• Nabiha Khalid and Anthony M Wheeler.
• Bratisl Med J. 2022 Jan 1; 123 (9): 631-633.

AbstractMany of the deletions and large mutations found in the Omicron version of COVID-19 are identical to those seen in the α, π, β, and δ based VOCs. Such deletions and alterations have long been known to increase the viral risk of transmission and binding ability. Additionally, these changes are anticipated to increase the chances of immunological evasion and antibody secretion. T478K, G339D, Y505H, S373P, S371L, S375F, N440K, K417N, S477N, G446S, Q493R, E484A, G496S, N501Y, Q498R, and D614G are all mutations that potentially affect the virus's behavior. The N terminal region of the spike is typically targeted by NABs or neutralizing antibodies, immunologic polypeptides that prevent viruses from infecting cells. If the target region of the NABs significantly alters, the viruses may be able to avoid the autoimmune response generated by initial infection and vaccination. A possible "receptor shift" wherein ACE2 is not exclusively an Omicron receptor is worrying, given the huge number of mutations within the RBD region. D614G is the most prevalent mutation discovered among the three major pandemic variants. The Omicron variant is the most divergent variation seen in large numbers thus far in the pandemic, raising concerns that it could be linked to a faster transmission rate, lower vaccine effectiveness, and a greater risk of re-infection. Since identifying the Omicron variant, various countries have made significant modifications to their vaccination programs, including the recommendation of a third injection of boosting vaccination dosages in large populations to reduce the risk of adverse effects. However, all three vaccine producers (Johnson et Johnson, BioNTech, Pfizer, and Moderna) have published statements claiming vaccines would protect against severe sickness and that variant-specific vaccinations and boosters are in the works. This review sheds insight on several genetic mutations and their evolution in distinct variations. However, further study is needed to improve our understanding of illness transmissibility, immune escape capacity, patient features and severity, and the use of further diagnostic and therapeutic techniques (Fig. 1, Ref. 20). Keywords: SARS-CoV-2, global vaccination, booster doses, COVID-19.

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