Behle kangakanani ubuthi be-Omicron? Izifundo eziningi zomhlaba wangempela ziyembula

"I-Virulence ye-Omicron isondele kumkhuhlane wesizini" futhi "I-Omicron incane kakhulu i-pathogenic kune-Delta". …… Muva nje, izindaba eziningi mayelana nokonakala kohlobo olusha lwe-crown mutant i-Omicron bezisabalala ku-inthanethi.

Impela, selokhu kwavela uhlobo lwe-Omicron mutant ngoNovemba 2021 kanye nokusabalala kwalo emhlabeni jikelele, ucwaningo nezingxoxo mayelana nobungozi kanye nokudluliswa kwegciwane kuqhubekile ngokunganqamuki. Ithini iphrofayili yamanje ye-virulence ye-Omicron? Luthini ucwaningo ngakho?

Ucwaningo oluhlukahlukene lwaselabhorethri: I-Omicron ayinabungozi kangako
Eqinisweni, ekuqaleni kukaJanuwari 2022, ucwaningo oluvela eNyuvesi yaseHong Kong i-Li Ka Shing Faculty of Medicine yathola ukuthi i-Omicron (B.1.1.529) ingase ibe ne-pathogenic encane uma iqhathaniswa nohlobo lokuqala kanye nezinye izinhlobo eziguqukayo.
Kwatholakala ukuthi i-Omicron mutant strain yayingasebenzi kahle ekusebenziseni i-transmembrane serine protease (TMPRSS2), kuyilapho i-TMPRSS2 ingenza kube lula ukuhlasela kwegciwane kumaseli asokhaya ngokukhipha iphrotheni ye-spike ye-coronavirus entsha. Ngasikhathi sinye, abacwaningi babona ukuthi ukuphindaphinda kwe-Omicron kwancishiswa kakhulu emigqeni yamaseli womuntu iCalu3 neCaco2.

Umthombo we-inthanethi wesithombe

Kumodeli yegundane le-k18-hACE2, ukuphindaphindeka kwe-Omicron kwehliswa kuzo zombili izindlela zokuphefumula eziphezulu neziphansi zamagundane uma kuqhathaniswa nohlobo lokuqala kanye ne-Delta mutant, futhi ukugula kwayo kwamaphaphu kwakungenzima kakhulu, kuyilapho ukutheleleka kwe-Omicron kubangele ukwehla kwesisindo nokufa kune uhlobo lwangempela kanye nezinguquko ze-Alpha, Beta kanye ne-Delta.
Ngakho-ke, abacwaningi baphetha ngokuthi ukuphindaphinda kwe-Omicron kanye ne-pathogenicity kwancishiswa kumagundane.

Umthombo we-inthanethi wesithombe

Mhla ziyi-16 kuNhlaba wezi-2022, iMvelo yashicilela iphepha lika-Yoshihiro Kawaoka, udokotela ohamba phambili wegciwane lengculazi waseNyuvesi yaseTokyo naseNyuvesi yaseWisconsin, eqinisekisa ngokokuqala ngqa kumodeli yezilwane ukuthi i-Omicron BA.2 ayinabungozi kangako kunohlobo lwangaphambilini. .

Abacwaningi bakhethe amagciwane e-BA.2 aphilayo ahlukanisiwe e-Japan ukuze athelele amagundane nama-hamster i-k18-hACE2 futhi bathola ukuthi, ngemva kokutheleleka ngedosi efanayo yegciwane, womabili amagundane anegciwane i-BA.2 kanye ne-BA.1 ayenezinhlayiya zegciwane eziphansi kakhulu emaphashini. kanye nekhala kunokutheleleka kokuqala kwe-New Crown strain (p<0.0001).

Lo mphumela ojwayelekile wegolide uqinisekisa ukuthi i-Omicron ayinabungozi kangako kunohlobo lokuqala lwasendle. Ngokuphambene, wawungekho umehluko ophawulekayo kuma-viral titres emaphashini nasemakhaleni ezinhlobo zezilwane ezilandela ukutheleleka kwe-BA.2 kanye ne-BA.1.

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Ukuhlolwa komthamo wegciwane egazini we-PCR kubonise ukuthi womabili amagundane atheleleke nge-BA.2 kanye ne-BA.1 anenani eliphansi legciwane egazini emaphashini nasemakhaleni kunohlobo lokuqala lwe-New Crown strain, ikakhulukazi emaphashini (p<0.0001).

Ngokufanayo nemiphumela yamagundane, i-viral titres etholwe ekhaleni nasemaphashini e-BA.2 kanye ne-BA.1 ama-hamster anegciwane ayephansi kunohlobo lokuqala ngemuva 'kokujova' ngomthamo ofanayo wegciwane, ikakhulukazi emaphashini, futhi kancane. ephansi ekhaleni le-BA.2 i-hamster enegciwane kune-BA.1 - empeleni, isigamu sama-hamster aphethwe yi-BA.2 asizange sibe nezifo zamaphaphu.

Kuphinde kwatholakala ukuthi izinhlobo zakuqala, i-BA.2 kanye ne-BA.1, zantula ukuhlukana kwe-sera kulandela ukutheleleka - okuhambisana nalokho okuye kwabonwa kubantu bomhlaba wangempela lapho bengenwa izifo eziguquguqukayo ezintsha ezihlukahlukene.

Umthombo we-inthanethi wesithombe

Idatha yomhlaba wangempela: I-Omicron mancane amathuba okuba ibangele ukugula okubi kakhulu

Eziningi zalezi zifundo ezingenhla zichaze ukuncipha kobungozi be-Omicron kumamodeli ezilwane zaselabhorethri, kodwa ingabe kuyafana emhlabeni wangempela?

Ngomhla ziyisi-7 kuNhlangulana wezi-2022, i-WHO yashicilela umbiko ohlola umehluko wobunzima babantu abangenwe yilesi sifo ngesikhathi sobhubhane lwe-Omicron (B.1.1.529) uma kuqhathaniswa nobhubhane lwe-Delta.

Lo mbiko uhlanganise iziguli ezintsha ezilaliswe yinhliziyo eziyizi-16,749 ezivela kuzo zonke izifundazwe zaseNingizimu Afrika, kuhlanganisa neziyi-16,749 ezivela kubhubhane lweDelta (2021/8/2 kuya ku-2021/10/3) kanye neziyi-17,693 ezivela kubhubhane lwe-Omicron (2021/11/15 kuya ku-2022/2/2/2019) 16). Iziguli nazo zahlukaniswa njengezinzima, ezibucayi futhi ezingenabucayi.

okubalulekile: ukuthola umoya ohlaselayo, noma umoya-mpilo kanye nomoya-mpilo ogeleza kakhulu we-transnasal, noma i-extracorporeal membrane oxygenation (ECMO), noma ukungeniswa e-ICU ngesikhathi sokulaliswa esibhedlela.
-inzima (inzima): ithole umoya-mpilo ngesikhathi sokulaliswa esibhedlela
-okungenamandla: uma kungekho kwezimo ezingenhla ezihlangene, isiguli asinamandla.

Imininingwane ikhombise ukuthi eqenjini le-Delta, u-49.2% wawubucayi, u-7.7% wawubucayi kwathi u-28% wazo zonke iziguli ezilaliswe esibhedlela i-Delta zashona, kanti eqenjini le-Omicron, u-28.1% wawubucayi, u-3.7% wawubucayi kanti u-15% wabo bonke abalaliswe esibhedlela. Iziguli ezinegciwane le-Omicron zafa. Futhi, ubude besilinganiso sokuhlala kwakuyizinsuku ezingu-7 eqenjini le-Delta uma kuqhathaniswa nezinsuku ezingu-6 eqenjini le-Omicron.

Ukwengeza, umbiko uhlaziye izici ezithonya zeminyaka yobudala, ubulili, isimo sokugoma kanye ne-commorbidities futhi waphetha ngokuthi i-Omicron (B.1.1.529) ihlotshaniswa namathuba aphansi okugula okubucayi nokubucayi (95% CI: 0.41 kuya ku-0.46; p <0.001) kanye nengozi ephansi yokufa esibhedlela (95% CI: 0.59 kuya 0.65; p<0.001).

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Kuma-subtypes ahlukene e-Omicron, ucwaningo olwengeziwe lubuye lwahlaziya ubungako bazo ngokuningiliziwe.

Ucwaningo lweqembu oluvela eNew England luhlaziye izehlakalo ezingu-20770 ze-Delta, izimo ezingu-52605 ze-Omicron B.1.1.529 kanye namacala angu-29840 e-Omicron BA.2, futhi lathola ukuthi ingxenye yokufa yayingu-0.7% ku-Delta, i-0.4% ye-B.1.1. 529 kanye no-0.3% we-BA.2. Ngemva kokulungiswa kwezici ezididayo, ucwaningo lwaphetha ngokuthi ingozi yokufa yayiphansi kakhulu ku-BA.2 uma kuqhathaniswa kokubili i-Delta ne-B.1.1.529.

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Olunye ucwaningo oluvela eNingizimu Afrika lwahlola ubungozi bokulaliswa esibhedlela kanye nengozi yomphumela onzima we-Delta, BA.1, BA.2 kanye ne-BA.4/BA.5. Imiphumela ikhombise ukuthi ezigulini ezisanda kutheleleka ezingu-98,710 ezifakwe ekuhlaziyeni, ezingu-3825 (3.9%) zingeniswe esibhedlela, ezingu-1276 (33.4%) zazo zaba nezifo ezinzima.

Phakathi kwalabo abangenwe uguquko oluhlukene, ama-57.7% eziguli ezine-Delta athola izifo ezinzima (97/168), uma kuqhathaniswa ne-33.7% yeziguli ezine-BA.1 (990/2940), 26.2% ye-BA.2 (167/ 637) kanye no-27.5% we-BA.4/BA.5 (22/80). Ukuhlaziywa kwe-multivariate kubonise ukuthi amathuba okuba nesifo esibi kakhulu phakathi kwalabo abangenwe yi-Delta> BA.1> BA.2, kuyilapho amathuba okuba nesifo esibi kakhulu phakathi kwalabo abangenwe yi-BA.4/BA.5 ayengahlukanga kakhulu uma kuqhathaniswa ne-BA. 2.
I-virulence eyehlisiwe, kodwa ukuqapha kuyadingeka

Ucwaningo lwaselabhorethri kanye nedatha yangempela evela emazweni amaningana kubonise ukuthi i-Omicron kanye nezinhlobo zayo ezincane ayinabo ubudlova futhi mancane amathuba okuba ibangele ukugula okubi kakhulu kunohlobo lokuqala kanye nezinye izinhlobo eziguqukayo.

Kodwa-ke, i-athikili ebuyekeziwe kumagazini kaJanuwari 2022 we-Lancet, enesihloko esithi 'Milder but not mild', yaphawula ukuthi nakuba ukutheleleka kwe-Omicron kudla u-21% wabantu abalaliswa esibhedlela kubantu abasha baseNingizimu Afrika, inani lokuqubuka kwezifo ezidala izifo ezinzima kungenzeka. ukwanda kwabantu abanamazinga ahlukene okutheleleka kanye namazinga ahlukene okugoma. (Noma kunjalo, kulesi sibalo esivamile sabantu baseNingizimu Afrika, u-21% weziguli ezilaliswe esibhedlela ezingenwe i-SARS-CoV-2 omicron variant zibe ne-oucome ebucayi yomtholampilo, ingxenye engase ikhule futhi ibangele umthelela omkhulu ngesikhathi sokuqubuka kwesibalo sabantu abanezinhlobo ezahlukene zabantu naphansi. amazinga okugomela okutholakala ekuthelelekeni noma okutholakala emuthini.)

Ekupheleni kombiko oshiwo ngenhla we-WHO, ithimba laphawula ukuthi naphezu kokunciphisa ubungozi bohlobo lwangaphambilini, cishe ingxenye yesithathu yeziguli ezilaliswe esibhedlela i-Omicron (B.1.1.529) zaba nesifo esibi kakhulu, nokuthi izinguquko ezihlukahlukene zomqhele ezintsha zaqhubeka noku kubangela ukugula okuphezulu nokufa kwabantu asebekhulile, abantu abangenawo amandla omzimba noma abangagonyiwe. (Sithanda futhi ukuxwayisa ukuthi ukuhlaziya kwethu akufanele kubonwe njengokusekela inguqulo 'emnene'. Cishe ingxenye eyodwa kwezintathu yeziguli ezilaliswe esibhedlela i-Omicron yaba nesifo esibi kakhulu kwathi u-15% washona; izinombolo ezingasho lutho……Phakathi kwabantu abasengozini , okungukuthi iziguli esezikhulile ngokwedlulele, ezixukwini ezinomthwalo omkhulu we-commorbid, ezigulini ezibuthaka naphakathi kwabangagonyiwe, i-COVID-19 (wonke ama-VOC) iyaqhubeka ukufaka isandla ekuguleni okukhulu nasekufeni.)

Idatha yangaphambilini evela ku-Omicron lapho idala igagasi lesihlanu lalolu bhubhane eHong Kong ikhombise ukuthi kusukela ngomhlaka-4 Meyi 2022, kwaba nokufa kwabantu abangama-9115 kwabangu-1192765 abasanda kuthweswa umqhele ngesikhathi segagasi lesihlanu (izinga lokufa kwabantu okungenamsoco lika-0.76%) kanye nohlaza. izinga lokufa lika-2.70% kubantu abangaphezu kweminyaka engama-60 ubudala (cishe u-19.30% waleli qembu lobudala babengagonyiwe).

Ngokuphambene, u-2% kuphela wabantu baseNew Zealand abaneminyaka engaphezu kwengu-60 ubudala abangagonyiwe, okuhlobene kakhulu nezinga lokufa eliphansi elingu-0.07% lobhubhane olusha.

Ngakolunye uhlangothi, nakuba kuvame ukuphikiswana ngokuthi iNewcastle ingase ibe yisifo sesizini, esisabalele ngokuzayo, kunongoti bezemfundo abathatha umbono ohlukile.

Ososayensi abathathu abavela eNyuvesi yase-Oxford kanye ne-European Union Joint Research Center bakholelwa ukuthi ubunzima obuphansi be-Omicron bungase bumane nje bube yingozi, nokuthi ukuqhubeka nokuziphendukela kwemvelo okusheshayo kwe-antigenic (ukuziphendukela kwe-antigenic) kungase kulethe ukuhlukahluka okusha.

Ngokungafani nokuphunyuka kwamasosha omzimba kanye nokusuleleka, okungaphansi kwengcindezi enamandla yokuguquguquka, ubungozi ngokuvamile 'buwumkhiqizo' wokuziphendukela kwemvelo. Amagciwane ayaguquguquka ukuze akhulise amandla awo okusabalala, futhi lokhu kungase kuholele ekwandeni kobungozi. Isibonelo, ngokwandisa umthamo wegciwane ukuze kube lula ukudluliswa, kusengadala izifo ezinzima kakhulu.

Hhayi lokho kuphela, kodwa ubungozi buzophinde bubangele ukulimala okulinganiselwe ngesikhathi sokusabalala kwegciwane uma izimpawu ezilethwa igciwane zivela ikakhulukazi kamuva ekuthelelekeni - njengasendabeni yamagciwane omkhuhlane, i-HIV kanye ne-hepatitis C, ukubiza amagciwane. ezimbalwa, ezinesikhathi esiningi sokusabalala ngaphambi kokudala imiphumela emibi.

Umthombo we-inthanethi wesithombe

Ezimweni ezinjalo, kungase kube nzima ukubikezela ukuthambekela kohlobo olusha lomqhele oluguquguqukayo olusuka ku-virulence ephansi ye-Omicron, kodwa izindaba ezinhle ukuthi umuthi wokugomela umqhele omusha ubonise ingozi encishisiwe yokugula okunzima nokufa kuzo zonke izinhlobo ze-mutant, kanye nezinga lokugoma labantu elikhuphuka ngamandla lihlala liyindlela ebalulekile yokulwa nalolu bhubhane kulesi sigaba.
Ukubonga: Lesi sihloko sibuyekezwe ngokomsebenzi nguPanpan Zhou, PhD, Tsinghua University School of Medicine kanye ne-Postdoctoral Fellow, i-Scripps Research Institute, e-USA.
I-Omicron self-testing antigen reagent ekhaya