In 2022, multiple new Omicron variants BA.1, BA.2, BA.4, and BA.5 assaulted the world’s population of humans and other animals. By the time multiple companies made and tested Omicron BA.1 vaccines, BA.1 was no longer the dominant variant; in fact, it was no longer present. On August 31, 2022, the FDA allowed rapid introduction of an Omicron BA.5 bivalent vaccine. However, this has had no effect on new immune evading BQ variants. In December the first highly infectious recombinant variant, XBB, began spreading around the world. An additional variant, XBB.1.5, is now rapidly spreading across the country and the world causing increased numbers of hospitalizations and critically ill patients in the USA. A new variant, CH.1.1 (BA.2.75.3.4.1.1.1.1) caused 5.9% of infections in the world from December 25 to January 14, 2023 and, from December 26 to January 1, 19.5% of infections in the United Kingdom.
On January 13, the World Health Organization (WHO) updated its recommendations on mask wearing to specify that, given the global spread of COVID-19, masks should be worn “irrespective of the local epidemiological situation,” meaning that masks are now recommended for everyone, not just people in areas with high levels of transmission. Here are our 14-day moving average determinations for SARS-CoV-2 for the United States. We use the WORLDOMETERS aggregators data set to make any projections since it includes data from the Department of Veterans Affairs, the U.S. Military, federal prisons and the Navajo Nation.
XBB.1.5 Variant Continues to Dominate
During the week ending in 1/14/22, the CDC estimates that based on genomic surveillance, XBB.1.5 accounted for 43% of infections, followed by BQ.1.1 at 28.8%, BQ.1 at 15.9%, XBB at 3.9%, BA.5 at 2.6%, BN.1 at 2.1%, BF.7 at 1.4%, and BA.2.75 at 1.3%. The remaining variants made up less than 1% each: BA.5.2.6 (0.5%), BA.2 (0.2%), BF.11 (0.2%), BA.4.6 (0.1%), and BA.2.75.2 (0.1%). We are keeping our eye on BA.2.75, as the CDC is likely lumping in its descendant, CH.1, and its subvariants under this label.
BQ.1.1 has five spike mutations that are different from BA.5. Four of these mutations allow escape from immunity from monoclonal antibodies, any prior infection (including Omicron BA.5), or any vaccine to include the bivalent Omicron BA.5 vaccine. Infections are still occurring in our clinic in patients that received the Omicron BA.5 bivalent vaccine. The XBB recombinant isolate XBB.1.5 has rapidly become the dominant infection in the USA. It took 28 days to become the cause of 40% of infections in the USA. As of 1/14/23, XBB.1.5 now causes over 80% of infections in Regions 1 and 2.
The “Omicron family feud” is a phrase coined by Dr. Raj Rajnarayanan to describe what’s going on between the Omicron BQ variants, BQ.1, BQ,1.1 (and other BQ variants) and XBB.1.5 (and other XBB variants). In the USA in regions 1 and 2, XBB.1.5 has won the feud. A new variant of BA2.75, CH.1.1, is now 4.9% of SARS-CoV-2 isolates in the world. It has the Delta mutation, P681R, which should raise a red flag. According to Saito et al, the P681R mutation, “facilitates cleavage of the spike protein and enhances viral fusogenicity [the ability of the virus to fuse to human cell membranes]….and pathogenicity [lethality].”
XBB.1.5 Proportion of Sequenced Isolates in the USA
| 12/3/22 | 12/10/22 | 12/17/22 | 12/24/22 | 12/31/22 | 1/7/23 | 1/14/23 |
| 2.3% | 4.4% | 7.4% | 11.8% | 20.1% | 30.4% | 43.0% |
BQ. 1 and BQ.1.1 Totaled Proportion of Sequenced Isolates in the USA
| 12/3/22 | 12/10/22 | 12/17/22 | 12/24/22 | 12/31/22 | 1/7/23 | 1/14/23 |
| 53.5% | 57.4% | 58.6% | 60.3% | 59.2% | 53.2% | 44.7% |
Percent of isolates identified as XBB.1.5 by Region
| Region | ||||||||||
| Week ending in | 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 | 10 |
| 12/31/22 | 75.3% | 72.2% | 32.7% | 19.0% | 6.0% | 21.5% | 8.1% | 2.1% | 9.2% | 2.5% |
| 1/14/23 | 81.7% | 82.7% | 49.0% | 31.1% | 14% | 24.9% | 8.8% | 15% | 15.8% | 8.1% |
SARS-CoV-2 infections per day in the United States have increased for the second time in 6 weeks. There is still widespread underreporting by states, a failure to capture all positive home tests, and a decreased PCR screening program in most states. Deaths per day in the United States have increased by 147 deaths per day. Many states are not reporting deaths or infections in a timely manner. The number of infections per day is expected to increase in the next four weeks due to a lack of mask use in schools, businesses, and airports; a failure of adequate building ventilation; lack of social distancing; and low rates of bivalent booster uptake. XBB, an Omicron recombinant variant first identified in India, caused a major outbreak in Singapore. XBB is the first recombinant variant combining spike protein sequences from two other Omicron BA.2 variants, that has spread aggressively around the world. New mutations of XBB, specifically XBB.1.5 are rapidly crowding out other variants in the USA. Current vaccines, monoclonal antibodies and prior infections will not protect you from getting an XBB.1.5 infection. A more detailed description of XBB variant mutations and epidemiology can be found on page 17 of the UK Health Security Agency Technical Briefing from November 25.
For a more detailed picture of COVID variant evolution in the United States, we recommend checking out the dashboard put together by Raj Rajnarayanan, Assistant Dean of Research and Associate Professor at NYITCOM at Arkansas State University.
To understand the true impact of these variants, it’s helpful to examine their evolution. Two virologists collaborated on Twitter to create the figure below, which Professor Johnson titled “Convergent Evolution on Steroids.” It shows the key mutations present in many of the currently-circulating Omicron subvariants and demonstrates that mutation at site 346 is becoming more and more common.
Past infections with a BA.1, BA.2 or BA.5 variants will not prevent infections with any of the newer variants. Monoclonal antibodies are no longer effective against newer BQ variants, XBB variants and other spike protein mutated variants. The last remaining monoclonal antibody, bebtelovimab, was removed from use by the FDA on 12/2/22. Paxlovid was only 89% effective in the original clinical trials against SARS-CoV-2. If resistance develops this winter to oral Paxlovid, we will have more Paxlovid failures and increased hospitalizations and deaths.
A Deeper Dive into U.S. COVID Data
On 1/13/23, the United States had 19,397 documented new infections. There were also 193 deaths. Thirty-seven states did not report their infections, and 37 states didn’t report their deaths. In the United States on 1/13/23 the number of hospitalized patients (44,806) has increased (+10.98% compared to the previous 14 days) and was 40,374 on December 30. On 1/13/22 there were 5,449 patients who were seriously or critically ill (a 6.1% increase); that number was 5,135 two weeks ago. The number of critically ill patients has increased by 315 in the last 14 days, while at least 7,064 new deaths occurred. The number of critically ill patients has increased for the 11th time in thirty-five 14-day periods. Patients are still dying each day (average 505/day).
As of 1/13/23, we have had 1,125,020 deaths and 103,482,187 SARS-CoV-2 infections in the United States. We have had 971,709 new infections in the last 14 days. We are adding an average of 485,855 new infections every seven days. For the pandemic in the United States we are averaging one death for every 91.98 infections or over 10,872 deaths for each one million infections. As of 1/13/22, thirty-nine states have had greater than 500,000 total infections, and 38 states and Puerto Rico have had greater than 5,000 total deaths. Forty-six states have had greater than 2,000 deaths, and 33 states have greater than 3,000 deaths per million population. Nine states have over 4,000 deaths per million population: Mississippi (4,406), Arizona (4,465), Alabama (4,246), West Virginia (4,340), New Mexico (4,240), Tennessee (4,186), Arkansas (4,225), Michigan (4,105) and New Jersey (4,016). Eighteen states (Alabama, Virginia, Missouri, North Carolina, Indiana, Tennessee, Massachusetts, Ohio, Michigan, Georgia, Illinois, New Jersey, Pennsylvania, Florida, Texas, New York, Arizona and California) have had greater than 20,000 deaths. Nine states have had greater than 40,000 deaths: Florida (84,170 deaths), Texas (92,600 deaths), New York (75,909 deaths), Pennsylvania (49,263 deaths), Georgia (41,648 deaths), Ohio (41,001 deaths) , Illinois (40,678 deaths), Michigan (41,001), and California (98,954 deaths, 20th most deaths in the world).
On 11/20/20, there were 260,331 (cumulative) deaths in the US from SARS-CoV-2. Since 11/20/20 (26 months), there were 857,919 new deaths from SARS-CoV-2. For twenty-two of those months, vaccines have been available to all adults. During these twenty-two months, 552,821 people have died of SARS-CoV-2 infections. Clearly, a vaccine-only approach is not working anywhere, especially not in the United States. In addition to getting more people vaccinated, most of the hospitalizations and deaths could have been prevented by proper masking (N95 or better), social distancing, and treatment with oral antiviral agents like Paxlovid. We recommend all of these precautions and treatments to every patient in our clinic, and we have only lost one patient to COVID in 2.5 years.
As of 1/13/23, California was ranked 32nd in the USA in infection percentage at 29.99%. In California, 26.02% of the people were infected in the last 22 months. As of 1/13/23, 31 states have had greater than 30% of their population infected. Fifty states, the District of Columbia and Puerto Rico have greater than 20% of their population infected.
FDA-Approved Oral Drug Treatments for SARS-CoV-2
Pfizer has developed PAXLOVID™, an oral reversible inhibitor of C3-like protease of SARS-CoV-2. The drug inhibits this key enzyme that is crucial for virus production. The compound, also called Compound 6 (PF-07321332), is part of the drug combination PAXLOVID™ (PF-07321332; ritonavir), which successfully completed a Phase 2-3 trial in humans in multiple countries. The preliminary results were announced on 11/5/21 by Pfizer. The results showed that 89% of the hospitalizations and deaths were prevented in the drug treatment arm. The drug was administered twice a day for five days. No deaths occurred in the treatment group, and ten deaths occurred in the placebo group. The study was stopped by an independent data safety monitoring board, and the FDA concurred with this decision. Pfizer applied for an Emergency Use Authorization for this drug on 11/15/21. This drug was approved on 12/23/21. PAXLOVID™ one year later is widely available at major pharmaceutical chains and smaller independent drug stores throughout the USA. We have been able to obtain PAXLOVID™ for any patient desiring treatment. We have only had one drug failure and death from SARS-CoV-2 during 2022. That death occurred in an octogenarian male in the fourth quarter of 2022.
Watching World Data
Over the next few months, we’ll be paying close attention to correlations between the SARS-CoV-2 data, the number of isolates identified in various countries and states, and the non-pharmaceutical interventions (like mask mandates and lockdowns) put in place by state and national governments. Data on infections, deaths, and percent of population infected was compiled from Worldometers. Data for this table for SARS-CoV-2 Isolates Currently Known in Location was compiled from GISAID and the CDC. It’s worth noting that GISAID provided more data than the CDC.
| Location | Total Infections as of 1/13/23 | New Infections on 1/13/23 | Total Deaths | New Deaths on 1/13/23 | % of Pop.Infected | SARS-CoV-2 Isolates Currently Known in Location | National/ State Mask Mandate | Currently in Lockdown |
| World | 670,816,950 | 319,987 | 6,728,270 | 1,607 | 8.60% | B2 lineageAlpha/B.1.1.7 (UK)Eta/B.1.525 (Nigeria/UK)Iota/B.1.526 (USA-NYC)Beta/B.1.351 (SA)Epsilon/B.1.427 + B.1.429 (USA)*Gamma/P.1 (Brazil)Zeta/P.2 (Brazil)A lineage isolateV01.V2 (Tanzania)APTK India VOC 32421Delta/B.1.617.2 (India)BV-1 (Texas, USA)Kappa/B.1.617.1 (India)Lambda/C.37 (Peru)Theta/P.3 (Philippines) Mu/B.1.621 (Colombia)C.1.2 (South Africa 2% of isolates in July 2021)R1 (Japan)Omicron/B.1.1.529 + BA.1 + BA.2 + BA.3 (South Africa November 2021)B.1.640.1 (Congo/France)B.1.640.2 (Cameroon/France)Four new recombinants 12/31 to 3/22)BA.2.12.1 (USA)BA.4 (South Africa)BA.5 (South Africa)BA.2.75 (India 7/22)BA.4.6 (USA 7/22)BF.7BJ.1XBBBQ.1BQ.1.1BS.1BN.1 | No | No |
| USA | 103,482,187 (ranked #1) | 19,397 (ranked #5) 37 states and D,C. failed to report infections on 12/2/22. | 1,125,020 (ranked #1) | 193 37 states and D.C. failed to report deaths on 1/13/23. | 30.90% | B2 lineageAlpha/B.1.1.7 (UK)Eta/B.1.525 (Nigeria/UK)Iota/B.1.526 (USA-NYC)Beta/B.1.351 (SA)Epsilon/B.1.427 + B.1.429 (USA)*Gamma/P.1 (Brazil)Zeta/P.2 (Brazil)Delta/B.1.617.2 (India)BV-1 (Texas, USA)Theta/P.3 (Philippines) Theta/P.3 (Philippines) Kappa/B.1.617.1 (India)Lambda/C.37 (Peru)Mu/B.1.621 (Colombia)R1(Japan) Omicron/B.1.1.529 + BA.1 + BA.2 (South Africa November 2021)B.1.640.1 (Congo/France)Recombinant Delta AY.119.2- Omicron BA.1.1 (Tennessee, USA 12/31/21)\BA.2BA.2.12.1 (United States)BA.4 (South Africa 11/21)BA.5 (South Africa 11/21)BA.2.75 (India 7/22)BA.4.6 (USA 7/22)BQ.1BQ.1.1BN.1 | No | No |
| Brazil | 36,623,217(ranked #5) | 20,548 (ranked#4) | 695,334 (ranked #2) | 79 | 17.00% | B2 lineageAlpha/B.1.1.7 (UK)Beta/B.1.351 (SA)Gamma/P.1 (Brazil)Zeta/P.2 (Brazil)Lambda/C.37 (Peru)Mu/B.1.621 (Colombia) Omicron/B.1.1.529 + BA.1 (South Africa November 2021)BA.2BA.2.12.1 (United States)BA.4 (South Africa 11/21)BA.5 (South Africa 11/21) | No | No |
| India | 44,681,884 (ranked #2) | – | 530,726(ranked #3) | – | 3.17% Unchanged in 4 weeks | B2 lineageAlpha/B.1.1.7 (UK)Beta/B.1.351 (SA)Gamma/P.1 (Brazil)Epsilon/B.1.427 + B.1.429 (USA)*Eta/B.1.525 (Nigeria/UK)APTK India VOI 32421Delta/B.1.617.2 (India)Kappa/B.1.617.1 (India)Iota/B.1.526 (USA-NYC) Omicron/B.1.1.529 + BA.1 (South Africa November 2021)B.1.640.1 (Congo/France)BA.4 (South Africa 11/21)BA.5 (South Africa 11/21)BA.2.75 (India) | No | No |
| United Kingdom | 24,243,576 (ranked #9) | – | 202,157 (ranked #7) 470 new deaths in 2 weeks | – | 35.39% | B2 lineageAlpha/B.1.1.7 (UK)Eta/B.1.525 (Nigeria/UK)Beta/B.1.351 (SA)Epsilon/B.1.427 + B.1.429 (USA)*Gamma/P.1 (Brazil)Delta/B.1.617.2 (India)Theta/P.3 (Philippines) Kappa/B.1.617.1 (India)Lambda/C.37 (Peru)Mu/B.1.621 (Colombia)C.1.2 (South Africa)Omicron/B.1.1.529 + BA.1 (South Africa November 2021)B.1.640.1 (Congo/France)XD (AY.4/BA.1) recombinantXF (Delta/BA.1) recombinantXE (BA.1/BA.2) recombinantBA.2BA.2.12.1 (United States)BA.4 (South Africa 11/21)BA.5 (South Africa 11/21)BA.2.75 (India 7/22) | No | No |
| California, USA | 11,852,546 (ranked #13 in the world) | 1,516 | 98,954 (ranked #20 in world) | 25 | 29.99% | B2 lineageAlpha/B.1.1.7 (UK)Eta/B.1.525 (Nigeria/UK)Beta/B.1.351 (SA)Gamma/P.1 (Brazil)Epsilon/B.1.427 + B.1.429 (USA)*Zeta/P.2 (Brazil)Delta/B.1.617.2 (India)Theta/P.3 (Philippines) Kappa/B.1.617.1 (India)Lambda/C.37 (Peru) Mu/B.1.621 (Colombia) Omicron/B.1.1.529 + BA.1 (South Africa November 2021)BA.2BA.2.12.1 (United States)BA.4 (South Africa 11/21)BA.5 (South Africa 11/21)BA.2.75 (India 7/22)BQ.1BQ.1.1BN.1 | No | No |
| Mexico | 7,303,600 (ranked #19) | 5,686 (ranked #11) | 331,452(ranked #5) | 45 | 5.55% | No | No | |
| South Africa | 4,051,243 (ranked #37; 4,347 new infections in 14 days). | 183 | 102,568 (ranked #18) 0 new deaths in 14 days) Unchanged in 4 weeks | – | 6.66% Unchanged in 4 weeks | B2 lineageAlpha/B.1.1.7 (UK)Beta/B.1.351 (SA)Delta/B.1.617.2 (India)Kappa/B.1.617.1 (India) C.1.2 (South Africa, July 2021)Omicron/B.1.1.529 + BA.1 (South Africa November 2021)B.1.640.1 (Congo/France)BA.2BA.4 (South Africa 11/21)BA.5 (South Africa 11/21) | No | No |
| Canada | 4,508275 (ranked #34) | – | 49,566 (ranked #24 ) | – | 11.74% | No | No | |
| Poland | 6,732,901 (ranked #21) | 324 | 118,640 (ranked #15) 87 new deaths in the last 14 days | 7 | 16.88% | B2 lineageAlpha/B.1.1.7 (UK)Eta/B.1.525 (Nigeria/UK)Beta/B.1.351 (SA)Delta/B.1.617.2 (India)Mu/B.1.621 (Colombia)Omicron/B.1.1.529 + BA.1 + (South Africa November 2021),Omicron/B.1.1.529 +BA.3 | No | No |
| Russia | 21,846,722 (ranked #10) | 5,978 (ranked #12) | 394,209(ranked #4) | 47 | 14.98% | No | No | |
| Peru | 4,473,821(ranked #35) | 627 | 218,490(ranked #6) | 13 | 13.28% | B2 lineageAlpha/B.1.1.7 (UK)Delta/B.1.617.2 (India)Gamma/P.1 (Brazil)Iota/B.1.526 (USA-NYC)Lambda/C.37 (Peru)Mu/B.1.621 (Colombia)Omicron/B.1.1.529 + BA.1 (South Africa November 2021) | No | No |
| Iran | 7,562,446 (ranked #18) | 75 | 144,723 (ranked #12) | 1 | 8.78% Unchanged in 4 weeks | B2 lineageAlpha/B.1.1.7 (UK)Delta/B.1.617.2 (India)Beta/B.1.351 (SA)Omicron/B.1.1.529 + BA.1 (South Africa November 2021) | No | No |
| Spain | 13,711,251 (ranked #12) | 9,871 (ranked #7) | 117,759 (ranked #16) new deaths in 14 days | 76 | 29.34% | B2 lineageAlpha/B.1.1.7 (UK)Delta/B.1.617.2 (India)Beta/B.1.351 (SA)Gamma/P.1 (Brazil)Epsilon/B.1.427 + B.1.429 (USA)*Eta/B.1.525 (Nigeria/UK)Iota/B.1.526 (USA-NYC)Kappa/B.1.617.1 (India)Mu/B.1.621 (Colombia)Omicron/B.1.1.529 + BA.1 (South Africa November 2021)B.1.640.1 (Congo/France) | No | No |
| France | 39,442,176 (ranked #3) | 6,238 (ranked #9) | 163,347 (ranked #10) | 101 | 60.13% | B2 lineageAlpha/B.1.1.7 (UK)Delta/B.1.617.2 (India) Omicron/B.1.1.529 South Africa November 2021)B.1.640.1 (Congo/France)B.1.640.2 (Cameroon/France)GKA (AY.4/BA.1) recombinantBQ.1.1 | No | No |
| Germany | 37,605,135 (ranked #4) | 10,609 (ranked #6) | 163,775 (ranked #9) | 150 | 44.83% | B2 lineageAlpha/B.1.1.7 (UK)Delta/B.1.617.2 (India) Delta/B.1.617.2 (India) Omicron/B.1.1.529 South Africa November 2021)GKA (AY.4/BA.1) recombinantBQ.1.1 | No | No |
| South Korea | 29,737,769 (ranked #7) | 39,726 (ranked #2) | 32,867 (ranked #34) | 66 | 57.93% | B2 lineageAlpha/B.1.1.7 (UK)Delta/B.1.617.2 (India) Delta/B.1.617.2 (India) Omicron/B.1.1.529 South Africa November 2021) | No | No |
| Vietnam | 11,526,089 (ranked #13) | 55 | 43,186(ranked #26) | – | 11.64% Unchanged in 4 weeks | B2 lineageAlpha/B.1.1.7 (UK)Delta/B.1.617.2 (India) Delta/B.1.617.2 (India) Omicron/B.1.1.529 South Africa November 2021) | , | No |
| Netherlands | 8,576,523 (ranked #17) | – | 22,989 (ranked #41) | – | 49.83% | B2 lineageAlpha/B.1.1.7 (UK)Delta/B.1.617.2 (India) Delta/B.1.617.2 (India) Omicron/B.1.1.529 South Africa November 2021)GKA (AY.4/BA.1) recombinant | No | No |
| Denmark | 3,171,515 (ranked #40) | 190 | 7,982 (ranked #76) | 11 | 54.35% | B2 lineageAlpha/B.1.1.7 (UK)Delta/B.1.617.2 (India) Delta/B.1.617.2 (India) Omicron/B.1.1.529 South Africa November 2021)GKA (AY.4/BA.1) recombinant | No | No |
| Taiwan | 9,167,795 (ranked #16) | 21,721 (ranked #3) | 15,755 (ranked #56) | 53 | 38.37% | B2 lineageAlpha/B.1.1.7 (UK)Delta/B.1.617.2 (India) Delta/B.1.617.2 (India) Omicron/B.1.1.529 South Africa November 2021) | No | No |
| Japan | 31,176,281(ranked #6) | 144,077 (ranked #1) | 61,761(ranked #23) | 480 | 24.82% 14 days. | B2 lineageAlpha/B.1.1.7 (UK)Delta/B.1.617.2 (India) Delta/B.1.617.2 (India) Omicron/B.1.1.529 South Africa November 2021)BA.2*BA.5* | No | No |
| Argentina | 10,004,679 (ranked #15) | – | 130,249(ranked #14) | – | 21.74% | No | No | |
| Italy | 25,363,742 (ranked #8) | – | 185,993(ranked #8) | – | 42.08% | No | No | |
| Chile | 5,081,862 (ranked #27) | 3,289 (ranked#14) | 63,466(ranked #22) | 29 | 26.39% | No | No | |
| Colombia | 6,349,971 (ranked #22) | – | 142,259(ranked #13) | – | 12.32% | No | No | |
| Australia | 11,247,412 (ranked #14) | 5,985 (ranked #10) | 17,712(ranked #50) | 59 | 43.14% | No | No | |
| Turkey | 17,042,722 (ranked #11) | – | 101,492 (ranked #19) | – | 19.91% Unchanged in 4 weeks | No | No | |
| Indonesia | 6,725,458 (ranked #20) | 363 | 160,719 (ranked #11) 478 new deaths in the last 14 days. | 8 | 24.09% | No | No | |
| Malaysia | 5,032,146 (ranked #28) | 320 | 36,908 (ranked #29) | 3 | 15.16% | No | No | |
| Hong Kong | 2,817,707(ranked#41) | 8,260 (ranked #8) | 12,693 (ranked#60) 345 new deaths in the last 14 days. | 71 | 37.05% | No | No | |
| China | 503,302 (ranked #91) | – | – | – | – | – |
What Our Team Is Reading This Week
- SARS-CoV-2 variants of concern and variants under investigation in England Technical briefing 49, 11 January 2023 https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/1128554/variant-technical-briefing-49-11-january-2023.pdf
- Long COVID: major findings, mechanisms and recommendations (Nature) https://www.nature.com/articles/s41579-022-00846-2
- Enhanced fusogenicity and pathogenicity of SARS-CoV-2 Delta P681R mutation (Nature) https://doi.org/10.1038/s41586-021-04266-9
- Virological characteristics of the SARS-CoV-2 XBB variant derived from recombination of two Omicron subvariants (Preprint) https://doi.org/10.1101/2022.12.27.521986
- SARS-CoV-2 infection and persistence in the human body and brain at autopsy (Nature) https://doi.org/10.1038/s41586-022-05542-y
- Lifting Universal Masking in Schools — Covid-19 Incidence among Students and Staff (NEJM) https://www.nejm.org/doi/full/10.1056/NEJMoa2211029
- FDA Announces Bebtelovimab is Not Currently Authorized in Any US Region (FDA) https://www.fda.gov/drugs/drug-safety-and-availability/fda-announces-bebtelovimab-not-currently-authorized-any-us-region
- SARS-CoV-2 variants of concern and variants under investigation in England Technical briefing 48, 25 November 2022 (UK Health Security Agency) https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/1120304/technical-briefing-48-25-november-2022-final.pdf
- Omicron sublineage BQ.1.1 resistance to monoclonal antibodies (The Lancet) https://doi.org/10.1016/S1473-3099(22)00733-2
- SARS-CoV-2 Infection and Increased Risk for Pediatric Stroke (Pediatric Neurology) https://www.pedneur.com/article/S0887-8994(22)00210-7/fulltext
- Single-cell multiomics revealed the dynamics of antigen presentation, immune response and T cell activation in the COVID-19 positive and recovered individuals https://doi.org/10.3389/fimmu.2022.1034159
- Novel treatment combining antiviral and neutralizing antibody-based therapies with monitoring of spike-specific antibody and viral load for immunocompromised patients with persistent COVID-19 infection (Experimental Hematology & Oncology) https://ehoonline.biomedcentral.com/articles/10.1186/s40164-022-00307-9
- Covid-19 is a leading cause of death in children and young people ages 0-19 years in the United States (Preprint) https://doi.org/10.1101/2022.05.23.22275458
- Post-COVID-19-associated morbidity in children, adolescents, and adults: A matched cohort study including more than 157,000 individuals with COVID-19 in Germany (PLOS Medicine) https://journals.plos.org/plosmedicine/article?id=10.1371%2Fjournal.pmed.1004122
- Endothelial dysfunction in COVID-19: an overview of evidence, biomarkers, mechanisms and potential therapies (Acta Pharmacologica Sinica) https://doi.org/10.1038/s41401-022-00998-0
- Cognitive Deficits in Long Covid-19 (NEJM) https://www.nejm.org/doi/full/10.1056/NEJMcibr2210069
- Brain 18F-FDG PET imaging in outpatients with post-COVID-19 conditions: findings and associations with clinical characteristics (European Journal of Nuclear Medicine and Molecular Imaging) https://doi.org/10.1007/s00259-022-06013-2
- Acute and postacute sequelae associated with SARS-CoV-2 reinfection (Nature) https://doi.org/10.1038/s41591-022-02051-3
- Associations between indoor relative humidity and global COVID-19 outcomes (Journal of the Royal Society) https://doi.org/10.1098/rsif.2021.0865
- Successful treatment of prolonged, severe COVID-19 lower respiratory tract disease in a B-cell ALL patient with an extended course of remdesivir and nirmatrelvir/ritonavir (Clinical Infectious Diseases) https://doi.org/10.1093/cid/ciac868
- Impact of SARS-CoV-2 ORF6 and its variant polymorphisms on host responses and viral pathogenesis (Preprint) https://doi.org/10.1101/2022.10.18.512708
- Anti-PF4 antibodies associated with disease severity in COVID-19 (PNAS) https://www.pnas.org/doi/10.1073/pnas.2213361119
- A multinational Delphi consensus to end the COVID-19 public health threat (Nature) https://doi.org/10.1038/s41586-022-05398-2
- Pfizer and BioNTech Announce Updated Clinical Data for Omicron BA.4/BA.5-Adapted Bivalent Booster Demonstrating Substantially Higher Immune Response in Adults Compared to the Original COVID-19 Vaccine https://www.pfizer.com/news/press-release/press-release-detail/pfizer-and-biontech-announce-updated-clinical-data-omicron
- Paxlovid and Long Covid (Ground Truths, Eric Topol) https://erictopol.substack.com/p/paxlovid-and-long-covid?utm_source=substack&utm_medium=email
- Risk of Infection and Hospitalization Among Children and Adolescents in New York After Emergence of the SARS-CoV-2 Omicron Variant – Comment and Response (JAMA) https://jamanetwork.com/journals/jama/article-abstract/2797231
- Myocarditis (NEJM) https://www.nejm.org/doi/full/10.1056/NEJMra2114478
- SARS-CoV-2 variants of concern and variants under investigation in England Technical briefing 47 (UK Health Security Agency) https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/1115077/Technical-Briefing-47.pdf
- Effectiveness of Monovalent mRNA Vaccines Against COVID-19–Associated Hospitalization Among Immunocompetent Adults During BA.1/BA.2 and BA.4/BA.5 Predominant Periods of SARS-CoV-2 Omicron Variant in the United States — IVY Network, 18 States, December 26, 2021–August 31, 2022 (MMWR) https://www.cdc.gov/mmwr/volumes/71/wr/mm7142a3.htm
- “Three-dose monovalent mRNA VE estimates against COVID-19–associated hospitalization decreased with time since vaccination. Three-dose VE during the BA.1/BA.2 and BA.4/BA.5 periods was 79% and 60%, respectively, during the initial 120 days after the third dose and decreased to 41% and 29%, respectively, after 120 days from vaccination.”
- Saliva antibody-fingerprint of reactivated latent viruses after mild/asymptomatic COVID-19 is unique in patients with myalgic-encephalomyelitis/chronic fatigue syndrome (Frontiers in Immunology) https://doi.org/10.3389/fimmu.2022.949787
- SARS-CoV-2 Nsp6 causes cardiac defects through MGA/MAX complex-mediated increased glycolysis (Preprint) https://doi.org/10.21203/rs.3.rs-1677754/v1
- WHO’s Therapeutics and COVID-19 Living Guideline on mAbs needs to be reassessed (The Lancet) https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(22)01938-9/fulltext
- SARS-CoV-2 disrupts host epigenetic regulation via histone mimicry (Nature) https://doi.org/10.1038/s41586-022-05282-z
David C. Wright, M.D. 
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