When looking at the COVID-19 variants, it is increasingly necessary to assess them in terms of the mutations embedded in the variants themselves, explained Scott Gottlieb, MD, former commissioner of the FDA from 2017 to 2019, during a session at the NACDS 2021 Annual Meeting. Ultimately, it’s the mutations that create the risk depending on the type embedded in the variant.
Currently, there are certain mutations and variants that are being followed closely by investigators across the world. For example, the mutation E484K present in the South African variant B.1.351 seems to create a greater risk for reinfection and decrease some of the efficacy of COVID-19 vaccines. This same E484K mutation has also been found to be present in the Brazilian variant P.1 and the New York variant B.1.526.
Gottlieb noted that the Los Angeles variant has a different mutation; however, a mutation present in this variant has been found to increase the fitness of the virus and its propensity to spread and, perhaps, reduce the efficacy of prior immunity.
Additionally, epistasis can occur among multiple variants, which is the combination of variant mutations into new strains that have much different characteristics from the original mutations.
“A mutation that has a certain characteristic and another mutation that has a certain characteristic, when you combine them together in 1 strain, suddenly you get a much different virus that has very unique characteristics that are very dissimilar to any of the characteristics of the individual mutations,” Gottlieb said during the session. “You