.1.lineage

described

in

Japan

and

Manaus,theP.2lineage(also

known

as

B.1.1.28.2

lineage,Brazil)and

501.V2(South

Africa)改變抗原E484Q

增加了ACE2

親和力，降低中和抗體能力N501Y

增加了ACE2

親和力，最強(qiáng)D614G

傳染性增大，高VL

和感染性增強(qiáng)，嗅覺影響最大P681H

類似于D614GP681R

常伴有E484Q

and

L452R

,P681R

in

B.1.617A701V

馬來西亞7新的clade命名符合條件：·In

another

source,

GISAIDbut

including

a

GV

clade.nameaset of

7

cladeswithout

theO

clade·According

to

the

WHO,

"Lineages

or

clades

can

be

defined

based

on

viruses

thshare

a

phylogenetically

determined

common

ancestor".·As

of

January

2021,

at

least

one

of

the

following

criteria

must

be

met

in

ordcount

as

a

clade

in

the

Nextstrain

system

(quote

from

source):A

clade

reaches

>20%

global

frequency

for

2

or

more

monthsA

clade

reaches

>30%

regional

frequency

for

2

or

more

monthsAVOC

(‘variant

of concern’)

is

recognized2021]

to

501Y.V1

and

501Y.V2)(applies全球總的發(fā)現(xiàn)的變異病毒的分類及特點(diǎn)：123410全球總的發(fā)現(xiàn)的變異病毒的分類及特點(diǎn)：AB"—"

denotes

that

no

reliable

sources

could

be

found

to

cite.The

naming

format

was

updated

in

March

2021,

changing

the

year

from

4

to

2

digits

and

themonth

from

2

digits

to

a

3-letter

abbreviation.

For

example,

VOC-202101-02

became

VOC-21JAN-02.CDEFAnother

preliminary

study

has

estimatedthat

P.1

ma

transmiyssible,

wbieth

a

cre1d7i0b–le24i0n%terval

wimtohrae

low

probability

of

50%.[better

source

neThe

reported

credible

interval

has

a

low

probability

of

only

50%,

so

the

estimated

lethcan

only

be

understood

as

possible,

not

certain

nor

likely.B.1.1.7

with

E484K

is

separately

designated

VOC-21FEB-02Another

study

has

estimated

that

B.1.1.7

may

be

32–104%

more

lethalIncludes

B.1.617,

B.1.617.1,

B.1.617.2,

and

B.1.617.3Formerly

VUI-21APR-02.IJKIncludes

B.1.525

and

B.1.526.Formerly

UK1188.Alternatively

VOC-202102/021211二、印度株有哪些變異及其可能特點(diǎn)？發(fā)現(xiàn)于2021-04-21，證實(shí)了100序列1213Delta

variant：Lineage

B.1.617.1.2.3又名G/452R.V3發(fā)現(xiàn)于：——Maharashtra,

India——5

October

2020主要的雙突變：E484Q

and

L452R;部分3個(gè)突變：

+P681R綽號(hào)：

this

moniker

has

been

considered

"misleading".14Lineage

B.1.617又名G/452R.V3三個(gè)亞系：

至May

2021B.1.617.1B.1.617.2December

2020December

2020B.1.617.3

October

2020

in

India

最少！其他：——There

were

few

known

cases

of

B.1.617

(of

allsublineages)

until

early

February

2021

when

there

was

asignificant

increase.15發(fā)現(xiàn)于印度的B.1.617：May

2021,

three

sublineages

have

been

found.SARS-CoV-2

Kappa

31

May

2021SARS-CoV-2

Delta

31

May

2021October202016B.1.1.7（Alpha），B.1.617.2（Delta）Alpha更具有致命性。Delta傳染性：比Alpha強(qiáng)50%，傳播力很強(qiáng)，致病性卻有所減弱。Delta復(fù)制能力增強(qiáng)，且偏好在上呼吸道，容易傳播，容易影響年輕人。

Delta在印度首次被發(fā)現(xiàn)。由于它攜帶了兩個(gè)可能對(duì)新冠病毒傳播力和免疫逃逸能力產(chǎn)生影響的重要突變，因此也被稱為“雙重突變”病毒。Delta為第2類值得關(guān)注變異體，威脅性低于Alpha、Beta、Gamma變異株。

推動(dòng)英國(guó)新一波疫情最常見的就是Alpha，它是2020年末在英國(guó)東南部被發(fā)現(xiàn)，同樣具有傳播力更強(qiáng)的特點(diǎn)。17Lineage

B.1.617又名G/452R.V3，發(fā)現(xiàn)于印度的B.1.617：early

February

2021

B.1.617there

was

a

significant

incre

asge.s)(of

alluntilsublinwehenB.1.617.2從VUI變?yōu)閂OC，傳染性可能On

6-7

May

2021接近于B.1.1.7.on

11

May

2021

W

H

O定為V

O

C，證實(shí)了：h

i

g

h

e

rtransmissibility

and

reduced

neutralisation.導(dǎo)致了印度的第二波疫情：

Thevariant

ispartlythought

to

bwave

ofresponsible

for

India"s

seceondthe

pandemic beginning

in

February

2021.B.1.617.1

remains

a

VOI

and

has

not

been

escalated

to

VOC

status.18命名過程：雙突變："Double

mutation"refers

to

B.1.617"s

mutations

in

the

gene

encoding

the

SARS-CoVspike

protein

causing

the

substitutions替代E484Q

and

L452R.Nextstrain

phylogenetic

classification

sys2t1eAm：clade.The

use

of

the

term

"double

mutant"

has

been

criticised

by

infectious

disease

scientiSARS-CoV-2

being

in

a

state

of

perpetual

mutation

with

numerous

variants

occurring

around

thworld,

most

of

which

carry

more

than

one

mutation,

so

use

of

this

ambiguous

and

misleading

teis

being

discouraged.Due

to

the

variant

having

first

been

discovered

in

the

country,

and

following

the

precalling

B.1.1.7

the

"UK

variant",

many

media

outlets

have

referred

to

B.1.617

as

thevariant",

contrary

to

recommendations

and

internal

policies

used

by

WHO

that

discourage

theof

names

that

stigmatize

countries,

particularly

the

ones

conducting

important

work

insequencing.·In

Scotland,

First

Minister

Nicola

Sturgeon

stated

that

its

government

would

refer

to

it

as

"02".On

21

May

2021,

India"s

Ministry

of

Electronics

and

Information

Technology

ordered

smedia

companies

to

remove

all

posts

that

refer

to

or

imply

an

"Indian

variant"

of

SARS-CoV-2classifying

it

as

misinformation

because

the

WHO

does

not

recognize

an

"Indian

variantSARS-CoV-2

as

per

its

policies19特征：Characteristics傳染性強(qiáng)： Emerging

research

suggests

the

variant

may

be

moretransmissible

than

previously

evolved

ones.疫苗有效性？ Whether

the

effectivenessvaccines

is

affecutrerdernetmlayi-ndsepulnodyeerdinvestigation.感染率：of

c<30the

first

wave in

the

second

wave31%32%30–40住院率：21%20-3923.7%25.5%0-194.2%.5.8%20Characteristics無癥狀感染者，呼吸困難增多：T

h

e

d

at

a

a

l

s

o

s

h

o

we

d

a

hiproportion

of

asymptomatic

patientsgwherre

admitted

during

the

second

wave,

wmore

complaints

of

breathlessness.傳播快：

On

7

May

2021,

British

sciPublic

Health

England

redesignatedenotniestosf

tahte

three

sublineages,

B.1.6"variant

of

concern"

(VOC-21APR-02),

after

they

flagged

evidence

in

May

20that

it

spreads

more

quickly

than

the

original

version

of

the

virus.社區(qū)獲得性傳播： Another

reason

was

that

they

identified48

clusters

of

B.1.617.2,

some

of which

revealed

a degree

ofmmunity

transmission21印度以外國(guó)家發(fā)現(xiàn)的傳播：late

February

2021India,6.

on

19

April

2021 Fiji

also

confirmed

its

first

case

of

the

variin

Lautoka,

and

has

since

then

climbed

up

to

42

cases

and

counting.

The

varihas

been

identified

as

a

super-spreader

and

has

led

to

the

lockdowns

ocities

(Lautoka,

Nadi,

Suva,

Lami

and

Nausori),

an

area

which

accountsalmost

two-thirds

of

the

country"s

population.1.

on

22

FebruaryUnited

Kingdomon

23

Februaryon

26

Februarythe

United

StatesSingapore.on

21

April

2021on

22

April

2021Canada"s

in

QuebecBritish

Columbia：Alberta.22印度以外國(guó)家發(fā)現(xiàn)的傳播：7.

On

29

April

2021health

officials

from

Finland"s

the

MinistrySocial

Affairs

and

Health

(STM)

and

the

Finnish

Institute

for

Health

aWelfare

(THL)

reported

that

the

variant

had

been

detected

in

three

samdating

back

to

March

2021.7.

On

11

May

2021 The

Philippines

confirmed

its

first

two

cases

ofthe

variant,

despite

the

imposed

travel

ban

of

the

country

from

the

nationsIndian

subcontinent

(except

for

Bhutan

and

Maldives).

Both

patients

hatravel

history

from

India

for

the

past

14

days,

but

instead

from

Oman

and

UAThe

detection

of

B.1.617

was

hampered

in

some

countries

by

a

lack

of

specialikits

for

the

variant

and

laboratories

that

can

perform

the

genetic

test.as

of

18

May,

Pakistan

had

not

reported

any

cases,

but

authorities

noted

thatof

COVID-19

samples

in

the

country

were

of

an

"unknown

variant";

they

couldnot

say

if

it

was

B.1.617

because

they

were

unable

to

test

for

it.Other

countries

had

reported

travellers

arriving

from

Pakistan

that

were

inwith

B.1.61723Lineage

B.1.617：

印度株In

an

announcement

on

15

April

2021,

Public

Health

England(PHE)

designated

B.1.617

as

a

"Variant

under

investigation",

VU21APR-01.October

2020January-April

2021early

May

2021被發(fā)現(xiàn)全球20個(gè)國(guó)家發(fā)現(xiàn)全球50個(gè)國(guó)家除Antartica外各大洲53個(gè)國(guó)家May

202124三、印度株有哪些主要變異？25ORF1ab61.

T749I2.

T77A3.

P323L4.

M429I5.

K259R6.

T93M其他：3：orf3a:S26L；orf6：I33T；orf7a:V82ASpikeG142DE154KL452RE484QD614GP681RQ1071HH1101D817個(gè)主要變異位點(diǎn)：8+6+3=1726含有變異位點(diǎn)：總數(shù)：值得關(guān)注的spike：

5個(gè)D111D

(synonymous

substitution)G142DP681R

增加細(xì)胞感染性E484Q

增加ACE2親和力和逃避免疫15-17個(gè)增加ACE2親和力和減弱免疫識(shí)別5.

L452R突變位點(diǎn)：共13

個(gè)(15

or

17），S：8個(gè)，其中4個(gè)of

great

concern:

D614G.

The

substitution

at

position

614,

an

aspartic

acid-toglycine

substitution,

is

shared

with

other

highly

transmissiblvariants

like

B.1.1.7,

B.1.351

and

P.1.

E484Q. The

substitution

at

position

484,

a

glutamic

acid-toglutamine

substitution,

confers

the

variant

stronger

bindingpotential

to

hACE2

(the

human

ACE2

receptor),

as

well

asbetter

ability

to

evade

hosts"

immune systems,

for

B.1.617

icomparison

to

other

variants.

This

mutation

is

not

present

in

theB.1.617.2

genome.3.

L452R. The

substitution

at

position

452,

a

leucine-to-argininesubstitution,

confers

stronger

affinity

of

the

spike

protein

forACE2

receptor

and

decreased

recognition

capability

of

theimmune

system.

These

mutations,

when

taken

individually,

are

notunique

to

the

variant;

rather,

their

simultaneous

occurrence

is.3.

P681R. The

substitution

at

position

681,

a

proline-to-argininesubstitution,

which,

according

to

William

A.

Haseltine,

may

boostcell-level

infectivity

of

the

variant

"by

facilitating

cleavage

oS

precursor

protein

to

the

active

S1/S2

configuration".29304個(gè)S區(qū)變異：

D614G.

an

aspartic

acid-to-glycine

substitution,

is

sharedother

highly

transmissible

variants

like

B.1.1.7,

B.1.351

and

P.1.

E484Q. a

glutamic

acid-to-glutamine

substitution,

confers

tvariant

stronger

binding

potential

to

hACE2

(the

human

ACE2

receptor),well

as

better

ability

to

evade

hosts"

immune

systems,

for

B.1.617

icomparison

to

other

variants.

This

mutation

is

not

present

in

the

B.1.genome.2.

L452R. a

leucine-to-arginine

substitution,

confers

stronaffinity

of

the

spike

protein

for

the

ACE2

receptor

and

decreasedrecognition

capability

of

the

immune

system.

These

mutations,whentindividually,

are

not

unique

to

the

variant;

rather,

their

simultaneous

occis.2.

P681R. a

proline-to-arginine

substitution,

which,

accordinWilliam

A.

Haseltine,

may

boost

cell-level

infectivity

of

the

varianfacilitating

cleavage

of

the

S

precursor

protein

to

the

active

S1/S2

config291、L452R：leucine(L)--arginine(R)常伴隨雙突變： There

has

been

a

significantCOVID-19

starting

2021

all

across

Indiasucraguesedofin

part

by

B.1.617,

frequentmisleadingly,

referred

to

as

a

"double

mutant".增加了ACE2受體的結(jié)合力： a

relevant

mutation

in

this

strain

thaenhances

ACE2

receptor

binding

ability減弱了疫苗的保護(hù)力：c

a

n

r

e

d

u

cvea

c

c

i

n

e

-

s

t

i

m

u

l

a

t

eantibodies

from

attaching

to

this

altered

spike

protein.減弱了T細(xì)胞免疫： L452R,

some

studies

show,

could

even

makethe

coronavirus

resistant

to

T

cells,

that

are

class

of

cells

necessary

to

tdestroy

virus-infected

cells.They

are

different

from

antibodies

that

are

useful

in

blocking

coronavirusand

preventing

it

from

proliferating.30altered

spike

protein.2、E484Q

增加ACE2親和力，降低中和抗體The

name

of

the

mutation,

E484Q,

refers

to

an

exchange

wherebythe

glutamic

acid

(E)

is

replaced

by

glutamine

(Q)

at

position

484India

is

seeing

a

significant

surge

of

COcaused

in

part

by

B.1.617.This

has

frequently

(but

misleadingly,

as

mostmultiple

mutations)

been

referred

to

as

a

"double

mutant".E484Q

may

enhance

ACE2

receptor

binding

ability

and

mayreduce

vaccine-stimulated

antibodies

from

attaching

to

thi313、P681RThe

name

of

the

mutation,

P681R,

refers

to

an

exchange

wherebythe

proline

(P)

is

replaced

by

arginine

(R)

at

position

681.印度的三劍客： I

n

d

i

a

n S

A

R

S

-

C

o

V-

2 G

e

n

o

m

iConsortium

(INSACOG)cfsound

that

other

than

the

two

mutationsE484Q

and

L452R,

there

is

also

a

third

significant

mutation,P681R

in

B.1.617.All

three

concerning

mutations

are

on

the

spike

protein,

thoperative

part

of

the

coronavirus

that

binds

to

receptor

cellsofbody.32On

7

May

2021,

Public

Health

England

reclassified

B.1.617.2

to

a

variantof

concern

under

the

name

VOC-21APR-02

due

to

evidence

that

it

is

at

least

as

transmissible

as

B.1.1.7.On

11

May

2021,

WHO

also

classified

it

as

a

variant

of

concern.·Simultaneously,

the

ECDC

released

a

brief

maintaining

all

three

B.1.617variants

as

VoI,

estimating

that

a

"greater

understanding

of

the

risks

reto

these

B.1.617

lineages

is

needed

before

any

modification

ofcurrent

measures

can

be

considered"L452RE484QT478KB.1.617.1VUI-21APR-01++-B.1.617.2VUI-21APR-02+-+B.1.617.3VUI-21APR-03++-33三、印度株對(duì)現(xiàn)有疫苗有影響嗎？34Vaccine

efficacyICMR

found

that

convalescent

sera

of

the

COVID-19

cases

and

recipientsBharat

Biotech"s

BBV152

(Covaxin)were

able

to

neutralise

VUI

B.1.617

althowith

a

lower

efficacy.

降低？Anurag

Agrawal,

the

Director

of

the

Institute

of

Genomics

and

IntegratBiology

(IGIB),

said

the

study

on

effectiveness

of

the

available

vaccines

oB.1.617

variant

of

SARS-CoV2

suggests

that

post

vaccination,

the

infectionmilder.He

tweeted:

疫苗后感染輕癥？Initial

positive

neutralization

studies

of

B.1.617,

with

both

post-CoCovishield

sera,

are

correlatable

with

milder

disease

during

post-vaccbreakthrough

infections.

This

is

a

positive

while

we

get

quantitative

dataunderstanding

of

infection

protection.Vaccine

efficacyAnthony

Fauci,

the

Chief

Medical

Advisor

tohas also

expressed

his

confidence

regarding

the

preliminary

results.interview

he

said:This

is

something

where

we"re

still

gaining

data

on

a

daily

basis.

Butrecent

data,was

looking

at

convalescent

Sera

of

COVID-19

cases

and

people

wreceived

the

vaccine

used

in

India,the

Covaxin.It

was

found

to

neutralisevariants.

有效？Another

study

by

the

Centre

for

Cellular

and

Molecular

Biology

(CCMB)Hyderabad

found

Covishield

(Oxford–AstraZeneca)vaccinated

sera

offerprotection

against

the

B.1.617

variant.Rakesh

Mishra,the

Director

ofsaid

in

a

tweet:

有效？Very

preliminary

but

encouraging result:

#Covishield

protectsEarly

results

using

in

vitro

neutralisation

assay

show

that

both

con3v5

alesce36Vaccine

efficacyThe

WHO

said

current

vaccines

will

continue

to

be

effective

against

the

varIn

an

updateeducedneutralization".in May,

they

said

theremay

be someevidence

of

"r降低？In

a

study

conducted

by

th