Covid strain that can ‘fool’ 3 antibodies found in Mumbai
Called the E484K mutation, it is linked to the South African strain. Malathy Iyer TNN January 10, 2021, 08:00 IST https://health.economictimes.indiatimes.com/news/diagnostics/covid-strain-that-can-fool-3-antibodies-found-in-mumbai/80194356 Mumbai: While the search for the highly contagious UK mutation of Covid-19 continues in India, researchers from Tata Memorial Centre in Kharghar have found three patients from the Mumbai Metropolitan Region (outside Mumbai) with an equally worrying mutation. Called the E484K mutation , it is linked to the South African strain . “This is one of three mutations (K417N, E484K and N501Y) seen in the South African lineage,” said Dr Nikhil Patkar, associate professor in haematopathology at Tata Memorial Centre’s Kharghar unit called ACTREC, whose team found the E484K mutation in three out of the 700 Covid-19 samples it put through gene sequencing. The E484 mutations are worrying as they can ‘fool’ or escape three antibodies that the body’s immune system makes. News outlets around the world have begun terming the South African variant as “more of a problem” than the UK variant, which has caused a second wave across Europe. As vaccines work on the principle of creating antibodies, researchers across the world are now weighing the E484’s effect on mass Covid-19 vaccination programmes under way in various countries. “The E484K mutation is less susceptible to neutralisation by antibodies formed against the virus,” said Dr Patkar. “It is still uncertain what this means for vaccination and resulting immune responses,” he said. The Tata Memorial Centre usually carries out genetic sequencing for cancer patients, but was roped in for SARS-CoV-2 testing and sequencing during the Covid pandemic. In April, the ACTREC team would find four to five mutations in the samples, but they increased to 10-12 by September. “ Interestingly, SARS-CoV-2 isolates from three male patients (aged 30, 32 and 43 years) with Covid-19 were found to harbour the E484K mutation and were diagnosed to have Covid-19 in September,” said Dr Patkar. These patients experienced a relatively milder form of Covid-19, with two requiring home quarantine, while one needed hospitalization but didn’t need oxygen support or ventilation. Incidentally, in a review study that is slated to be published soon, the Delhi-based Institute of Genomics and Integrative Biology found that 19 out of the 86 genetic variants were found in genomes from India. However, the jury is still out there as far as the B1117 and E484 mutations are concerned. “If we were to have newer strains infecting people, then it would have spread like wildfire by now. These variants have been in circulation since September, and haven’t resulted in larger outbreaks here,” said Bengaluru-based epidemiologist Dr Giridhar Babu from PHFI ( Public Health Foundation of India ).
Ganga Ram reports 13 cases, 5 deaths In 15 days
Durgesh Nandan Jha TNN December 15, 2020, 05:06 IST New Delhi: Low immunity among people recovering from Covid-19 , either due to the infection or medicines administered, is leading to a unique crisis. Doctors at Sir Ganga Ram Hospital (SGRH), one of the leading city hospitals, say many patients are developing mucormycosis , a rare-but-deadly fungal infection. It has been a cause of death in patients requiring prolonged ICU stay. However, it is the rapid increase in the numbers seen in unsuspected recovering Covid-19 patients that is causing the grave concern, SGRH states. “In the last 15 days, we have seen 13 cases of Covid-19-triggered mucormycosis. Five have died. At least three patients have suffered vision loss and have had to undergo removal of the nose and jaw bone to prevent the spread of infection. One of them is a 32-year-old,” Dr Manish Munjal, senior ENT surgeon, said. “Usually, we see one to two cases of mucormycosis in a month,” he added. Similar instances of mucormycosis in Covid-19-recovered patients have also been reported from hospitals in Ahmedabad, Gujarat. “The mainstay of Covid-19 treatment in patients with severe symptoms is steroid administration. We also give medicines to suppress the immune system because the infection can lead to a cytokine storm where the body starts to attack its own cells. However, this leaves the patients at risk to develop opportunistic fungal infections. Mucormycosis is one of them,” the SGRH doctors said. They added that the fungal infection was mostly hospital-acquired and seen in admitted patients. “Early clinical suspicion on symptoms such as nose obstruction, swelling in the eye or cheeks, and black dry crusts in the nose should immediately prompt the conduct of a biopsy in the OPD and start of the antifungal therapy as early as possible,” said Dr Varun Rai, consultant ENT surgeon at SGRH. Mucormycosis presents mostly as a sinus infection that is accompanied by nasal congestion, nasal discharge and sinus pain. A fever and headache can also occur. The doctors say the infection spreads in tissues and causes disintegration of the thin wall of cartilage and bone that divides the nostrils among others. According to National Organisation of Rare Disorders (NORD), sometimes, there is bluish discolouration of the skin near the sinuses or the eye socket due to lack of oxygen. “If unrecognised and untreated, significant tissue death (necrosis) can occur and the infection can significantly damage facial structures. It can also affect the brain,” says NORD. The only available treatment for mucormycosis is antifungal medication and symptom management. Despite that, doctors claim that 50% patients succumb.