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🏥 | Elderly people may be treated at home "People with mild symptoms and low risk" Minister of Health, Labor and Welfare


Photo Norihisa Tamura, Minister of Health, Labor and Welfare

Elderly people may also be treated at home "People with mild symptoms and low risk" Minister of Health, Labor and Welfare

 
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On the 2nd, the government decided to limit hospitalization to severely ill people and those at high risk of becoming severely ill in areas where infection is rapidly spreading due to the spread of Delta strains, and other than that, it will be based on home medical treatment. Were determined.
 

Minister of Health, Labor and Welfare Norihisa Tamura said at a press conference on the 3rd about the government policy that tightened the hospitalization requirements for patients with new coronavirus. → Continue reading

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SARS Coronavirus 2-Delta Strain

SARS Coronavirus 2-Delta Strain(Thirds Coronavirus Two Delta Turnip,English: SARS-CoV-2 Delta variant,alias: Lineage B.1.617.2,VOC-21APR-02) IsNew coronavirus infection Cause of (COVID-19)ウ イ ル スIsSARS coronavirus 2 (SARS-CoV-2)Mutant strainAndLineage B.1.617Is one of the sub-strains of[1].2020In the second halfIndiaFirst detected in[2][3].whoOn the (WHO) label,Delta stock(Delta variant)[4].

Delta strain is SARS coronavirus 2Spike proteinCodegeneTo T478K,P681R,L452RCauses replacement ofMutationThere is.These amino acid mutations not only affect the infectivity of the virus, but also against previously circulating mutant strains of the virus.antibodyByneutralizeIt has been clarified that it affects whether or not it can be done[5].2021In 5 month(English edition(PHE) has a secondary incidence of Delta strainsLineage B.1.1.7Showed 51-67% higher than (Alpha strain)[6] .

This stock is as of September 2021Europe,America,Australia,JapanIncludingAsiaIt has become a mainstream stock in a wide area of ​​the world, and WHO is at the same time.Variant of concernSpecified as (VOC)[4].

History

May 2021, 5, PHEThe United KingdomBased on the assessment of infectivity corresponding to strain B.1.1.7 (alpha strain) first identified in, the classification of strain B.1.617.2 is from the variant strain (VUI) under investigation.Variant of concernChanged to (VOC). On May 5, WHO also stated that it had classified the strain as VOCs, showing evidence of higher infectivity and reduced neutralization.This mutant strain started in February of the same yearSecond wave of Indian pandemicIs believed to be part of the cause of.afterwards,Third wave in the UKIt has also spread to.

On May 5, WHO named this mutant Delta variant.[7](For Variant of Concern and Notable Mutant StrainsGreek scriptAccording to the policy of using).

XNUM X Month X NUM X Day,(English edition(NCID) researchers found that patients with delta strains were more likely than those with conventional or alpha strains.pneumoniaMore likely to developoxygenI submitted a treatise suggesting that I am likely to need.

On July 7st, WHO announced not only the United Kingdom mentioned above, but alsoEuropeWarned that it could have similar effects elsewhere[8].

Sort

The Delta strain has a mutation in the gene that encodes the SARS-CoV-2 spike protein.D614GAnd cause substitution of T478K, P681R, L452R.this is(English editionIdentified as a 21A clade under a phylogenetic system.

At the end of May 2021, WHOVariant of concern(VOC) and notable mutant strains (VOI)Greek lettersFor grid B.1.617.2 after introducing a new policy to usedeltaAssigned a label of (Δ: Delta)[7].

Other sub-strains of B.1.617

B.1.617 has been classified into three sub-strains B.1.617.1 to B.3 to B.3 and B.1.617.1 are WHO labels, respectively.Kappa stock(Kappa variant),Delta stock(Delta variant).

B.1.617.1(VUI-21APR-01)は、2021年4月にPHEによって調査中の変異株(VUI)に指定された。4月後半には、他の2つの変異株であるB.1.617.2(VUI-21APR-02)とB.1.617.3(VUI-21APR-03)が調査中の変異株(VUI)として指定された。 B.1.617.3はB.1.617.1で発見されたL452RおよびE484Q変異を共有しているが、B.1.617.2にはNo E484Q mutation..On the other hand, B.1.617.2 has a T478K mutation, but B.1.617.1 and B.1.617.3 do not.[9][10].. at the same time,European Center for Disease Control and Prevention(ECDC) has released an overview of maintaining all three substrains of B.1.617 as a Variant of Concern (VOI), saying, "Before considering changes to current measures, these B.3 strains are relevant. We need to have a deeper understanding of the risks[11].

On May 2021, 5, PHE evaluated that it was at least as infectious and transmissible as B.6, and from a mutant strain (VUI) investigating the B.1.1.7 strain.Variant of concernRaised to (VOC) and positioned as "VOC-21APR-02"[12]..On May 5, the same year, WHO lifted the entire B.11 strain from the notable mutant (VOI) and classified it as a Variant of Concern (VOC), but in Junepublic healthOnly the B.1.617.2 strains with the higher risk above are classified as VOCs (the other two sub-strains are downgraded).[13]..This mutant strain started in February 2021Second wave of infection spread in IndiaIs considered to be one of the factors of[14][15][16].

Mutation

Delta strain / B.1.617.2 genome, it encodesprotein OfAmino acid sequenceThere are 13 mutations (15 or 17 depending on whether more common mutations are included, according to some sources) that cause changes in.Of these, four of them, which are contained in the peplomer code of all viruses, are of particular concern.

  • D614G-Amino acid 614residue OfAspartic acidからglycineSubstitution toalpha,beta,gammaShared with other highly infectious mutants such as[17].
  • T478K-of the 478th amino acid residueThreonineからlysineIs a replacement for[18].
  • L452R-of the 452nd amino acid residueLeucineからArginineIs a replacement forACE2It results in a stronger affinity for peplomers for receptors and a decrease in the cognitive ability of the immune system.
  • P681R-The 681th amino acid residueProlineIs a substitution from arginine and, according to William A. Hazeltin, may increase cell-level infectivity of the mutant strain "by promoting cleavage of the S precursor protein into the active S1 / S2 composition".[19].

The E1.617Q mutation found in other substrains of strain B.484 is not present in the B.1.617.2 genome.[19].

"Delta Plus" mutant

Delta strains with the K417N mutationSystem AY.1AY.2Corresponding to, "Delta Plus(Delta plus) or "ネ パ ー ルIt is called a "stock".It has a K417N mutation that is also present in beta strains[20]..The 417th change in sequence is the substitution of lysine for asparagine.[21].

On June 2021, 6, the K22N mutation was added to B1.617.2, and it is said that the infectivity is even stronger.B.1.617.2.1(AY.1[22][Note 1]Has been designated as a Variant of Concern (VOC) by Indian health officials[23]..Infected peoplevaccineOf the inoculatorImmunology(antibody),Monoclonal antibodyMay also show resistance to treatment[24][25][26]..On the other hand, there are experts who say that the data that it is more dangerous than the mutant strains so far, such as high infectivity and risk of aggravation, is not sufficient at this time and should be judged carefully.[26].

Besides thisORFHas an I1V mutation at site 3731aAmericaFound inSystem AY.3Also exists[27].

symptom

It has been suggested that the most common symptoms may have changed from the most common symptoms associated with previous standard COVID-19.Infected people may mistake their symptoms for a severe cold and may not realize that they need to be quarantined.Common reported symptoms are headache, sore throat, runny nose, or fever.[28][29]..In the United Kingdom, where Delta strains account for 91% of new cases, one study found that the most reported symptoms were headache, sore throat, and runny nose.[30].

It is as if the infected person emits a large amount of virus.AirborneIt is characterized by being observed as if it were (strictly speaking, it corresponds to an aerosol infection).[31].

治療

Treatment for people infected with the Delta strain is the same as for other COVID-19-infected individuals.

Vaccine effect

Indian Medical Research Council (ICMR) convalescent period for COVID-19 casesserumWhen,(English edition OfCovaxin(BBV152) recipient, although less effective, B.1.617neutralizeI found out what I can do[32].

Anurag Agrawal, director of the Institute of Genomics and Integrative Biology (IGIB), an Indian scientific research institute, said in a study on the efficacy of vaccines available in strain B.1.617.Infection after vaccinationSaid suggesting that is milder[33].

President of the United StatesChief Medical AdvisorAnthony FauciAlso shows confidence in the preliminary results. In an interview on April 2021, 4, he said:

This is where we are still getting data every day.However, the latest data examined convalescent sera from COVID-19 cases and people who received the vaccine Covaxin used in India.It was found to neutralize the B.1.617 mutant strain[34].

In another study by the Center for Cellular and Molecular Biology (CCMB) in Hyderabad,Oxford-AstraZeneca(Covishield) vaccinated serum was found to protect against strain B.1.617[35].

WHO states that the current vaccine remains effective against mutant strains.According to a study conducted by the British Public Health Agency (PHE)Pfizer-BioNTechBoth the Oxford-AstraZeneca vaccine and the Oxford-AstraZeneca vaccine were found to protect 33% of the symptomatological disease caused by the mutant strain after the first vaccination. Two weeks after the second vaccination, the Pfizer-Biontech vaccine was 2% effective in protecting against symptomatic disease from the Delta strain, while the Oxford-AstraZeneca vaccine was 2% effective.[36][37].

LancetHumans who have completed Pfizer-Biontech vaccination may have more than five-fold lower levels of neutralizing antibodies to delta strains than conventional strains, according to a study by a group of researchers at the Francis Crick Institute published in Was there[38].

In June 2021, PHE released findings that after two doses of the Pfizer-Biontech vaccine and the AstraZeneca vaccine, it was 6% and 2% effective in preventing hospitalization with Delta strains, respectively.[39][40].

footnote

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注 釈

  1. ^ It was first detected in Europe in March of the same year, and was subsequently detected in Asia and the United States.[22].. A further mutant of B.1.617.2 (Delta strain).

Source

  1. ^ “Confirmed cases of COVID-19 variants identified in UK”(July 2021, 4). https://www.gov.uk/government/news/confirmed-cases-of-covid-19-variants-identified-in-uk 2021/4/20Browse. 
  2. ^ "Tracking of Variants". gisaid.org. GISAID (September 2021, 4). 2021/7/2Browse.
  3. ^ "Expert reaction to cases of variant B.1.617 (the'Indian variant') being investigated in the UK”. Science Media Center. 2021/4/20Browse.
  4. ^ a b "Tracking SARS-CoV-2 variants" (English). who.int. World Health Organization. 2021/9/1Browse.
  5. ^ "SARS-CoV-2 Variant Classifications and Definitions". CDC.gov. Centers for Disease Control and Prevention. 2021/6/15Browse.
  6. ^ "SARS-CoV-2 variants of concern and variants under investigation in England”(May 2021, 5). 2021/6/18Browse.
  7. ^ a b “Covid: WHO renames UK and other variants with Greek letters”. BBC News. (April 2021, 5). https://www.bbc.com/news/world-57308592 2021/6/8Browse. 
  8. ^ Ellyatt, Holly (July 2021, 7). “New Covid wave could be imminent as delta variant sweeps Europe, WHO says" (English). CNBC. 2021/7/2Browse.
  9. ^ "SARS-CoV-2 Variant Classifications and Definitions". Centers for Disease Control and Prevention (September 2021, 5). 2021/5/16Browse.
  10. ^ Di Giacomo, Simone; Mercatelli, Daniele; Rakhimov, Amir; Giorgi, Federico M. (2021). “Preliminary report on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Spike mutation T478K”. Journal of Medical Virology. two:10.1002 / jmv.27062. PMC 8242375. PMID 33951211. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8242375/. 
  11. ^ "Threat Assessment Brief: Emergence of SARS-CoV-2 B.1.617 variants in India and situation in the EU / EEA". European Center for Disease Prevention and Control (September 2021, 5). 2021/5/17Browse.
  12. ^ "expert reaction to VUI-21APR-02 / B.1.617.2 being classified by PHE as a variant of concern". Science Media Center (September 2021, 5). 2021/5/15Browse.
  13. ^ WHO Aims at "Delta Strain" Mutant Confirmed in India --AFPBB News (June 2021, 6)
  14. ^ WHO labels a Covid strain in India as a'variant of concern' — here's what we know, CNBC, 11 May 2021.
  15. ^ WHO says India Covid variant of'global concern', BBC News, 11 May 2021.
  16. ^ India's second COVID-19 wave, The Wire Science, 22 April 2021.
  17. ^ "SARS-CoV-2 variants of concern as of 24 May 2021". European Center for Disease Prevention and Control. 2021/5/29Browse.
  18. ^ Greenwood, Michael (March 2021, 3). “SARS-CoV-2 mutation T478K spreading at alarming speed in Mexico”. Medical News. https://www.news-medical.net/news/20210330/SARS-CoV-2-mutation-T478K-spreading-at-alarming-speed-in-Mexico.aspx 2021/6/15Browse. 
  19. ^ a b Haseltine, William. “An Indian SARS-CoV-2 Variant Lands In California. More Danger Ahead?” (English). Forbes. https://www.forbes.com/sites/williamhaseltine/2021/04/12/an-indian-sars-cov-2-variant-lands-in-california-more-danger-ahead/?sh=1ff3056b3b29 2021/4/20Browse. 
  20. ^ Sample, Ian (October 2021, 6). “Nepal Covid variant: does it exist and should we be concerned?”. The Guardian. https://www.theguardian.com/world/2021/jun/03/nepal-covid-variant-does-it-exist-should-concerned 2021/6/23Browse. 
  21. ^ Tang, Julian W .; Oliver, TR (2021). “Introduction of the South African SARS-CoV-2 variant 501Y.V2 into the UK”. The Journal of Infection 82 (4): e8–e10. two:10.1016 / j.jinf.2021.01.007. PMC 7813514. PMID 33472093. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7813514/. 
  22. ^ a b “Delta plus: New Covid variant identified, experts say no cause of concern for now”. .. (January 2021, 6). https://indianexpress.com/article/india/delta-plus-new-covid-variant-identified-experts-say-no-cause-of-concern-7358752/ 2021/6/23Browse. 
  23. ^ India Concerns New Mutant "Delta Plus" Infectivity Stronger - Reuters (December 2021, 6)
  24. ^ Indian Corona "Delta Plus" recognized as "a variant of concern" Infection, immunity with vaccine has no effect - SputnikJapanese version (June 2021, 6)
  25. ^ Found in XNUMX countries including Delta Plus, Japan, US and China, which are stronger than Delta stocks - JoongAng Daily NewsJapanese version (June 2021, 6)
  26. ^ a b New mutant "Delta Plus" How much attention should be paid - BBC News (December 2021, 6)
  27. ^ New mutant strain of new coronavirus (SARS-CoV-2), which is concerned about increased infectivity / transmission and changes in antigenicity (10th report)/PDF version (PDF) - National Institute of Infectious Diseases (July 2021, 7), Retrieved September 6, 2021.
  28. ^ Grover, Natalie (June 2021, 6). “Delta variant Covid symptoms'include headaches, sore throat and runny nose'”. The Guardian (London). https://www.theguardian.com/world/2021/jun/14/delta-variant-covid-symptoms-include-headaches-sore-throat-and-runny-nose 2021/6/30Browse. 
  29. ^ Roberts, Michelle (February 2021, 6). “Headache and runny nose linked to Delta variant”. BBC News (London). https://www.bbc.co.uk/news/health-57467051 2021/7/2Browse. 
  30. ^ Radcliffe, Shawn (June 2021, 6). “The COVID-19 Delta Variant: Here's Everything You Need to Know”. Healthline. https://www.healthline.com/health-news/the-covid-19-delta-variant-heres-everything-you-need-to-know#What-symptoms-does-the-Delta-variant-cause? 2021/7/2Browse. 
  31. ^ Japan Broadcasting Corporation. “New Corona Delta strain "airborne" ?! What we know now". NHK News. 2021/9/14Browse.
  32. ^ Yadav, PD; Sapkal, GN; Abraham, P; Ella, R; Deshpande, G; Patil, DY et al. (7 May 2021). “Neutralization of variant under investigation B.1.617 with sera of BBV152 vaccinees.”. Clinical Infectious Diseases. two:10.1093 / cid / ciab411. PMID 33961693. 
  33. ^ "Covishield Covaxin effective against'Indian strain' of coronavirus study suggests" (English). The Week. 2021/4/27Browse.
  34. ^ “Covaxin found to neutralise 617 variant of COVID-19, says Dr. Fauci” (English). The Hindu(July 2021, 4). https://www.thehindu.com/news/international/covaxin-found-to-neutralise-617-variant-of-covid-19-says-dr-fauci/article34428175.ece 
  35. ^ “Covishield, Covaxin effective against'Indian strain'of coronavirus, study suggests --ET HealthWorld” (English). ETHealthworld.com (The Economic Times). (April 2021, 4). https://health.economictimes.indiatimes.com/news/industry/covishield-covaxin-effective-against-indian-strain-of-coronavirus-study-suggests/82283901 
  36. ^ Ellyatt, Holly (May 2021, 5). “Two doses of Covid vaccines provide effective protection against variant found in India: Study” (English). CNBC. https://www.cnbc.com/2021/05/24/two-doses-of-covid-vaccines-provide-protection-against-india-variant.html 
  37. ^ Bernal, Jamie Lopez; Andrews, Nick; Gower, Charlotte; Gallagher, Eileen; Simmons, Ruth; Thelwall, Simon et al. (2021-05-24). “Effectiveness of COVID-19 vaccines against the B.1.617.2 variant” (English). medRxiv. two:10.1101/2021.05.22.21257658. https://www.medrxiv.org/content/10.1101/2021.05.22.21257658v1. 
  38. ^ “COVID-19 vaccine: Pfizer jabs not the best for Delta variant, says Lancet study”. The New Indian Express(July 2021, 6). https://www.newindianexpress.com/lifestyle/health/2021/jun/05/covid-19-vaccine-pfizer-jabs-not-the-best-for-delta-variant-says-lancet-study-2312005.html 
  39. ^ “Vaccines highly effective against hospitalisation from Delta variant” (English). www.gov.uk (Public Health England). (June 2021, 6). https://www.gov.uk/government/news/vaccines-highly-effective-against-hospitalisation-from-delta-variant 
  40. ^ “UK study finds vaccines offer high protection against hospitalisation from Delta variant” (English). Reuters(July 2021, 6). https://www.reuters.com/business/healthcare-pharmaceuticals/uk-study-finds-vaccines-offer-high-protection-against-hospitalisation-delta-2021-06-14/ 2021/6/15Browse. 

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