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The Independent
09-07-2025
- Health
- The Independent
Should we be worried about ‘Stratus'? The new Covid variant spreading fast
Given the number of times this has happened already, it should come as little surprise that we're now faced with yet another new subvariant of SARS-CoV-2, the virus responsible for Covid. This new subvariant is known as XFG (nicknamed 'Stratus') and the World Health Organization (WHO) designated it a 'variant under monitoring' in late June. XFG is a subvariant of Omicron, of which there are now more than 1,000. A 'variant under monitoring' signifies a variant or subvariant which needs prioritised attention and monitoring due to characteristics that may pose an additional threat compared to other circulating variants. XFG was one of seven variants under monitoring as of June 25. The most recent addition before XFG was NB.1.8.1 (nicknamed 'Nimbus'), which the WHO declared a variant under monitoring on May 23. Both nimbus and stratus are types of clouds. Nimbus is currently the dominant subvariant worldwide – but Stratus is edging closer. So what do you need to know about Stratus, or XFG? A recombinant variant XFG is a recombinant of LF.7 and LP.8.1.2 which means these two subvariants have shared genetic material to come up with the new subvariant. Recombinants are designated with an X at the start of their name. While recombination and other spontaneous changes happen often with SARS-CoV-2, it becomes a problem when it creates a subvariant that is changed in such a way that its properties cause more problems for us. Most commonly this means the virus looks different enough that protection from past infection (and vaccination) doesn't work so well, called immune evasion. This basically means the population becomes more susceptible and can lead to an increase in cases, and even a whole new wave of Covid infections across the world. XFG has four key mutations in the spike protein, a protein on the surface of SARS-CoV-2 which allows it to attach to our cells. Some are believed to enhance evasion by certain antibodies. Early laboratory studies have suggested a nearly two-fold reduction in how well antibodies block the virus compared to LP.8.1.1. Where is XFG spreading? The earliest XFG sample was collected on January 27. As of June 22, there were 1,648 XFG sequences submitted to GISAID from 38 countries (GISAID is the global database used to track the prevalence of different variants around the world). This represents 22.7% of the globally available sequences at the time. This was a significant rise from 7.4% four weeks prior and only just below the proportion of NB.1.8.1 at 24.9%. Given the now declining proportion of viral sequences of NB.1.8.1 overall, and the rapid rise of XFG, it would seem reasonable to expect XFG to become dominant very soon. According to Australian data expert Mike Honey, the countries showing the highest rates of detection of XFG as of mid-June include India at more than 50%, followed by Spain at 42%, and the United Kingdom and United States, where the subvariant makes up more than 30% of cases. In Australia as of June 29, NB.1.8.1 was the dominant subvariant, accounting for 48.6% of sequences. In the most recent report from Australia's national genomic surveillance platform, there were 24 XFG sequences with 12 collected in the last 28 days meaning it currently comprises approximately 5% of sequences. The big questions When we talk about a new subvariant, people often ask questions including if it's more severe or causes new or different symptoms compared to previous variants. But we're still learning about XFG and we can't answer these questions with certainty yet. Some sources have reported XFG may be more likely to course 'hoarseness' or a scratchy or raspy voice. But we need more information to know if this association is truly significant. Notably, there's no evidence to suggest XFG causes more severe illness compared to other variants in circulation or that it is necessarily any more transmissible. Will vaccines still work against XFG? Relatively frequent changes to the virus means we have continued to update the Covid vaccines. The most recent update, which targets the JN.1 subvariant, became available in Australia from late 2024. XFG is a descendant of the JN.1 subvariant. Fortunately, based on the evidence available so far, currently approved Covid vaccines are expected to remain effective against XFG, particularly against symptomatic and severe disease. Because of SARS-CoV-2's continued evolution, the effect of this on our immune response, as well as the fact protection from Covid vaccines declines over time, Covid vaccines are offered regularly, and recommended for those at the highest risk. One of the major challenges we face at present in Australia is low Covid vaccine uptake. While rates have increased somewhat recently, they remain relatively low, with only 32.3% of people aged 75 years and over having received a vaccine in the past six months. Vaccination rates in younger age groups are significantly lower. Although the situation with XFG must continue to be monitored, at present the WHO has assessed the global risk posed by this subvariant as low. The advice for combating Covid remains unchanged, including vaccination as recommended and the early administration of antivirals for those who are eligible. Measures to reduce the risk of transmission, particularly wearing masks in crowded indoor settings and focusing on air quality and ventilation, are worth remembering to protect against Covid and other viral infections.
Medscape
08-07-2025
- Health
- Medscape
Common Cold Virus Infections Drop After SARS-CoV-2 Exposure
TOPLINE: Detection of common cold coronaviruses (ccCoVs) decreased by approximately half after the widespread SARS-CoV-2 exposure and COVID-19 vaccination, whereas detection of respiratory syncytial virus (RSV) and influenza virus remained largely unchanged. METHODOLOGY: As ccCoVs share genetic and antigenic features with SARS-CoV-2, widespread exposure to SARS-CoV-2 (through infection and vaccination) might affect ccCoV circulation. Researchers conducted a single-center retrospective study at Boston Medical Center comparing the incidence of ccCoV, RSV, and influenza virus infections before the COVID-19 pandemic and after the SARS-CoV-2 Omicron surge and widespread vaccination. The data collected encompassed five pre-COVID-19 seasons (October 2015 to March 2020), designated as period 1, and two post-widespread Omicron infection and COVID-19 vaccination seasons (October 2022 to April 2024), designated as period 2. Test positivity was evaluated while accounting for age, biological sex at birth, and level of hospitalization. TAKEAWAY: Weekly ccCoV detection decreased by approximately 50% in period 2 vs period 1 (intercept, 12.35; β, -5.87; P < .0001), while RSV (intercept, 14.55; β, 4.34; P = .08) and influenza virus (intercept, 41.86; β = 2.83; P = .73) showed no significant decrease. After adjusting for age, sex, and level of medical care, the odds of detecting ccCoV were > 50% lower in period 2 than in period 1, whereas the odds of detecting RSV were approximately 25% higher. Individuals younger than 18 years had significantly higher ccCoV and RSV infections but not those older than 65 years. higher ccCoV and RSV infections but not those older than 65 years. Biological sex at birth was not associated with the incidence of either ccCoV or RSV disease. IN PRACTICE: 'Our current work demonstrates changes in ccCoV epidemiology in the city of Boston after nearly ubiquitous exposure to SARS-CoV-2 antigens from infection and COVID-19 vaccination,' the authors wrote. 'SARS-CoV-2 infection potentially provides this heterotypic immunity, we cannot discount the effect of COVID-19 vaccination in this investigation,' they added. SOURCE: The study was led by Trisha Parayil, Boston University Chobanian & Avedisian School of Medicine, Boston. It was published online on June 18, 2025, in Open Forum Infectious Diseases. LIMITATIONS: The study showed associations but did not prove causation. The findings need to be validated from health centers beyond Boston to establish generalizability. Ongoing CoV evolution and waning SARS-CoV-2 immunity may alter these associations in the future. DISCLOSURES: This study was supported by the Massachusetts Consortium for Pathogen Readiness. The authors reported having no relevant conflicts of interest. This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.
Al Arabiya
08-07-2025
- Health
- Al Arabiya
COVID-19 cases surge across GCC as WHO reports global rise in infections
COVID-19 infections are rising sharply across GCC countries, with Saudi Arabia and the UAE among nations driving a global surge that has pushed test positivity rates to levels not seen since July 2024, according to the latest World Health Organization report. Global SARS-CoV-2 activity has increased significantly since mid-February 2025, with test positivity rates reaching 11 percent across 73 reporting countries - matching peaks observed during last summer's wave, the WHO report indicated. The Eastern Mediterranean region, which includes GCC states, has emerged as a key driver of the current surge, with test positivity rates climbing from four percent in mid-March to 17 percent by late April before declining slightly to 15 percent in mid-May. 'Recent reports of increases in circulation have been observed in five countries to date, including Egypt, Kuwait, Oman, Saudi Arabia, United Arab Emirates and Pakistan,' the WHO said in its latest epidemiological update. The surge represents a sharp reversal from the relatively low transmission levels observed in the first quarter of 2025, when many countries reported test positivity rates as low as 2 percent. New variant Contributing to the rise is the emergence of NB.1.8.1, a new variant under monitoring that WHO designated in early 2025. The variant, which carries mutations that may enhance transmissibility and immune evasion, now represents 10.7 percent of global sequences reported as of mid-May, up from just 2.5 percent four weeks earlier. 'Spike mutations at position 445 have been shown to enhance binding affinity to hACE2 receptor, which could increase the variant's transmissibility,' the WHO said. The variant's rapid spread coincides with the declining circulation of LP.8.1, which had been the dominant strain since mid-March but is now being overtaken by NB.1.8.1 in many regions. While the Eastern Mediterranean region shows concerning trends, WHO officials reported gaps in surveillance data from the region, including GCC countries. 'The reporting of COVID-19 associated hospitalizations, Intensive Care Unit (ICU) admissions, and deaths is very limited from the countries in the Eastern Mediterranean Region, the South-East Asia Region, and the Western Pacific Region and does not allow for evaluation of the impact on health systems by WHO,' the organization stated. The WHO report highlighted persistently low vaccination rates globally, including among high-risk groups in Gulf countries. Among older adults across 75 reporting member states, just 1.68 percent had received a COVID-19 vaccine dose in 2024 through September, while uptake among healthcare workers stood at only 0.96 percent. Regional disparities were also noted, with the Eastern Mediterranean region reporting coverage rates of less than 0.5 percent among older adults, significantly lower than the 5.1 percent achieved in Europe and 3.6 percent in the Americas. The WHO's Technical Advisory Group on COVID-19 Vaccine Composition continues to recommend vaccines for at-risk groups, it said. The current surge across the GCC reflects a broader pattern of renewed COVID-19 activity across multiple regions. The Western Pacific region has seen test positivity rates climb from 5 percent to 11 percent over the past month, while the South-East Asia region experienced increases from 0.5 percent to 5 percent since early April. Unlike previous waves, the current surge lacks clear seasonal patterns, complicating efforts to predict and prepare for transmission peaks. 'Recent increases in SARS-CoV-2 activity are broadly consistent with levels observed during the same period last year, however, there still lacks a clear seasonality in SARS-CoV-2 circulation,' the WHO said. The WHO maintains that the global public health risk associated with COVID-19 remains high, despite evidence of decreasing impact on human health compared to earlier pandemic years. GCC countries, like other WHO member countries, are encouraged to maintain integrated surveillance systems, ensure equitable vaccine access, strengthen healthcare delivery, and enhance risk communication efforts. The organization specifically recommends that countries 'continue to monitor and report SARS-CoV-2 activity and burden, public health and healthcare system impacts of COVID-19, strengthen genomic sequencing capacity and reporting, in particular information on SARS-CoV-2 variants.'
Medscape
08-07-2025
- Health
- Medscape
Why Long COVID May Hit Toddlers Harder Than Thought
In young children, the long-term effects of SARS-CoV-2 infection may differ significantly from those in older children or adults. A recent study in JAMA Pediatrics systematically investigated the symptoms experienced by children under the age of 5 years and the frequency of long COVID in this age group. The analysis revealed that 14% of infants and toddlers and 15% of preschoolers in the cohort showed symptoms consistent with long COVID. Roland Elling, MD, is the head of Pediatric Infectious Disease Research at University Medical Center Freiburg, Freiburg, Germany. He also serves as the principal investigator of the MOVE-COVID-BW project, a multicenter initiative in Baden-Württemberg, Germany, focused on long COVID in children and adolescents. Speaking to Medscape Medical News, Elling expressed surprise at the reported rates. Symptom Discrepancy 'This would mean that 1 in 6 children in these age groups develop long-term COVID after a SARS-CoV-2 infection. This does not correspond to the clinical reality we experience in our specialized outpatient clinics,' said Elling. 'In our view, long COVID is primarily a condition of the second decade of life, not the first 10 years. We see almost no cases in toddlers — and that holds true at all university clinics in Baden-Württemberg, not just Freiburg,' he added. In contrast, findings from a multicenter cohort study suggested a different age pattern. Rachel S. Gross, MD, professor at NYU Grossman School of Medicine in New York City, and co-principal investigator of the NIH RECOVER Pediatric Observational Cohort Study, led the study from 2022 to 2024. The results identified persistent post-COVID symptoms, even among children under the age of 5 years. The study combined retrospective and prospective data to identify symptoms that are more common in children with prior SARS‑CoV‑2 infection and to develop an age-specific long COVID index. The researchers enrolled 472 children aged 0-2 years and 539 children aged 3-5 years. Among them, 59% (278 of 472) of the younger group and 74% (399 of 539) of the older group had documented prior infections. These findings produced distinct symptom indices for each age group. Elling noted a key limitation: 'Seroprevalence studies showed that by 2023, over 90% of children had been infected with SARS-CoV-2. As younger children often have asymptomatic infections, many cases may have been missed. No serologic testing was performed; all data relied on parental information.' On average, parents of younger children were surveyed 10 months after infection, and parents of preschoolers were surveyed 17 months after infection. Although this helps separate long COVID from short-term symptoms, Elling stated that the long delay makes the data unreliable. 'I cannot reliably ask parents if their child had symptoms lasting 4 weeks over a year ago,' he said. The questionnaires assessed 41 symptoms in children aged 0-2 years and 75 symptoms in preschoolers aged 3-5 years. These symptoms were grouped into eight clinical areas: general health, ENT, heart and lungs, digestion, skin, muscles and joints, nervous system, and mental health. According to the Long COVID Symptom Index developed in the RECOVER project, 14% of children aged 0-2 years and 15% of those aged 3-5 years were identified as likely to have long COVID. Age-Specific Symptom The most common symptoms in infants and toddlers were sleep disturbances, irritability, loss of appetite, nasal congestion, and a productive cough. According to parents, preschoolers more often experience dry cough, daytime fatigue, and low energy levels. Parents also reported that children with more severe symptoms had a poorer quality of life, reduced overall well-being, and sometimes developmental delays. 'In older children and adolescents, it is neurocognitive symptoms such as postexertional malaise or brain fog that significantly impact daily life — not cough or other respiratory issues,' said Elling. He noted that these complex symptoms are difficult to detect in young children. Conclusion Studies have shown that less than 1% of adolescents develop long COVID, with the risk likely to be even lower in younger children. Elling said, 'Young children cope better with COVID-19 than adolescents and adults.' Elling agreed with the authors that long COVID presents differently in very young children than in older children and should be defined and studied by age. 'I would go even further,' he said. 'To truly understand the disease, we need to move away from the broad term 'long COVID,'' he said. Elling emphasized that long COVID should be classified not only by age but also by the organ systems affected. 'It is medically inaccurate to group all symptoms lasting more than 12 weeks — such as headache, anosmia, or dyspnea — under one broad diagnosis. We don't do this for any other disease,' he said. These symptoms are likely to have different underlying mechanisms; for example, loss of smell after COVID-19 is not the same as chronic headaches or breathing issues. Despite some methodological limitations, Elling supported the study's approach. 'Systematic assessment of long COVID in early childhood is important. However, we must remain realistic. If the data suggest that four children in every class develop long COVID after a SARS-CoV-2 infection, it would be a serious concern. But I don't think that's actually the case,' he said. This story was translated from Medscape's German edition.
Medscape
03-07-2025
- Health
- Medscape
Influencers of COVID Vaccine Response in Dialysis Patients
TOPLINE: Among patients undergoing maintenance dialysis, chronic heart failure and hypoalbuminaemia were significantly associated with a poor humoral response at 3 months after completing three doses of the SARS-CoV-2 messenger RNA (mRNA) vaccine; however, no association was observed between haemodialysis-related variables and antibody response levels. METHODOLOGY: Researchers in France performed a retrospective observational study to identify factors associated with a poor humoral response after completion of the SARS-CoV-2 mRNA vaccination schedule (three doses) in 80 adult patients (median age, 71 years; 44% women) undergoing maintenance dialysis for more than 3 months. Anti-SARS-CoV-2 antibody levels were measured using a quantitative serology test at two timepoints: 3 months after the third dose and either 7 months after the third dose or 3 months after the fourth (second booster) dose. On the basis of antibody titres at 3 months after the third dose, the patients were classified as low responders (n = 28; anti-SARS-CoV-2 antibody level, 50-1830 AU/mL) and responders (n = 52; anti-SARS-CoV-2 antibody level > 1830 AU/mL). Data on laboratory values, dialysis parameters, history of kidney disease, chronic heart failure, and immunosuppressive treatments were extracted from medical records. The primary endpoint was the humoral immune response, evaluated using the SARS-CoV-2 antibody level at 3 months after the third dose. TAKEAWAY: Low responders were more likely to have chronic heart failure (P < .00001), worse functional abilities and well-being (P = .004), hypoalbuminaemia (P < .001), lymphopenia (P = .003), rhesus status positivity (P = .02), and no response to a hepatitis B virus vaccine (P = .02) than responders. No significant differences were observed between both groups regarding the history of kidney transplantation, use of immunosuppressive therapy, and haemodialysis parameters. In multivariate analysis, chronic heart failure (odds ratio [OR], 20.63; P < .0001) and lower serum albumin levels (OR, 0.63; P = .0004) were associated with a poor response to the SARS-CoV-2 mRNA vaccine. However, post-vaccination SARS-CoV-2 infection rates did not differ significantly between low responders and responders (P = .59). IN PRACTICE: "CHF [chronic heart failure], like CKD [chronic kidney disease], is also an immunocompromised condition, which could explain the reduced vaccine response," the authors wrote. "The French government currently recommends administering a SARS-CoV-2 vaccine booster every six months for immunocompromised patients," they added. SOURCE: This study was led by Pierre Laurent, Department of Nephrology, Dialysis, and Transplantation, University of Picardie Jules Verne, Amiens University Hospital, Amiens, France. It was published online on June 23, 2025, in BMC Nephrology. LIMITATIONS: The retrospective, single-centre design of the study introduced potential biases. The small patient population limited the statistical power for group comparisons and restricted the number of variables that could be included in the analysis. Moreover, the study included only patients who received SARS-CoV-2 mRNA vaccines, excluding those who initially received viral-vector-based vaccines. DISCLOSURES: This study did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. The authors declared having no competing interests. This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.
