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2 agosto, 2021

SARS-CoV-2 Variant Classifications and Definitions

  • Viral mutations and variants in the United States are routinely monitored through sequence-based surveillance, laboratory studies, and epidemiological investigations.
  • A US government SARS-CoV-2 Interagency Group (SIG) developed a Variant Classification scheme that defines three classes of SARS-CoV-2 variants:
    • Variant of Interest
    • Variant of Concern
    • Variant of High Consequence
  • The B.1.1.7 (Alpha), B.1.351 (Beta), B.1.617.2 (Delta), and P.1 (Gamma) variants circulating in the United States are classified as variants of concern.
  • To date, no variants of high consequence have been identified in the United States.
  • Laboratory studies suggest specific monoclonal antibody treatments may be less effective for treating cases of COVID-19 caused by variants with certain substitutions or combinations of substitutions in the spike protein.
    • L452R is present in B.1.526 (Iota), B.1.427 (Epsilon), and B.1.429 (Epsilon) lineages, as well as the B.1.617 (Kappa, Delta) lineages and sub-lineages.
    • E484K is present in B.1.525 (Eta), P.2 (Zeta), P.1 (Gamma), and B.1.351 (Beta), but only some strains of B.1.526 (Iota) and B.1.1.7 (Alpha).
    • The combination of K417N, E484K, and N501Y substitutions is present in B.1.351 (Beta).
    • The combination of K417T, E484K, and N501Y substitutions is present in P.1 (Gamma).
  • P.2 (Zeta) has been removed from the variants of interest list due to declining prevalence and very few detections in recent months. In addition to variants of interest and variants of concern, CDC continues to monitor all variants circulating within the United States.

Viruses constantly change through mutation. A variant has one or more mutations that differentiate it from other variants in circulation. As expected, multiple variants of SARS-CoV-2 have been documented in the United States and globally throughout this pandemic. To inform local outbreak investigations and understand national trends, scientists compare genetic differences between viruses to identify variants and how they are related to each other.

Variant classifications

The US Department of Health and Human Services (HHS) established a SARS-CoV-2 Interagency Group (SIG) to improve coordination among the Centers for Disease Control and Prevention (CDC), National Institutes of Health (NIH), Food and Drug Administration (FDA), Biomedical Advanced Research and Development Authority (BARDA), and Department of Defense (DoD). This interagency group is focused on the rapid characterization of emerging variants and actively monitors their potential impact on critical SARS-CoV-2 countermeasures, including vaccines, therapeutics, and diagnostics.

  • Variant of Interest (VOI)–  View current VOI in the United States that are being monitored and characterized
  • Variant of Concern (VOC)– View current VOC in the United States that are being closely monitored and characterized by federal agencies
  • Variant of High Consequence (VOHC) – Currently there are no SARS-CoV-2 variants that rise to the level of high consequence

Notes: Each classification of variant includes the possible attributes of lower classes (i.e., VOC includes the possible attributes of VOI); variant status might escalate or deescalate based on emerging scientific evidence. This page will be updated as needed to show the variants that belong to each class. The World Health Organizationexternal icon (WHO) also classifies variant viruses as Variants of Concern and Variants of Interest; US classifications may differ from those of WHO because the importance of variants may differ by location. To assist with public discussions of variants, WHO proposed using labels consisting of the Greek Alphabet, i.e., Alpha, Beta, Gamma, as a practical way to discuss variants by non-scientific audiences. The labels assigned to each variant are provided in the tables below

Variant of Interest

A variant with specific genetic markers that have been associated with changes to receptor binding, reduced neutralization by antibodies generated against previous infection or vaccination, reduced efficacy of treatments, potential diagnostic impact, or predicted increase in transmissibility or disease severity.

Possible attributes of a variant of interest:

  • Specific genetic markers that are predicted to affect transmission, diagnostics, therapeutics, or immune escape.
  • Evidence that it is the cause of an increased proportion of cases or unique outbreak clusters.
  • Limited prevalence or expansion in the US or in other countries.

A variant of interest might require one or more appropriate public health actions, including enhanced sequence surveillance, enhanced laboratory characterization, or epidemiological investigations to assess how easily the virus spreads to others, the severity of disease, the efficacy of therapeutics and whether currently authorized vaccines offer protection.

Current variants of interest in the United States that are being monitored and characterized are listed below. This will be updated when a new variant of interest is identified.

Selected Characteristics of SARS-CoV-2 Variants of Interest

B.1.427 (Pango lineageexternal icon)a

Spike Protein Substitutions: L452R, D614G

Name (Nextstrainexternal icon)b: 20C/S:452R

WHO Label: Epsilon

First Identified: United States-(California)

Attributes:

  • ~20% increased transmission21
  • Modest decrease in susceptibility to the combination of bamlanivimab and etesevimab; however, the clinical implications of this decrease are not known.Alternative monoclonal antibody treatments are available.14
  • Reduced neutralization by convalescent and post-vaccination sera21
  • Deescalated from a VOC on June 29, 2021, due to the significant decrease in the proportion of B.1.427 lineage viruses circulating nationally and available data indicating that vaccines and treatments are effective against this variant.

B.1.429 (Pango lineageexternal icon)a

Spike Protein Substitutions: S13I, W152C, L452R, D614G

Name (Nextstrainexternal icon)b: 20C/S:452R

WHO Label: Epsilon

First Identified: United States-(California)

Attributes:

  • ~20% increased transmission21
  • Reduced susceptibility to the combination of bamlanivimab and etesevimab; however, the clinical implications of this decrease are not known.Alternative monoclonal antibody treatments are available.14
  • Reduced neutralization by convalescent and post-vaccination sera21.
  • Deescalated from a VOC on June 29, 2021, due to the significant decrease in the proportion of B.1.429 lineage viruses circulating nationally and available data indicating that vaccines and treatments are effective against this variant.

https://www.cdc.gov/coronavirus/2019-ncov/variants/variant-info.html?fbclid=IwAR31px-zM-Kyr2QYZJ8oIgz3Js3vQsLpcaDqcRREMRQVgddVDsIBzKfdT_c#Concern


Créditos: Comité científico Covid

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