Ubuthi be-Omicron bunciphe kangakanani? Izifundo eziningi zangempela zembula

“Ubungozi be-Omicron bucishe bufane nobe-flu yesizini” kanye nokuthi “i-Omicron ayinazo izifo eziningi kakhulu kune-Delta”. …… Muva nje, izindaba eziningi mayelana nobungozi be-crown mutant strain entsha i-Omicron zisakazeke ku-inthanethi.

Ngempela, selokhu kwavela uhlobo lwe-Omicron mutant ngoNovemba 2021 kanye nokusabalala kwalo emhlabeni jikelele, ucwaningo kanye nengxoxo mayelana nokuba khona kwegciwane kanye nokusabalala kwalo kuye kwaqhubeka ngaphandle kokuphazamiseka. Iyini iphrofayili yokuba khona kwegciwane kwe-Omicron njengamanje? Ucwaningo luthini ngakho?

Izifundo ezahlukahlukene zelebhu: I-Omicron ayinawo amagciwane amaningi
Eqinisweni, kusukela ngoJanuwari 2022, ucwaningo oluvela eNyuvesi yaseHong Kong Li Ka Shing Faculty of Medicine luthole ukuthi i-Omicron (B.1.1.529) ingase ingabi yingozi kangako uma iqhathaniswa nohlobo lokuqala kanye nezinye izinhlobo eziguquliwe.
Kutholakale ukuthi uhlobo lwe-Omicron mutant belungaphumeleli kahle ekusebenziseni i-transmembrane serine protease (TMPRSS2), kuyilapho i-TMPRSS2 ingenza kube lula ukuhlasela kwamagciwane kwamaseli abanjwe ngokususa iphrotheni ebukhali ye-coronavirus entsha. Ngesikhathi esifanayo, abacwaningi baphawula ukuthi ukuphindaphindwa kwe-Omicron kuncishiswe kakhulu emigqeni yamaseli omuntu i-Calu3 ne-Caco2.

I-inthanethi yomthombo wesithombe

Kumodeli yegundane ye-k18-hACE2, ukuphindaphindeka kwe-Omicron kuncishisiwe kokubili ezindaweni zokuphefumula eziphezulu nezingezansi zamagundane uma kuqhathaniswa nohlobo lokuqala kanye ne-Delta mutant, futhi isifo sayo samaphaphu sasingesibi kakhulu, kuyilapho ukutheleleka kwe-Omicron kubangele ukwehla kwesisindo kanye nokufa okuncane kunohlobo lokuqala kanye ne-Alpha, Beta kanye ne-Delta mutants.
Ngakho-ke, abacwaningi baphetha ngokuthi ukuphindaphindana kwe-Omicron kanye nesifo se-pathogenic kunciphile kumagundane.

I-inthanethi yomthombo wesithombe

Ngomhlaka-16 Meyi 2022, i-Nature yashicilela iphepha likaYoshihiro Kawaoka, isazi segciwane esihamba phambili eNyuvesi yaseTokyo naseNyuvesi yaseWisconsin, eqinisekisa okokuqala kumodeli yesilwane ukuthi i-Omicron BA.2 empeleni ayinawo amandla amaningi kunezinhlobo zokuqala zangaphambilini.

Abacwaningi bakhethe amagciwane e-BA.2 aphilayo ahlukaniswe eJapane ukuze athelele amagundane nama-hamster e-k18-hACE2 futhi bathola ukuthi, ngemva kokutheleleka ngesilinganiso esifanayo segciwane, womabili amagundane anegciwane le-BA.2 ne-BA.1 ayenegciwane eliphansi kakhulu emaphashini nasekhaleni kunokutheleleka kokuqala kwe-New Crown strain (p<0.0001).

Lo mphumela wegolide ojwayelekile uqinisekisa ukuthi i-Omicron empeleni ayinawo amagciwane amaningi kunezinhlobo zasendle zokuqala. Ngokuphambene nalokho, bekungekho mehluko omkhulu kuma-viral titres emaphashini nasemakhaleni ezilwane ezilandela ukutheleleka kwe-BA.2 kanye ne-BA.1.

I-inthanethi yomthombo wesithombe

Ukuhlolwa kwe-PCR viral load kubonise ukuthi amagundane athelelekile nge-BA.2 kanye ne-BA.1 ayene-viral load ephansi emaphashini nasemakhaleni kunohlobo lokuqala lwe-New Crown, ikakhulukazi emaphashini (p<0.0001).

Ngokufanayo nemiphumela emagundwini, ama-viral titres atholakale ekhaleni nasemaphashini ama-hamster anegciwane le-BA.2 kanye ne-BA.1 ayephansi kunohlobo lokuqala ngemuva 'kokugoma' ngesilinganiso esifanayo segciwane, ikakhulukazi emaphashini, futhi ayephansi kancane ekhaleni lama-hamster anegciwane le-BA.2 kune-BA.1 - empeleni, ingxenye yama-hamster anegciwane le-BA.2 ayizange ibe nokutheleleka emaphashini.

Kwaphinde kwatholakala ukuthi izinhlobo zokuqala, i-BA.2 kanye ne-BA.1, zazingenawo ama-sera angenawo umthelela oqondile ngemva kokutheleleka - okuhambisana nalokho okuye kwabonwa kubantu bangempela lapho betheleleka ngezinhlobo ezintsha ze-crown mutants.

I-inthanethi yomthombo wesithombe

Idatha yangempela: I-Omicron cishe ayinakho ukubangela ukugula okukhulu

Izifundo eziningana ezingenhla zichaze ukwehla kwe-Omicron kumamodeli ezilwane zaselabhorethri, kodwa ingabe kunjalo nasemhlabeni wangempela?

Ngomhlaka-7 Juni 2022, i-WHO yashicilela umbiko ohlola umehluko wobunzima babantu abangenwe yileli gciwane ngesikhathi sobhubhane lwe-Omicron (B.1.1.529) uma kuqhathaniswa nobhubhane lwe-Delta.

Umbiko uhlanganise iziguli ezintsha ezingu-16,749 ezingeniswe emithanjeni yegazi ezivela kuzo zonke izifundazwe zaseNingizimu Afrika, okuhlanganisa nezingu-16,749 ezinesifo se-Delta (2021/8/2 kuya ku-2021/10/3) kanye nezingu-17,693 ezinesifo se-Omicron (2021/11/15 kuya ku-2022/2/16). Iziguli nazo zihlukaniswe njengezinobunzima, ezibucayi kanye nezingezona ezibucayi.

okubalulekile: ukuthola umoya ongenayo, noma i-oxygen kanye ne-transnasal oxygen egeleza kakhulu, noma i-extracorporeal membrane oxygenation (ECMO), noma ukungeniswa e-ICU ngesikhathi sokulaliswa esibhedlela.
-okunzima (okunzima): wathola umoya-mpilo ngesikhathi elaliswa esibhedlela
-akukubi kakhulu: uma kungekho mibandela engenhla ehlangatshezwayo, isiguli asikubi kakhulu.

Idatha ikhombisile ukuthi eqenjini le-Delta, ama-49.2% ayebucayi, ama-7.7% ayebucayi kanti ama-28% azo zonke iziguli ezinegciwane le-Delta ezilaliswe esibhedlela zafa, kanti eqenjini le-Omicron, ama-28.1% ayebucayi, ama-3.7% ayebucayi kanti ama-15% azo zonke iziguli ezinegciwane le-Omicron ezilaliswe esibhedlela zafa. Futhi, ubude obuphakathi bokuhlala kwakuyizinsuku eziyi-7 eqenjini le-Delta uma kuqhathaniswa nezinsuku eziyi-6 eqenjini le-Omicron.

Ngaphezu kwalokho, umbiko uhlaziye izici ezithonyayo zobudala, ubulili, isimo sokugoma kanye nezinkinga ezihambisana nalesi sifo futhi waphetha ngokuthi i-Omicron (B.1.1.529) ihlotshaniswa namathuba aphansi okugula okubi kakhulu (95% CI: 0.41 kuya ku-0.46; p<0.001) kanye nengozi ephansi yokufa esibhedlela (95% CI: 0.59 kuya ku-0.65; p<0.001).

I-inthanethi yomthombo wesithombe

Ngezinhlobo ezahlukene ze-Omicron, izifundo ezengeziwe zihlaziye nokuba khona kwazo ngokuningiliziwe.

Ucwaningo lweqembu oluvela eNew England luhlaziye amacala angu-20770 e-Delta, amacala angu-52605 e-Omicron B.1.1.529 kanye namacala angu-29840 e-Omicron BA.2, futhi lwathola ukuthi isilinganiso sokufa sasingu-0.7% e-Delta, u-0.4% we-B.1.1.529 kanye no-0.3% we-BA.2. Ngemva kokulungisa izici ezididayo, ucwaningo luphethe ngokuthi ingozi yokufa yayiphansi kakhulu ku-BA.2 uma kuqhathaniswa ne-Delta kanye ne-B.1.1.529.

I-inthanethi yomthombo wesithombe

Olunye ucwaningo oluvela eNingizimu Afrika luhlole ingozi yokulaliswa esibhedlela kanye nengozi yemiphumela emibi ye-Delta, BA.1, BA.2 kanye ne-BA.4/BA.5. Imiphumela ikhombisile ukuthi ezigulini ezisanda kutheleleka ezingu-98,710 ezifakiwe ekuhlaziyweni, ezingu-3825 (3.9%) zangeniswa esibhedlela, kanti ezingu-1276 (33.4%) zazo zaba nesifo esibi kakhulu.

Phakathi kwalabo abangenwe yizinguquko ezahlukene, ama-57.7% eziguli ezinegciwane le-Delta athole isifo esibi kakhulu (97/168), uma kuqhathaniswa nama-33.7% eziguli ezinegciwane le-BA.1 (990/2940), ama-26.2% e-BA.2 (167/637) kanye nama-27.5% e-BA.4/BA.5 (22/80). Ukuhlaziywa kwe-Multivariate kubonise ukuthi amathuba okuthola isifo esibi kakhulu phakathi kwalabo abanegciwane le-Delta > BA.1 > BA.2, kuyilapho amathuba okuthola isifo esibi kakhulu phakathi kwalabo abanegciwane le-BA.4/BA.5 ayengafani kakhulu uma kuqhathaniswa ne-BA.2.
Ukwehla kobuthi, kodwa kudingeka ukuqapha

Izifundo zelebhu kanye nedatha yangempela evela emazweni amaningana ibonise ukuthi i-Omicron kanye nezinhlobo zayo ezincane azinawo amagciwane amaningi futhi cishe azibanga ukugula okukhulu kunezinhlobo zokuqala kanye nezinye izinhlobo eziguquliwe.

Kodwa-ke, isihloko sokubuyekezwa kumagazini i-The Lancet kaJanuwari 2022, onesihloko esithi 'Okuncane kodwa okungekho okumnene', saphawula ukuthi yize ukutheleleka kwe-Omicron kubangelwe u-21% wokungeniswa esibhedlela kubantu abasha baseNingizimu Afrika, isilinganiso sokuqubuka okubangela izifo ezinzima cishe sasinganda kubantu abanamazinga ahlukene okutheleleka kanye namazinga ahlukene okugonywa. (Noma kunjalo, kuleli nani labantu abasha baseNingizimu Afrika, u-21% weziguli ezilaliswe esibhedlela ezitheleleke nge-SARS-CoV-2 omicron variant zazine-oucome enzima yezokwelapha, isilinganiso esingase sande futhi sibangele umthelela omkhulu ngesikhathi sokuqubuka kwabantu abanezinhlobo ezahlukene zabantu kanye namazinga aphansi okuzivikela okuthelelekile noma okutholwe ngomuthi wokugomela.)

Ekupheleni kombiko we-WHO oshiwo ngenhla, ithimba liphawule ukuthi naphezu kokuncipha kobungozi bohlobo lwangaphambilini, cishe ingxenye yesithathu yeziguli ze-Omicron (B.1.1.529) ezilaliswe esibhedlela zathola isifo esibi kakhulu, nokuthi izinhlobo ezintsha zokuguqulwa komqhele zaqhubeka nokubangela ukugula nokufa okuphezulu kubantu asebekhulile, abantu amasosha omzimba abo angasebenzi kahle noma abangagonyiwe. (Singathanda futhi ukuxwayisa ukuthi ukuhlaziya kwethu akufanele kubhekwe njengokusekela indaba 'ethambile' ehlukile. Cishe ingxenye yesithathu yeziguli ze-Omicron ezilaliswe esibhedlela zathola isifo esibi kakhulu kwathi u-15% wafa; izinombolo ezingabalulekile…Phakathi kwabantu abasengozini, okungukuthi iziguli ezineminyaka eyeqile, kubantu abanomthwalo omkhulu wezifo ezihambisana naso, ezigulini ezibuthakathaka naphakathi kwabantu abangagonyiwe, i-COVID-19 (zonke i-VOC) iyaqhubeka nokufaka isandla ekuguleni nasekufeni okukhulu.)

Idatha yangaphambilini evela ku-Omicron lapho iqala igagasi lesihlanu lobhubhane eHong Kong ibonise ukuthi kusukela mhla ziyi-4 kuMeyi 2022, kwakunokufa okungu-9115 kwamacala angu-1192765 asanda kuqokwa ngesikhathi segagasi lesihlanu (isilinganiso sokufa okungakahleleki esingu-0.76%) kanye nesilinganiso sokufa okungakahleleki esingu-2.70% kubantu abangaphezu kweminyaka engama-60 ubudala (cishe u-19.30% waleli qembu leminyaka babengagonyiwe).

Ngokuphambene nalokho, yi-2% kuphela yabantu baseNew Zealand abaneminyaka engaphezu kwengu-60 abangagonywanga, okuhlobene kakhulu nesilinganiso esiphansi sokufa okungavuthiwe esingu-0.07% ngenxa yobhubhane olusha lwe-crown.

Ngakolunye uhlangothi, nakuba kuvame ukuphikisana ngokuthi iNewcastle ingaba yisifo esivame ukwenzeka ngezikhathi ezithile esikhathini esizayo, kukhona ochwepheshe bezemfundo abanombono ohlukile.

Ososayensi abathathu abavela eNyuvesi yase-Oxford kanye ne-European Union Joint Research Centre bakholelwa ukuthi ubukhali obuphansi be-Omicron bungaba yinto eyenzeka ngengozi nje, nokuthi ukuqhubeka nokuvela kwe-antigen okusheshayo (ukuvela kwe-antigenic) kungaletha izinhlobo ezintsha.

Ngokungafani nokuphuma komzimba kanye nokusabalala kwawo, okungaphansi kwengcindezi enkulu yokuziphendukela kwemvelo, ukuba khona kwegciwane ngokuvamile kumane 'kungumkhiqizo' wokuziphendukela kwemvelo. Amagciwane ayavela ukuze andise ikhono lawo lokusabalala, futhi lokhu kungaholela ekwandeni kokuba khona kwegciwane. Isibonelo, ngokwandisa umthwalo wegciwane ukuze kube lula ukudluliselwa, kusengadala izifo ezimbi kakhulu.

Akukhona lokho kuphela, kodwa ukutheleleka kuzophinde kubangele umonakalo omncane kakhulu ngesikhathi sokusabalala kwegciwane uma izimpawu ezilethwa yileli gciwane zivela kakhulu kamuva ekuthelelekeni - njengasendabeni yamagciwane omkhuhlane, i-HIV kanye namagciwane e-hepatitis C, ukubala ambalwa, anesikhathi esanele sokusabalala ngaphambi kokuba abangele imiphumela emibi kakhulu.

I-inthanethi yomthombo wesithombe

Ezimweni ezinjalo, kungaba nzima ukubikezela ukuthambekela kohlobo olusha lwe-crown mutant kusukela ekuthelelekeni okuphansi kwe-Omicron, kodwa izindaba ezinhle ukuthi umuthi omusha wokugomela i-crown ubonise ingozi encishisiwe yokugula okukhulu nokufa kuzo zonke izinhlobo ze-mutant, futhi amazinga okugomela abantu akhula ngamandla ahlala eyindlela ebalulekile yokulwa nobhubhane kulesi sigaba.
Ukubonga: Lesi sihloko sibuyekezwe ngobungcweti yiPanpan Zhou, PhD, iTsinghua University School of Medicine kanye nePostdoctoral Fellow, iScripps Research Institute, e-USA.
I-reagent ye-antigen yokuzihlola ye-Omicron ekhaya