Clinical Outcomes of Omicron subvariants including XBB, the dominant SARS-CoV-2 in the US

Posted on by Jesse Santiano, M.D.

The Omicron subvariant XBB.1.5 is the dominant cause of COVID-19 in the US. It is highly infectious and resistant to previous vaccinations, therapeutic monoclonal antibodies, and immunity from past infections.

Being highly infectious is concerning, but does it have a high fatality rate? That is what is more important.

Today, a new study was released as a preprint from BioRxiv that answers that question.

The study Clinical Characteristics and Outcomes of Laboratory-Confirmed SARS-CoV-2 Cases Infected with Omicron subvariants and XBB recombinant variant is from Maharashtra, India.

The study sequenced 1,039 samples of PCR (+) SARS-CoV-2 infections in India. Here is the breakdown of the Omicron subvariants.

  • BA.2.75 (67.31%)
  • XBB* (17.13%)
  • BA.2.38* (5.43%)
  • BA.2.10* (3.62%)
  • BA.5* (3.50%).

Being a coronavirus, the SARS-CoV-2 is prone to inter-lineage recombination, and it generally occurs when a wave declines and a new variant emerges. The (*) means the subvariant is a recombinant.

Symptoms and outcomes of the new subvariants

A total of 494 cases were contacted telephonically, of which 455 (92.11%) were
symptomatic with mild symptoms.

Fever (78.46%) was the most common symptom, followed by a runny nose (46.37%), cough (42.20%), muscle pain (19.56%), and fatigue (18.24%). These symptoms are similar to influenza.

Of the 494 cases, 379 (76.72%) patients recovered at home, and 115 (23.28%) were hospitalized.

Most infections treated at home are mild, with 99.74% survival and 0.26% deaths.

Among those hospitalized, 87.83% of hospitalized patients recovered with symptomatic treatment, but 12.17% died from COVID-19.

Vaccination status

Of the 494 cases, 90.89% were vaccinated with at least one dose of the COVID-19 vaccine, and 8.10% were unvaccinated. Vaccine data was not available in 1% of the cases.

In this study population from India, 8.93% got Covishield 11.09% had Covaxin. Both vaccines are made in India.

Only 1.33% and 0.22% were vaccinated with Pfizer and Moderna, respectively.

XBB*

I focused on the XBB* data in the study since it causes 41% of COVID-19 in the US, according to the latest CDC report.

96.47% of those infected with XBB* survived, while 3.53% died, which looks high to me. It is not clear to me whether people died due to XBB or if they died with the XBB. The same mortality rate may not necessarily apply to other countries with different treatment modalities.

93.94% of those who had it are vaccinated, and only 4.71% are unvaccinated,  Showing that COVID vaccination is not protective against the XBB.

In their discussion, the pathogenicity or ability to cause severe disease of the XBB is comparable to other Omicron variants. Which means it is less pathogenic than the Delta variant.

As I discussed in The Dominant Omicron XBB1.5 Evades Antibodies and has Stronger ACE2 Binding, the XBB resists antibodies from previous Omicron infections. 

In one study by Tamura and colleagues, the only antibody effective against XBB is the one from a previous XBB infection.

Furthermore, XBB is resistant to all monoclonal antibodies. Due to its resistance to antibodies and high infectivity, XBB can soon become the dominant SARS-CoV-2 globally.

Comment

It is a relief to know that XBB is not any more dangerous than other Omicron variants, but we should expect to catch it even if you had COVID-19 recently.

However, this study does not explain why there are so many deaths in China, such that people have started to burn their dead on the streets.

 


Jennifer Zeng reports that 30 million might have died in China recently due to COVID-19. What strain is circulating there?

It is within the realm of possibility that what happens in China can occur anywhere in the world too.

 

Truth heals. Lies kill. Don’t Get Sick!

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You may be interested in the following:

  1. 12 Reasons Why COVID-19 Cases and Deaths May Increase Again. 
  2. The Dominant Omicron XBB1.5 Evades Antibodies and has Stronger ACE2 Binding
  3. Three Studies Link High IgG4 to Severe COVID-19
  4. 16 Ways to Avoid COVID-19
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  7. Influenza Cases at Two Decades High and Why
  8. Spike Proteins found in Shingles Lesions that Lasted for Three Months after Pfizer shot

Reference:

  1. Karyakarte, R et al. Clinical Characteristics and Outcomes of Laboratory-Confirmed SARS-CoV-2 Cases Infected with Omicron subvariants and XBB recombinant variant medRxiv 2023.01.05.23284211; doi: https://doi.org/10.1101/2023.01.05.23284211
  2. Tamura T et al. Virological characteristics of the SARS-CoV-2 XBB variant derived from recombination of two Omicron subvariants
    bioRxiv 2022.12.27.521986; doi: https://doi.org/10.1101/2022.12.27.521986

2 Replies to “Clinical Outcomes of Omicron subvariants including XBB, the dominant SARS-CoV-2 in the US”

  1. A COVID variant that could be endowed with more transmissability and evasion of antibody capabilities is so frightening!

    Thank you for your compassionate efforts to help us!

    1. You’re welcome. Is is indeed concerning that is why we should continue efforts to minimize our risks.

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