Dear Editor,
In the last couple of years, the Omicron variant has emerged as the deadliest among
coronavirus disease 2019 (COVID-19) variants, and as a result, it has granted rise
to several subvariants. According to statistics provided by the Centers for Disease
Control and Prevention (CDC), two of the most common subvariants, BQ.1 and BQ.1.1,
are now suspected for the vast majority of COVID-19 occurrences that have been reported
in the United States. Infectious disease specialist Dr Anthony Fauci, director of
the National Institute of Allergy and Infectious Diseases, has expressed skepticism
regarding BQ.1 and BQ.1.1. Dr Fauci told the CBS News that the subvariants have characteristics
with the potential to reduce the efficacy of our traditional therapies as well as
our immunity. Besides, these two variants may cause patients to get a severe illness
or even drive to death1.
According to Thomas Russo, professor and head of infectious disease at the University
of Buffalo in New York, BQ.1 and BQ.1.1 are part of a new assault of COVID-19 variations.
He describes this as the ‘next wave’ in the conversation. ‘BQ.1, BQ1.1, and these
other novel variations have all developed in separate areas; but, to some extent,
they contain identical spike proteins that make them at least as infectious as the
parental variants that they were generated from.’ According to Dr Russo’s explanation,
BQ.1 and BQ.1.1 are subvariants of the Omicron account for the majority of COVID-19
cases. He refers to them as ‘first cousins,’ pointing out that they are pretty similar.
Both BQ.1 and BQ.1.1 have rapidly disseminated. Previously, they were included together
in CDC data under BA.5, but since the number of reported cases kept climbing significantly,
they were moved to their section on the ‘Nowcast’ COVID-19 data tracker on the CDC
website. Each week, statistics from the CDC reveal an increase in COVID-19 cases caused
by BQ.1 and BQ.1.1 and a decrease in patients affected by BA.51.
The combined monoclonal antibodies tixagevimab and cilgavimab (Evusheld) are utilized
for pre-exposure prophylaxis against severe acute respiratory syndrome coronavirus
2 (SARS-CoV-2) infection. Since about 20 January 2023, more than 90% of the circulating
SARS-CoV-2 variants in the United States, particularly the Omicron BQ.1, BQ.1.1, XBB,
and XBB.1.5 sublineages, are unlikely to be vulnerable to these antibodies. Since
the combined lineage was first discovered on 8 February 2023, a total of 280 077 sequences
that belong to the BQ.1* [Omicron (BQ.1.X)] combined lineage have been found2,3.
Midway through July 2022 in Nigeria, the first BQ.1 and BQ.1.1 sublineages sequences
were reported to GISAID (Global Initiative on Sharing Avian Influenza Data). Since
then, these sequences have been documented in different countries, including Nigeria,
the United Kingdom, Japan, the United States, France, Belgium, Denmark, and Italy4.
Both BQ.1 and BQ.1.1 have mutations that can be found within the spike (S) protein.
These variants are K444T, L452R, N460K, and F486V. Moreover, the mutation R346T.6
may be found in BQ.1.1. Based on the results of earlier comprehensive mutational scanning
analyses, it has been hypothesized that several of these spike protein mutational
sites are likely to result in antibody evasion. Not only do BQ.1 and BQ.1.1 share
the spike (S) protein, but they also share the NSP12 protein (RNA-dependent RNA polymerase)
mutation Y273H (also labeled as ORF1b: Y264H), and BQ.1.1 also carries the NSP13 protein
(helicase) mutation N268S. These mutations can be found in BQ.1.1 (also annotated
as ORF1b: N1191S)4.
The symptoms associated with BQ.1 and BQ.1.1 seem to be the same as those associated
with other COVID-19 variations. Tiredness, fever, cough, congestion, shortness of
breath, sore throat, nausea, diarrhea, and muscular pains or headaches are some of
the most prevalent symptoms. Loss of smell, formerly a characteristic of COVID-19
infections, is not nearly as frequent5.
According to Pfizer, the revised booster, developed to target Omicron BA.4 and BA.5,
also protects against the proliferation of Omicron subvariants such as BQ.1.1 and
BQ1. According to a statement by Pfizer in a press release, adults aged 55 and older
were found to have nine times the normal number of antibodies against BQ.1.1 one month
after receiving the bivalent booster. People who received a second dose of the first
vaccination exhibited a significant rise in the number of antibodies they had against
BQ1.16.
Fighting against SARS-CoV-2 has grown more challenging because Omicron/BQ.1 and BQ.1.1
have emerged. There is evidence in the form of a significant number of mutations in
the spike protein that it has been changed day by day. As a result of the current
COVID-19, vaccines are losing their effectiveness. So, the scientific community and
global policymakers should be conscious of these new variants and take appropriate
steps to stop the spread.
Ethics approval
Not applicable.
Sources of funding
Not applicable.
Conflicts of interest disclosure
The authors declare no conflicts of interest, financial or otherwise.
Data availability statement
All data used to support the findings of this study are included in the article.