Yehlile kangakanani ubutyhefu be-Omicron? Izifundo ezininzi zehlabathi lokwenyani zityhila

"Intsholongwane ye-Omicron isondele kumkhuhlane wonyaka" kwaye "i-Omicron incinci kakhulu ye-pathogenic kune-Delta". …… Kutshanje, uninzi lweendaba malunga nokonakala kwesithsaba esitsha sohlobo oluguqukileyo i-Omicron isasazeke kwi-intanethi.

Ewe, ukusukela oko kwathi kwavela uhlobo lwe-Omicron mutant ngoNovemba ka-2021 kunye nokuxhaphaka kwayo kwihlabathi jikelele, uphando kunye nengxoxo malunga nentsholongwane kunye nosulelo luqhubekile lungathintelwa. Yintoni iprofayile ye-virulence yangoku ye-Omicron? Uphando luthini ngayo?

Amaphononongo ahlukeneyo elabhoratri: I-Omicron ayinabungozi kangako
Enyanisweni, ekuqaleni kukaJanuwari 2022, uphando oluvela kwiYunivesithi yaseHong Kong Li Ka Shing Faculty of Medicine yafumanisa ukuba i-Omicron (B.1.1.529) ingaba yi-pathogenic encinci xa kuthelekiswa noxinzelelo lwangaphambili kunye nezinye iintlobo ze-mutant.
Kwafunyaniswa ukuba i-Omicron mutant strain yayingasebenzi kakuhle ekusebenziseni i-transmembrane serine protease (TMPRSS2), ngelixa i-TMPRSS2 inokwenza kube lula uhlaselo lwentsholongwane kwiiseli zomkhosi ngokucanda iprotein ye-spike ye-coronavirus entsha. Ngelo xesha, abaphandi baqaphela ukuba ukuphindaphinda kwe-Omicron kwancitshiswa kakhulu kwimigca yeseli yomntu iCalu3 kunye neCaco2.

Umthombo womfanekiso we-intanethi

Kwimodeli yempuku ye-k18-hACE2, ukuphindaphindwa kwe-Omicron kwancitshiswa kuzo zombini iimpuku eziphezulu kunye nezisezantsi zokuphefumla xa kuthelekiswa noxinzelelo lwangaphambili kunye ne-Delta eguquguqukayo, kwaye i-pulmonary pathology yayincinci kakhulu, ngelixa usulelo lwe-Omicron lubangele ukwehla kobunzima obuncinci kunye nokufa kunoko. uhlobo lokuqala kunye neAlpha, Beta kunye neDelta mutants.
Ke ngoko, abaphandi bagqiba kwelokuba ukuphindaphindwa kwe-Omicron kunye ne-pathogenicity yancitshiswa kwiigundane.

Umthombo womfanekiso we-intanethi

Ngomhla we-16 ngoMeyi ka-2022, iNdalo yapapasha iphepha nguYoshihiro Kawaoka, i-virologist ehamba phambili evela kwiYunivesithi yaseTokyo kunye neYunivesithi yaseWisconsin, eqinisekisa okokuqala kwimodeli yezilwanyana ukuba i-Omicron BA.2 ngokwenene ayinabungozi kunobunzima bangaphambili. .

Abaphandi bakhetha iintsholongwane ze-BA.2 eziphilayo ezibekwe zodwa eJapan ukuba zosulele iimpuku ze-k18-hACE2 kunye neehamster kwaye bafumanisa ukuba, emva kosulelo ngedosi efanayo yentsholongwane, zombini iimpuku ezosulelekileyo ze-BA.2 kunye ne-BA.1 zineentsholongwane ezisezantsi kakhulu kwimiphunga. kunye nempumlo kunokosuleleka yi-New Crown strain yokuqala (p <0.0001).

Esi siphumo somgangatho wegolide siqinisekisa ukuba i-Omicron eneneni ayinabungozi kangako kunohlobo lwasendle. Ngokwahlukileyo, kwakungekho mmahluko obalulekileyo kwiintsholongwane zentsholongwane kwimiphunga kunye neempumlo zezilwanyana ezilandela i-BA.2 kunye ne-BA.1 usulelo.

Umthombo womfanekiso we-intanethi

Uvavanyo lwe-PCR lomthamo wentsholongwane egazini lubonise ukuba zombini iimpuku ze-BA.2 kunye ne-BA.1 ezinentsholongwane ephantsi kwimiphunga kunye neempumlo kunobunzima boqobo obuNtsha beCrown, ngakumbi kwimiphunga (p<0.0001).

Ngokufana neziphumo kwiimpuku, i-titres yentsholongwane efunyenwe empumlweni nakwimiphunga ye-BA.2 kunye ne-BA.1 i-hamster esulelekileyo yayingaphantsi kunobunzima bokuqala emva 'kwe-inoculation' kunye nedosi efanayo yentsholongwane, ngakumbi kwimiphunga, kwaye kancinci. ephantsi kwimpumlo ye-BA.2 i-hamster enentsholongwane kune-BA.1 - ngokwenene, isiqingatha se-BA.2 i-hamster echaphazelekayo ayizange ivelise ukusuleleka kwimiphunga.

Kwaye kwafunyaniswa ukuba iintlobo zantlandlolo, i-BA.2 kunye ne-BA.1, ziswele ukulungelelaniswa kwe-sera emva kokusuleleka - okuhambelana noko kuye kwabonwa kubantu behlabathi lokwenyani xa bosulelwe ziziguqugu ezitsha ezahlukeneyo.

Umthombo womfanekiso we-intanethi

Idatha yelizwe lokwenyani: I-Omicron ayinakwenzeka ukuba ibangele ukugula okukhulu

Uninzi lwezi zifundo zingasentla zichaze ukuthotywa kwe-Omicron kwimodeli yezilwanyana zaselabhoratri, kodwa ngaba kuyafana nakwihlabathi lokwenyani?

Ngomhla wesi-7 kuJuni ka-2022, i-WHO yapapasha ingxelo evavanya umahluko kubunzima babantu abosulelekileyo ngexesha le-Omicron (B.1.1.529) bhubhane xa kuthelekiswa nobhubhane weDelta.

Le ngxelo ibandakanya i-16,749 yezigulane ezitsha ze- coronary eziphuma kuwo onke amaphondo oMzantsi Afrika, kubandakanywa i-16,749 evela kwi-Delta ebhubhane (2021/8/2 ukuya ku-2021/10/3) kunye ne-17,693 evela kubhubhane we-Omicron (2021/11/15 ukuya ku-2022/2/2022). 16). Izigulana ziphinde zahlelwa njengezingqongqo, ezinobuzaza kwaye ezingenabungozi.

Okubaluleke kakhulu: ufumene i-invasive ventilation, okanye i-oksijini kunye ne-high-flow transnasal oxygen, okanye i-extracorporeal membrane oxygenation (ECMO), okanye ukwamkelwa kwi-ICU ngexesha lokulaliswa esibhedlele.
-inzima (inzima): ifumene i-oksijini ngexesha lokulaliswa esibhedlele
-engekho ngqongqo: ukuba akukho nanye kwezi meko zingentla zidibene, isigulane asinzima kakhulu.

Idatha ibonise ukuba kwiqela le-Delta, i-49.2% yayinzulu, i-7.7% yayibaluleke kakhulu kwaye i-28% yazo zonke izigulane ezibhedlele esibhedlele ze-Delta zifa, ngelixa kwiqela le-Omicron, i-28.1% yayinzulu, i-3.7% yayibaluleke kakhulu kwaye i-15% yazo zonke izibhedlele. Abaguli abosuleleke yi-Omicron basweleka. Kwakhona, ubude obuphakathi kokuhlala kwakuyientsuku ze-7 kwiqela le-Delta xa kuthelekiswa neentsuku ze-6 kwiqela le-Omicron.

Ukongezelela, ingxelo ihlalutye izinto ezichaphazelayo zeminyaka yobudala, isini, isimo sokugonywa kunye ne-comorbidities kwaye yagqiba ukuba i-Omicron (B.1.1.529) idibaniswe nethuba eliphantsi lokugula okunzulu kunye nokugula (95% CI: 0.41 ukuya kwi-0.46; p; p. <0.001) kunye nomngcipheko ophantsi wokufa esibhedlele (95% CI: 0.59 ukuya 0.65; p <0.001).

Umthombo womfanekiso we-intanethi

Kwii-subtypes ezahlukeneyo ze-Omicron, izifundo ezongezelelweyo ziye zahlalutya ubungangamsha bazo ngokweenkcukacha.

Uphando lweqela elivela eNew England lihlalutye iimeko ze-20770 zeDelta, iimeko ze-52605 ze-Omicron B.1.1.529 kunye ne-29840 iimeko ze-Omicron BA.2, kwaye zafumanisa ukuba umlinganiselo wokufa wawuyi-0.7% ye-Delta, i-0.4% ye-B.1.1. 529 kunye ne-0.3% ye-BA.2. Emva kokulungelelanisa izinto eziphazamisayo, uphando lugqibe ukuba umngcipheko wokufa wawuphantsi kakhulu kwi-BA.2 xa kuthelekiswa ne-Delta kunye ne-B.1.1.529.

Umthombo womfanekiso we-intanethi

Olunye uphando oluvela eMzantsi Afrika luvavanye umngcipheko wokulaliswa esibhedlele kunye nomngcipheko wesiphumo esibi seDelta, BA.1, BA.2 kunye ne-BA.4 / BA.5. Iziphumo zibonise ukuba kwi-98,710 yezigulane ezisandul 'ukusuleleka ezibandakanyiweyo kuhlalutyo, ama-3825 (3.9%) alaliswa esibhedlele, kwaye i-1276 (33.4%) yafumana izifo ezinzima.

Phakathi kwabo basuleleke ngeenguqu ezahlukeneyo, i-57.7% yezigulane ezisulelekileyo ze-Delta zahlakulela isifo esibi (97/168), xa kuthelekiswa ne-33.7% ye-BA.1-izigulane ezosulelekileyo (990 / 2940), i-26.2% ye-BA.2 (167 / 637) kunye ne-27.5% ye-BA.4 / BA.5 (22/80). Uhlalutyo lwe-multivariate lubonise ukuba amathuba okuba nesifo esibi kakhulu phakathi kwe-Delta esulelekileyo> BA.1> BA.2, ngelixa amathuba okuba nesifo esibi kakhulu phakathi kwalabo abasulelekileyo be-BA.4 / BA.5 abazange bahluke kakhulu xa kuthelekiswa ne-BA. 2.
Ubugwenxa obuncitshisiweyo, kodwa ukuphaphama kuyafuneka

Uphononongo lwaselabhoratri kunye nedatha yokwenyani evela kumazwe aliqela ibonise ukuba i-Omicron kunye neentlobo zayo ezincinci azinabungozi kangako kwaye azifane zibangele isigulo esimandundu kunohlobo lokuqala kunye nezinye iintlobo eziguqukayo.

Nangona kunjalo, inqaku lophononongo kushicilelo lukaJanuwari 2022 lweThe Lancet, elinesihloko esithi 'Milder kodwa hayi buthathaka', liphawule ukuba nangona usulelo lwe-Omicron luthatha i-21% yabantu abalaliswa esibhedlele kubantu abancinci baseMzantsi Afrika, inani lokuqhambuka okubangela isifo esiqatha linokwenzeka. ukwanda kwabemi abanamanqanaba ahlukeneyo osulelo kunye namanqanaba ahlukeneyo ogonyo. (Nangona kunjalo, kolu luntu luncinci lwaseMzantsi Afrika, i-21% yezigulana ezilaliswe esibhedlele ezosulelwe kukwahluka kwe-SARS-CoV-2 omicron zineziphumo ezibi kakhulu zeklinikhi, umlinganiselo onokuthi unyuke kwaye ubangele impembelelo enkulu ngexesha lokuqhambuka kwabantu abaneemografi ezahlukeneyo nangaphantsi. Amanqanaba osulelo oluvela kwisitofu okanye isitofu sokugonya.)

Ekupheleni kwengxelo ye-WHO ekhankanywe ngasentla, iqela laphawula ukuba nangona i-virulence encitshisiweyo yoxinzelelo lwangaphambili, phantse isithathu kwisibhedlele i-Omicron (B.1.1.529) izigulane zenze isifo esibi kakhulu, kwaye ukuba iziguquguquko ezitsha zesithsaba saqhubeka kubangele ukugula okuphezulu kunye nokufa kwabantu abadala, abantu abangakhuselekanga okanye abangagonywanga. (Singathanda ukulumkisa kwakhona ukuba uhlalutyo lwethu kufuneka lungabonwa njengoluxhasa ingxelo 'ethambileyo' eyahlukileyo. Phantse isinye kwisithathu sezigulane ezilaliswe esibhedlele ze-Omicron ziye zahlaselwa sisifo esinzima kwaye i-15% yasweleka; amanani angabalulekanga ……Phakathi kwabantu abasesichengeni. , oko kukuthi izigulana ezikwiminyaka egqithileyo, kuluntu olunomthwalo ophezulu we-commorbid, kwizigulana ezibuthathaka kunye naphakathi kwabangagonywanga, i-COVID-19 (zonke ii-VOCs) iyaqhubeka ukuba negalelo kwizigulo ezininzi kunye nokufa.)

Idatha yangaphambili evela kwi-Omicron xa ibangele ubhubhane wesihlanu eHong Kong yabonisa ukuba ukusukela nge-4 kaMeyi ka-2022, bekukho abantu ababhubhileyo abangama-9115 kwi-1192765 yamatyala amatsha athweswe isithsaba ngexesha lesihlanu (izinga lokufa okukrwada kwe-0.76%) kunye nokrwada. izinga lokusweleka kwe-2.70% kubantu abangaphezu kweminyaka engama-60 ubudala (malunga ne-19.30% yeli qela lobudala bebengagonywanga).

Ngokuchaseneyo, kuphela yi-2% yabemi baseNew Zealand abangaphezulu kweminyaka engama-60 ubudala abangagonywanga, nto leyo enxulunyaniswa kakhulu nezinga lokufa okukrwada eliphantsi le-0.07% kubhubhani omtsha wesithsaba.

Kwelinye icala, ngelixa kuhlala kuxoxwa ukuba iNewcastle inokuba sisifo sexesha elizayo, kukho iingcali zemfundo ezithatha imbono eyahlukileyo.

Izazinzulu ezintathu ezivela kwiYunivesithi yaseOxford kunye ne-European Union Joint Research Centre zikholelwa ukuba ubunzima obuphantsi be-Omicron bunokuthi bube yinto nje, kwaye ukuqhubeka kwe-antigenic evolution ngokukhawuleza (i-antigenic evolution) inokuzisa iintlobo ezintsha.

Ngokungafaniyo nokuphuncuka komzimba kunye nokusuleleka, eziphantsi koxinzelelo olunamandla lwendaleko, ubugwenxa budla ngokuba 'yimveliso' yendaleko. Iintsholongwane ziyavela ukuze zandise amandla azo okusasazeka, kwaye oku kunokukhokelela ekwandeni kobugwenxa. Umzekelo, ngokunyusa umthamo wentsholongwane egazini ukwenza lula usulelo, kusenokubangela isifo esiqatha.

Ayisiyiyo loo nto kuphela, kodwa ubundlobongela buya kubangela umonakalo omncinci kakhulu ngexesha lokusasazeka kwentsholongwane ukuba iimpawu eziziswa yintsholongwane zivela ngakumbi kamva kusulelo - njengakwimeko yeentsholongwane zomkhuhlane, i-HIV kunye ne-hepatitis C, ukubiza igama ezimbalwa, ezinexesha elininzi lokusasazeka ngaphambi kokubangela iziphumo ezibi.

Umthombo womfanekiso we-intanethi

Kwiimeko ezinjalo, kunokuba nzima ukuqikelela umkhwa wesithsaba esitsha se-mutant strain ukusuka kwi-virulence esezantsi ye-Omicron, kodwa iindaba ezimnandi zezokuba isitofu esitsha sesithsaba sibonakalise umngcipheko oncitshisiweyo wokugula kakhulu kunye nokufa ngokuchasene nazo zonke iintlobo eziguqukayo, kunye nokwanda ngamandla amazinga ogonyo lwabemi kuhlala kuyindlela ebalulekileyo yokulwa lo bhubhani okwangoku.
Imibulelo: Eli nqaku lihlaziywe ngokusemthethweni nguPanpan Zhou, PhD, iSikolo seYunivesithi yaseTsinghua yezoNyango kunye ne-Postdoctoral Fellow, i-Scripps Research Institute, eU.SA
I-Omicron yokuvavanya i-antigen reagent ekhaya