SARS-CoV-2 변이

위키백과, 우리 모두의 백과사전.

코로나바이러스감염증-19(코로나19)를 일으키는 SARS-CoV-2는 다수의 변이가 있다. 일부는 전염성이 증가하거나, 독성이 늘거나, 백신의 효과가 감소하기 때문에 특히 중요하다. 사상 최초의 변이 바이러스는 영국발 변이 바이러스이다.

개괄

상대적 위험도:   매우 높음   높음   보통   낮음   모름[1][2][3][4][5][6][7]

식별 출현 우한에서 처음 발견된 바이러스와의 차이
WHO[1] PANGO 계통[8] PHE 변종[A] Nextstrain clade[9][2] 첫 발발 초기 샘플 Designated variant of concern 주요 돌연변이 감염성 병독성 항원성
알파 B.1.1.7 VOC‑20DEC‑01 20I/501Y.V1[B] 영국 2020/9/20[10][11] 2020/12/18[12] 69–70del, N501Y, P681H[13][14] +82% (43130%)[15] 치사율: +61% (4282%)[16][C] 변화 없음[18]
베타 B.1.351 VOC‑20DEC‑02 20H/501Y.V2 남아프리카 공화국 2020/5[11] 2021/1/14[19] K417N, E484K, N501Y[13] +50% (20113%)[18] 변화 증거 없음[20] 항체에 의한 중화의 현저한 감소[21][22]
감마 P.1 VOC‑21JAN‑02 20J/501Y.V3 브라질 2020/11[11] 2021/1/15[23][24] K417T, E484K, N501Y[13] +161% (145176%) [25][E] 치사율: +50% (50% CrI, 2090%)[26][D][F] 효과적인 중화의 전반적인 감소[18]
B.1.1.7 with E484K[28] VOC‑21FEB‑02 20I/501Y.V1[B] 영국 2021/1/26[29] 2021/2/5[30] 69–70del, E484K, N501Y, P681H[13][14] 조사 중 조사 중 항체에 의한 중화의 현저한 감소.[31]
엡실론 B.1.429, B.1.427 20C/S:452R 미국 2020/3[11] 2021/3/17[32] L452R[13] +20% (19%–24%)[2][33] 조사 중 중화 항체에 대한 민감도가 약간 감소[34]
델타 B.1.617.2 VOC‑21APR‑02 21A/S:478K[11][4] 인도 2020/10[11] 2021/5/6[35] L452R, T478K, P681R[36] +198%[G] 조사 중 효과적인 중화의 약간의 감소[38]
카파 B.1.617.1 VUI‑21APR‑01 21A/S:154K[11] 인도 2020/10[11] L452R, E484Q, P681R[39] 조사 중 조사 중 효과적인 중화의 약간의 감소[38]
에타 B.1.525 VUI‑21FEB‑03[H] 20A/S:484K 나이지리아 2020/12/11[40][41][11] E484K, F888L[44] 조사 중 조사 중 중화 가능성 감소 [2]
  1. The naming format was updated in March 2021, changing the year from 4 to 2 digits and the month from 2 digits to a 3-letter abbreviation. For example, VOC-202101-02 became VOC-21JAN-02.[3]
  2. Formerly 20B/501Y.V1.
  3. Another study[17] has estimated that B.1.1.7 may be ~64% (32–104%) more lethal
  4. The reported confidence or credible interval has a low probability, so the estimated value can only be understood as possible, not certain nor likely.
  5. Another study[26] has estimated that P.1 may be 100% (50% CrI, 70140%) more transmissible.[D]
  6. Preliminary results from a study in the Southern Region of Brazil found P.1 much more lethal for healthy young people. In groups without pre-existing conditions, the variant was found to be 490% (220985%) more lethal for men in the 20-39 age group, 465% (1901003%) more lethal for women in the 20-39 age group and 670% (4011083%) for women in the 40-59 age group.[27]
  7. About 40% more transmissible than the Alpha variant.[37]
  8. Formerly UK1188.

각주

  1. “Tracking SARS-CoV-2 variants”. 《who.int》 (영어). World Health Organization. 2021년 6월 1일에 확인함. 
  2. “SARS-CoV-2 Variant Classifications and Definitions”. 《CDC.gov》. Centers for Disease Control and Prevention. 
  3. “Variants: distribution of cases data”. 《GOV.UK》. Government Digital Service. Public Health England. 
  4. “Living Evidence – SARS-CoV-2 variants”. Agency for Clinical Innovation. 《nsw.gov.au》. Ministry of Health (New South Wales). 2021년 3월 22일에 확인함. 
  5. “SARS-CoV-2 variants of concern”. 《ECDC.eu》. European Centre for Disease Prevention and Control. 2021년 6월 7일에 확인함. 
  6. “Coronavirus Disease (COVID-19) Situation Reports”. 《who.int》. World Health Organization. 
  7. “Investigation of SARS-CoV-2 variants of concern: technical briefings”. 《GOV.UK》. Government Digital Service. Public Health England. 
  8. “Lineage descriptions”. 《cov-lineages.org》. Pango team. 
  9. “Nextstrain”. 《nextstrain.org》. Nextstrain. 
  10. Rambaut A, Loman N, Pybus O, Barclay W, Barrett J, Carabelli A, 외. (2020년 12월 18일). “Preliminary genomic characterisation of an emergent SARS-CoV-2 lineage in the UK defined by a novel set of spike mutations”. 《Virological》. 2021년 6월 14일에 확인함. 
  11. 《Weekly epidemiological update on COVID-19 - 15 June 2021》 (Situation report). World Health Organization. 2021년 6월 15일. 2021년 6월 16일에 확인함. 
  12. 《Investigation of novel SARS-COV-2 variant, technical briefing 1》 (PDF) (Briefing). Public Health England. 2020년 12월 21일. 2021년 6월 6일에 확인함. 
  13. “Emerging SARS-CoV-2 Variants”. 《CDC.gov》 (Science brief). Centers for Disease Control and Prevention. 2021년 1월 28일. 2021년 1월 4일에 확인함.  이 문서는 퍼블릭 도메인 출처의 본문을 포함합니다.
  14. Chand et al. (2020), 6쪽, Potential impact of spike variant N501Y.
  15. Davies NG, Abbott S, Barnard RC, Jarvis CI, Kucharski AJ, Munday JD; 외. (2021). “Estimated transmissibility and impact of SARS-CoV-2 lineage B.1.1.7 in England.”. 《Science》 372 (6538). doi:10.1126/science.abg3055. PMC 8128288 |pmc= 값 확인 필요 (도움말). PMID 33658326 |pmid= 값 확인 필요 (도움말). 
  16. Davies G, Jarvis C, Edmunds WJ, Jewell N, Diaz-Ordaz K, Keogh R (2021년 3월 15일). “Increased mortality in community-tested cases of SARS-CoV-2 lineage B.1.1.7”. 《Nature》 (Published) 593 (7858): 270–274. doi:10.1038/s41586-021-03426-1. PMID 33723411 |pmid= 값 확인 필요 (도움말). 2021년 4월 29일에 확인함. 
  17. DChallen R, Brooks-Pollock E, Read J, Dyson L, Tsaneva-Atanasova K, Danon L (2021년 3월 10일). “Risk of mortality in patients infected with SARS-CoV-2 variant of concern 202012/1: matched cohort study”. 《The BMJ》 (Published) 372: n579. doi:10.1136/bmj.n579. PMC 7941603 |pmc= 값 확인 필요 (도움말). PMID 33687922 |pmid= 값 확인 필요 (도움말). 
  18. 《Risk related to the spread of new SARS-CoV-2 variants of concern in the EU/EEA – first update》 (Risk assessment). European Centre for Disease Prevention and Control. 2021년 2월 2일. 
  19. Horby, Peter; Barclay, Wendy; Huntley, Catherine (2021년 1월 13일). 《NERVTAG paper: brief note on SARS-CoV-2 variants》 (Note). Public Health England. 2021년 6월 6일에 확인함. 
  20. Sruthi S (2021년 2월 10일). “Notable Variants And Mutation Of SARS-CoV-2”. 《BioTecNika》. 2021년 3월 22일에 확인함. 
  21. Planas D, Bruel T, Grzelak L, 외. (2021년 4월 14일). “Sensitivity of infectious SARS-CoV-2 B.1.1.7 and B.1.351 variants to neutralizing antibodies”. 《Nature Medicine》 27 (5): 917–924. doi:10.1038/s41591-021-01318-5. PMID 33772244 |pmid= 값 확인 필요 (도움말). 
  22. “Coronavirus: Sinovac vaccine gives 70 per cent less protection against South African variant, but Hongkongers urged to still get jab”. 《South China Morning Post》. 2021년 4월 20일. 2021년 4월 20일에 확인함. 
  23. “Confirmed cases of COVID-19 variants identified in UK”. Friday 15 January: GOV.UK. Public Health England. 2021년 1월 15일. 
  24. Horby, Peter; Barclay, Wendy; Gupta, Ravi; Huntley, Catherine (2021년 1월 27일). 《NERVTAG paper: note on variant P.1》 (Note). Public Health England. 2021년 6월 6일에 확인함. 
  25. Coutinho RM, Marquitti FM, Ferreira LS, Borges ME, da Silva RL, Canton O, 외. (2021년 3월 23일). “Model-based estimation of transmissibility and reinfection of SARS-CoV-2 P.1 variant”. 《medRxiv》 (Preprint): 9. doi:10.1101/2021.03.03.21252706. 2021년 4월 29일에 확인함. The new variant was found to be about 2.6 times more transmissible (95% Confidence Interval (CI): 2.4–2.8) than previous circulating variant(s). ... Table 1: Summary of the fitted parameters and respective confidence intervals considering the entire period, November 1, 2020-January 31, 2021 maintaining the same pathogenicity of the previous variant. Parameter: Relative transmission rate for the new variant. Estimate: 2.61. 2.5%: 2.45. 97.5%: 2.76. 
  26. Faria NR, Mellan TA, Whittaker C, Claro IM, Candido DS, Mishra S, 외. (2021년 5월 21일). “Genomics and epidemiology of the P.1 SARS-CoV-2 lineage in Manaus, Brazil”. 《Science》 372 (6544): 815–821. doi:10.1126/science.abh2644. ISSN 0036-8075. PMC 8139423 |pmc= 값 확인 필요 (도움말). PMID 33853970 |pmid= 값 확인 필요 (도움말). Within this plausible region of parameter space, P.1 can be between 1.7 and 2.4 times more transmissible (50% BCI, 2.0 median, with a 99% posterior probability of being >1) than local non-P1 lineages and can evade 21 to 46% (50% BCI, 32% median, with a 95% posterior probability of being able to evade at least 10%) of protective immunity elicited by previous infection with non-P.1 lineages, corresponding to 54 to 79% (50% BCI, 68% median) cross-immunity ... We estimate that infections are 1.2 to 1.9 times more likely (50% BCI, median 1.5, 90% posterior probability of being >1) to result in mortality in the period after the emergence of P.1, compared with before, although posterior estimates of this relative risk are also correlated with inferred cross-immunity. More broadly, the recent epidemic in Manaus has strained the city’s health care system, leading to inadequate access to medical care. We therefore cannot determine whether the estimated increase in relative mortality risk is due to P.1 infection, stresses on the Manaus health care system, or both. Detailed clinical investigations of P.1 infections are needed. 
  27. Freitas AR, Lemos DR, Beckedorff OA, Cavalcanti LP, Siqueira AM, Mello RC, 외. (2021년 4월 19일). “The increase in the risk of severity and fatality rate of covid-19 in southern Brazil after the emergence of the Variant of Concern (VOC) SARS-CoV-2 P.1 was greater among young adults without pre-existing risk conditions” (Preprint). doi:10.1101/2021.04.13.21255281 – medRxiv 경유. Female 20 to 39 years old, with no pre-existing risk conditions, were at risk of death 5.65 times higher in February (95% CI, 2.9-11.03; p <0.0001) and in the age group of 40 and 59 years old, this risk was 7.7 times higher (95% CI, 5.01-11.83; p <0.0001) comparing with November–December. ... The heterogeneity observed between the age groups was greater when we analyzed the subgroup of the population without preexisting risk conditions where we found that the CFR in the female sex in the second wave was 1.95 times (95% CI, 1.38-2.76) the CFR of the first wave in the population over 85 years old and was 7.7 times (95% CI, 5.01-11.83; p < 0.0001) in the population between 40 and 59 years old. In the male population without previous diseases, the CFR in the second wave was 2.18 (95% CI, 1.62-2.93) times the CFR of the first wave in the population over 85 years old and 5.9 (95% CI, 3.2-10.85; p < 0, 0001) higher in the range between 20 and 39 years old. 
  28. Public Health England (2021년 2월 16일). “Variants: distribution of cases data”. 《GOV.UK》. 2021년 2월 17일에 확인함. 
  29. 《Investigation of novel SARS-CoV-2 variant 202012/01, technical briefing 5》 (PDF) (Briefing). Public Health England. 2021년 2월 2일. GW-1905. 2021년 6월 14일에 확인함. 
  30. 《Investigation of SARS-CoV-2 variants of concern in England, technical briefing 6》 (PDF) (Briefing). Public Health England. 2021년 2월 13일. GW-1934. 2021년 6월 6일에 확인함. 
  31. Collier DA, De Marco A, Gupta RK, 외. (2021년 5월 6일). “Sensitivity of SARS-CoV-2 B.1.1.7 to mRNA vaccine-elicited antibodies.”. 《Nature》 (Published) 593: 136–141. doi:10.1038/s41586-021-03412-7. 2021년 6월 1일에 확인함. We therefore generated pseudoviruses that carried the B.1.1.7 spike mutations with or without the additional E484K substitution and tested these against sera obtained after the first and second dose of the BNT162b2 mRNA vaccine as well as against convalescent sera. After the second vaccine dose, we observed a considerable loss of neutralizing activity for the pseudovirus with the B.1.1.7 spike mutations and E484K (Fig. 3d, e). The mean fold change for the E484K-containing B.1.1.7 spike variant was 6.7 compared with 1.9 for the B.1.1.7 variant, relative to the wild-type spike protein (Fig. 3a–c and Extended Data Fig. 5). Similarly, when we tested a panel of convalescent sera with a range of neutralization titres (Fig. 1f, g and Extended Data Fig. 5), we observed additional loss of activity against the mutant B.1.1.7 spike with E484K, with fold change of 11.4 relative to the wild-type spike protein (Fig. 3f, g and Extended Data Fig. 5). 
  32. Azad, Arman (2021년 3월 17일). “Coronavirus strains first detected in California are officially 'variants of concern,' CDC says”. 《CNN》. 2021년 6월 6일에 확인함. 
  33. Deng X, Garcia-Knight MA, Khalid MM, Servellita V, Wang C, Morris MK, 외. (March 2021). “Transmission, infectivity, and antibody neutralization of an emerging SARS-CoV-2 variant in California carrying a L452R spike protein mutation”. 《MedRxiv》 (Preprint). doi:10.1101/2021.03.07.21252647. PMC 7987058 |pmc= 값 확인 필요 (도움말). PMID 33758899 |pmid= 값 확인 필요 (도움말). 
  34. Wadman M (2021년 2월 23일). “California coronavirus strain may be more infectious – and lethal”. 《Science News》. doi:10.1126/science.abh2101. 2021년 3월 17일에 확인함. 
  35. 《SARS-CoV-2 variants of concern and variants under investigation in England, technical briefing 10》 (PDF) (Briefing). Public Health England. 2021년 5월 7일. GOV-8226. 2021년 6월 6일에 확인함. 
  36. “SARS-CoV-2 Variant Classifications and Definitions”. 《CDC.gov》. Centers for Disease Control and Prevention. 2021년 5월 12일. 2021년 5월 16일에 확인함. 
  37. Walker, Peter (2021년 6월 6일). “Covid Delta variant ‘about 40% more transmissible’, says Matt Hancock”. 《The Guardian》. 2021년 6월 6일에 확인함. 
  38. Yadav PD, Sapkal GN, Abraham P, Ella R, Deshpande G, Patil DY, 외. (2021년 5월 7일). “Neutralization of variant under investigation B.1.617 with sera of BBV152 vaccinees.”. 《Clinical Infectious Diseases》 (Oxford University Press). bioRxiv 10.1101/2021.04.23.441101 |biorxiv= 값 확인 필요 (도움말). doi:10.1093/cid/ciab411. PMID 33961693 |pmid= 값 확인 필요 (도움말). 
  39. Nuki, Paul; Newey, Sarah (2021년 4월 16일). “Arrival of India's 'double mutation' adds to variant woes, but threat posed remains unclear”. 《The Telegraph》 (영어). ISSN 0307-1235. 2021년 4월 17일에 확인함. 
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  43. “A coronavirus variant with a mutation that 'likely helps it escape' antibodies is already in at least 11 countries, including the US”. Business Insider. 2021년 2월 16일. 2021년 2월 16일에 확인함. 
  44. “B.1.525”. 《cov-lineages.org》. Pango team. 2021년 3월 22일에 확인함.