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 ye-k18-hACE2, ukuphindaphinda kwe-Omicron kwehliswa kuzo zombili izindlela zokuphefumula ezingaphezulu neziphansi zamagundane uma kuqhathaniswa nohlobo lokuqala kanye ne-Delta mutant, futhi isifo se-pulmonary pathology yayingenzima kakhulu, kuyilapho ukutheleleka kwe-Omicron kubangele ukuncipha kwesisindo nokufa kunohlobo lokuqala 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 lengculaza waseNyuvesi yaseTokyo naseNyuvesi yaseWisconsin, eqinisekisa ngokokuqala ngqa kumodeli yezilwane ukuthi i-Omicron BA.2 ayinabungozi kangako kunohlobo lwangaphambili lwangaphambili.

Abacwaningi bakhethe amagciwane e-BA.2 aphilayo ahlukaniswe eJapane ukuze atheleleke amagundane nama-hamster e-k18-hACE2 futhi bathola ukuthi, ngemva kokutheleleka ngesilinganiso esifanayo segciwane, womabili amagundane anegciwane le-BA.2 kanye ne-BA.1 ayenezinhlayiya zegciwane eziphansi kakhulu emaphashini nasemakhaleni kune-New Crown strain infection (p<0.0001).

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

Umthombo we-inthanethi wesithombe

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, ama-viral titres atholwe ekhaleni nasemaphashini e-BA.2 kanye ne-BA.1 ama-hamster anegciwane ayephansi kunobunzima bokuqala ngemuva 'kwe-inoculation' ngomthamo ofanayo wegciwane, ikakhulukazi emaphashini, futhi aphansi kancane emakhaleni e-BA.2 ama-hamster anegciwane kune-BA.1 - empeleni, ingxenye ye-BA.2 ayizange ihlakulele ukutheleleka kwamaphaphu.

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 uhlanganisa iziguli ezintsha ezilaliswa 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 nezi-17,693 ezivela kubhubhane lwe-Omicron (2021/11/15 kuya ku-2022/2/2022/2022). 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 futhi u-28% wazo zonke iziguli ezinegciwane le-Delta ezilaliswe esibhedlela zashona, kanti eqenjini le-Omicron, u-28.1% wawubucayi, u-3.7% wawubucayi kanti u-15% wazo zonke iziguli ezinegciwane le-Omicron zishonile. 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 nethuba eliphansi lokugula okubucayi nokubucayi (95% CI: 0.41 kuya ku-0.46; p <0.001) kanye nengozi ephansi yokufa kwe-in-9: 5%. 0.65; p<0.001).

Umthombo we-inthanethi wesithombe

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

Ucwaningo lweqembu oluvela eNew England luhlaziye izehlakalo ezingu-20770 ze-Delta, izehlakalo ezingu-52605 ze-Omicron B.1.1.529 kanye nezingu-29840 ze-Omicron BA.2, futhi zathola ukuthi ingxenye yokufa yayingu-0.7% ku-Delta, u-0.4% we-B.1.1.529 we-BA.0. Ngemva kokulungiswa kwezici ezididayo, ucwaningo lwaphetha ngokuthi ingozi yokufa yayiphansi kakhulu ku-BA.2 uma kuqhathaniswa kokubili i-Delta ne-B.1.1.529.

Umthombo we-inthanethi wesithombe

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 yizinguquko ezihlukahlukene, i-57.7% yeziguli ezithelelekile ze-Delta zaba nesifo esibi (97/168), uma kuqhathaniswa ne-33.7% yeziguli ezine-BA.1 ezithelelekile (990/2940), 26.2% ye-BA.2 (167/637) kanye ne-27.5% ye-BA.4/BA.5 (27.5). Ukuhlaziywa kwe-multivariate kubonise ukuthi amathuba okuba nesifo esibi kakhulu phakathi kwalabo abangenwe yi-Delta> BA.1> BA.2, kuyilapho amathuba okuba nesifo esibi phakathi kwalabo abangenwe yi-BA.4/BA.5 ayengafani 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 kwenze u-21% wabantu abalaliswa esibhedlela kubantu abasha baseNingizimu Afrika, inani lokuqubuka kwezifo eziyingozi lingase likhule kubantu abanamazinga ahlukene okutheleleka kanye namazinga ahlukene okugoma. (Noma kunjalo, kulesi sibalo esivamile sabantu baseNingizimu Afrika, u-21% weziguli ezilaliswe esibhedlela ezine-SARS-CoV-2 omicron variant zibe ne-oucome ebucayi yomtholampilo, ingxenye engase ikhule futhi ibangele umthelela omkhulu ngesikhathi sokuqubuka kwabantu abanezibalo ezahlukene kanye namazinga aphansi okugomela okutholakala ekuthelelekeni noma okutholakala egomeni.)

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) zithole isifo esibi kakhulu, nokuthi izinguquko ezihlukahlukene zomqhele ezintsha zaqhubeka zibangela ukugula okuphezulu nokufa kwabantu asebekhulile, abantu abangenakuzivikela noma abangagonyiwe. (Sithanda futhi ukuxwayisa ngokuthi ukuhlaziya kwethu akufanele kubonwe njengokusekela ukulandisa okuhlukile 'okumnene'. Cishe ingxenye eyodwa kwezintathu yeziguli ezilaliswe esibhedlela i-Omicron zaba nesifo esibi kakhulu futhi u-15% washona; amanani angeyona into encane… ukufaka isandla ekuguleni okukhulu nasekufeni.)

Idatha yangaphambilini evela ku-Omicron ngenkathi 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 okungafanele lika-0.76%) kanye nezinga lokufa okungafanele le-2.70% yeminyaka yobudala engaphezu kuka-19% kubantu abaneminyaka engaphezu kwengu-2.60. 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, ukubala ambalwa, anesikhathi esiningi sokusabalala ngaphambi kokudala imiphumela emibi.

Umthombo we-inthanethi wesithombe

Ezimweni ezinjalo, kungase kube nzima ukubikezela ukuthambekela kohlobo olusha lwe-crown mutant olusuka ku-virulence ephansi ye-Omicron, kodwa izindaba ezinhle ukuthi umuthi wokugomela umqhele omusha ubonise ingozi encishisiwe yokugula okunzima kanye nokufa kuzo zonke izinhlobo eziguqukayo, futhi izinga 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