What is known about the new Ómicron BA.4.6 sub-variant: should we worry?

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The Omicron BA.4.6 sublineage has already been detected in patients with COVID-19 in Spain, Chile, Argentina, Brazil, Ecuador, Mexico, Costa Rica, Peru, Israel, Colombia, among other countries (Getty Images)
The Omicron BA.4.6 sublineage has already been detected in patients with COVID-19 in Spain, Chile, Argentina, Brazil, Ecuador, Mexico, Costa Rica, Peru, Israel, Colombia, among other countries (Getty Images)

The COVID-19 disease has already affected more than 610 million people in the world and caused the death of more than 6.4 million. Since the beginning of its appearance, the coronavirus has been evolving and has given rise to increasingly transmissible variants and sublineages that have contributed to its spread.

Now, there’s a new sublineage that’s getting more attention: it’s called Omicron BA.4.6 and it has already been detected in samples from patients with COVID-19 in Spain, Chile, Argentina, Brazil Ecuador, Mexico, Costa Rica, Peru, Israel, Colombia, Austria, the United Kingdom and the United States, among other countries.

BA.4.6 is a sublineage of the Omicron BA.4 variant. This new sublineage shares mutations with BA.4, but has an acquired mutation in the Spike protein called R346T which made scientific researchers pay more attention.

In dialogue with Infobaethe virology researcher at the National Institute of Agricultural Technology (INTA) and member of the Country Project, the coronavirus genomic surveillance consortium of the National Ministry of Science, Technology and Innovation, Humberto Debat“the BA.4.6 sublineage is being detected in samples of patients with COVID-19 from more countries, including Argentina. Although there are still few studies, the R346T mutation could give this sublineage an advantage over other sublineages. But BA.4.6 is not a steamroller like other sublineages that have generated large waves of COVID-19 cases. A strong epidemiological impact is not expected.

Although the BA.4.6 sublineage is expanding, a strong epidemiological impact is not expected” according to virologist Humberto Debat /Getty
Although the BA.4.6 sublineage is expanding, a strong epidemiological impact is not expected” according to virologist Humberto Debat /Getty

The first sample from a patient with the Ómicron BA.4.6 sublineage was uploaded to the GISAID data platform from Spain on April 25. So far, more than 14,000 genomes with that sublineage have been identified in more than 60 countries.

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According to the UK Health Security Agency, BA.4.6 represented 3.31% of the sequences in that country in the week of August 14. As of September 5, 2022, BA.4.6 has a growth rate of 36%, relative to the dominant lineage which is BA.5.

“It is not entirely clear how BA.4.6 arose, but it is possible that it is a recombinant variant. Recombination occurs when two different variants of the virus that causes COVID-19 infect the same person at the same time. Although BA.4.6 will be similar to BA.4 in many ways, it carries a mutation in the spike protein, a protein on the surface of the virus that allows it to enter our cells. This mutation, R346T, has been seen in other variants and is associated with immune evasion, meaning it helps the virus escape antibodies acquired by vaccination and previous infection.” wrote in The Conversation Manal Mohammedresearcher in medical microbiology at the University of Westminster, in England.

  According to the Centers for Disease Control and Prevention (CDC), BA.4.6 now accounts for more than 9 percent of recent cases in the United States (REUTERS / Brendan McDermid)
According to the Centers for Disease Control and Prevention (CDC), BA.4.6 now accounts for more than 9 percent of recent cases in the United States (REUTERS / Brendan McDermid)

Also the BA.4.6 sublineage has been rapidly gaining ground in the United States. According to the Centers for Disease Control and Prevention (CDC), BA.4.6 now accounts for more than 9 percent of recent cases in the United States.

“In Argentina, we have also detected the Ómicron BA.4.6 sublineage in samples from patients with COVID-19. But the truth is that we do not see a substantial increase in this sublineage compared to the others. BA. 5 and its derivatives is also observed”, he told Infobae Mariana Viegascoordinator of the Country Project and Conicet researcher at the Ricardo Gutiérrez Children’s Hospital in the city of Buenos Aires.

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The Oxford University reported that it found that people who had received three doses of a messenger RNA vaccine against COVID-19 produced fewer antibodies in response to the BA.4.6 sublineage compared to the BA.4 or BA.5 sublineages. “However, the ability of BA.4.6 to evade immunity may be addressed to some extent by the new bivalent boosters, which specifically target Omicron, alongside the parent strain of SARS-CoV-2. Time will tell,” said Dr. Mohammed.

Some available treatments for COVID-19 may be less effective if a person becomes infected with the Omicron BA.4.6 sublineage of the coronavirus (Getty)
Some available treatments for COVID-19 may be less effective if a person becomes infected with the Omicron BA.4.6 sublineage of the coronavirus (Getty)

From Dr. Debat’s perspective, it must be taken into account that the booster dose that are being applied after having received the primary scheme, are still key to gaining protection against the Omicron sub-lineages that circulate today. “Sublineages such as Ómicron BA.4.6 could impact a relative reduction in the levels of protection against infection given by vaccines. However, the available doses most likely offer high levels of protection against the possibility of developing severe conditions, as we have also observed with other Omicron sublineages.”, stated the scientist.

It was also recently found that Some available treatments for COVID-19 may be less effective if a person becomes infected with the Omicron BA.4.6 sublineage of the coronavirus. The work was carried out by researchers from Taiwan and the United States, led by renowned scientist David D. Ho. They explored the resistance of Ómicron sublineages to monoclonal antibody treatments currently used to treat COVID-19.

They compared what happened to the Ómicron subvariants BA.4.6, BA.4.7 and BA.5.9 with that of the BA.5 subvariant The results that the antibodies showed reduced neutralizing potency. As for the combination of the cilgavimab and tixagevimab antibodies, it was suggested that it was ineffective against the three newly emerged subvariants.

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Currently, the drug bebtelovimab, which was authorized for emergency use by the United States FDA last February, would become the only potent monoclonal antibody against all circulating variants and subvariants of the coronavirus.

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