COVID-19 Variants of Concern

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] ; Associate Editor(s)-in-Chief:

Overview

As a result of mutations occurring in COVID-19 virus, new variants of COVID-19 emerge and most of them are being tracked in the United States. The "variants of concern" refer to those COVID-19 variants with clear evidence of an increased rate of transmission, severe illness and death, marked decrease in neutralization by antibodies produced as a result of previous infection or vaccination, decreased effectiveness of vaccines or treatments, or failure of diagnostic detection.

Variants of Concern

As in all viruses, COVID-19 virus continuously undergo spontaneous mutations followed by emergence of new variants of COVID-19. Some of these variants appear then disappear; however, others persist causing global pandemic. The best way to fight against the appearance of new variants is commitment to the protective measures.

The "variants of concern" refer to those COVID-19 variants with clear evidence of an increased rate of transmission, severe illness and death, marked decrease in neutralization by antibodies produced as a result of previous infection or vaccination, decreased effectiveness of vaccines or treatments, or failure of diagnostic detection. The genomic and epidemiological as well as other properties of these variants are summarized in the table below.

WHO Label	Name	Countries of Earlier Detection	Time of First Detection	Spike Protein Substitutions	BEI Reference Isolate	Properties	Rate of Spread	Severe Illness and Mortality	Vaccine	Treatments
Alpha B.1.1.7	20I/501Y.V1	United Kingdom	September 2020	69del, 70del, 144del, (E484K*), (S494P*), N501Y, A570D, D614G, P681H, T716I, S982A, D1118H (K1191N*)	NR-54000external icon	Approximately 50% increased transmissibility Increased severity according to hospitalizations and case fatality rates Little effect on neutralization by convalescent and post-vaccination sera	High	Occur	Effective Rarely, breakthrough infections in vaccinated individuals may occur	Effective
Beta B.1.357	20H/501.V2	South Africa	September 2020	D80A, D215G, 241del, 242del, 243del, K417N, E484K, N501Y, D614G, A701V	NR-55282	Approximately 50% increased transmissibility A marked decrease in the susceptibility to the combination of bamlanivimab and etesevimab monoclonal antibody treatment; however, other EUA monoclonal antibody treatments are available Decreased neutralization by convalescent and post-vaccination sera	High	Not common	Effective Rarely, breakthrough infections in vaccinated individuals may occur	Less effective
Gamma P.1	20J/501Y.V3	Brazil and Japan	December 2020	L18F, T20N, P26S, D138Y, R190S, K417T, E484K, N501Y, D614G, H655Y, T1027I	NR-54982	A marked decrease in the susceptibility to the combination of bamlanivimab and etesevimab monoclonal antibody treatment; however, other EUA monoclonal antibody treatments are available Decreased neutralization by convalescent and post-vaccination sera	High	Not common	Effective Rarely, breakthrough infections in vaccinated individuals may occur	Less effective
Delta B.1.617.2	21A/S:478K	India	December 2020	T19R, (V70F*), T95I, G142D, E156-, F157-, R158G, (A222V*), (W258L*), (K417N*), L452R, T478K, D614G, P681R, D950N		Increased transmissibility Decreased neutralization by some EUA monoclonal antibody treatments  Significant decrease in neutralization by post-vaccination sera	Characterized by the highest rate of spread among these variants	Characterized by higher rates of hospitalizations, severe illness, and death than other variants	Effective Rarely, breakthrough infections in vaccinated individuals may occur	Less effective

BEI Resources: refer to the "Biodefense and Emerging Infections Research Resources" that is a NIAID-funded repository to provide reagents, tools, and information to the research community.