Stay informed and prepared with our comprehensive guide to the Omicron virus. From understanding its symptoms and treatment options

Omicron

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ZAKA CLINIC GULBERG LAHORE

Saad Ullah Siddiqui

Overview

The COVID-19 Omicron variant is a variant of concern that has become the most common strain worldwide.&nbsp;&nbsp; 
&nbsp;

Since the start of the <a href="https://merisehat.pk/disease/covid-19">COVID-19</a> pandemic, the SARS-CoV-2 virus has undergone several mutations, leading to multiple different variants around the world. The World Health Organization (WHO) has divided these variants into three groups: variants of concern (VOCs), variants of interest (VOIs), and variants under monitoring (VUMs).

The previous four VOCs include Alpha (B.1.1.7), Beta (B.1.351), Gamma (P.1), and Delta (B.1.1.7) (B.1.617.2) forms of COVID-191. Each of these caused a continuous pandemic wave that killed thousands of people across nations, regions, and even the entire globe. In November 2021, the WHO named Omicron (B.1.1.529) as the fifth VOC, prompting immediate concerns across the globe.

Following findings from the WHO, a specimen taken on November 9, 2021, in South Africa, was the source of the first known verified Omicron infection<a href="#accordion">[2]</a>. Due to its high transmissibility and capacity for immune evasion, it has caused considerable global attention. Compared to the Delta and Beta varieties, the Omicron variant is considered more transmissible and infectious.

Furthermore, since its discovery, several sub-variants of Omicron have also developed. These strains are currently being monitored by the WHO. The BA.5 subvariant of Omicron is the most dominant worldwide.

Researchers have discovered several concerning sub variants of Omicron, which include<a href="#accordion">[11]</a>: 
&nbsp;

<ol>
	<li>
	<h5>&nbsp;Omicron BA.2 Or &quot;Stealth&quot; Subvariant</h5>
	</li>
</ol>

This variation was given the label Omicron BA.2 to distinguish it from the original BA.1 Omicron variant. Scientists initially believed BA.2 would quickly disappear because it wasn&#39;t as contagious as BA.1. However, that was not the reality. Beginning in January 2022, BA.2 seemed to spread as easily as BA.1.

According to a Danish study published in 2022, there was no difference between BA.2 and BA.1 in terms of the number of hospitalizations. Also, it demonstrated a decrease in BA.1 cases as BA.2 cases increased. However, BA.2 increases were documented in Sweden, Norway, and Great Britain and it was noticed that the number of cases rose at a slower rate.

Early research suggests that current vaccines and boosters appear to protect against this variety, preventing both a primary infection and the progression to a severe form.

&nbsp;

<ol start="2">
	<li>
	<h5>&nbsp;BA.4 Subvariant</h5>
	</li>
</ol>

The BA.4 subvariant was first discovered in South Africa in 2022, with the BA.5 subvariant being discovered shortly after. Since then, the number of nations and cases connected to these variations has increased dramatically.

Due to mutations, BA.4 and BA.5 are distinct from earlier Omicron sub variants. These mutations affect the &quot;spike&quot; proteins that enable the virus to attach to and infect cells. This facilitates infection. Moreover, it aids BA.4 and BA.5 in evading COVID-19 virus-fighting antibodies acquired from earlier infections. 
&nbsp;

<ol start="3">
	<li>
	<h5>&nbsp;BA.5 Subvariant</h5>
	</li>
</ol>

One significant distinction is that BA.5 appears to spread more quickly than BA.4 does. Over 78% of COVID cases in the United States were caused by BA.5 by the end of July 2022, compared to 13% by BA.4. BA.5 differs from BA.4 due to other mutations in addition to the spike protein mutation. According to experts, the symptoms of BA.4 and BA.5 are comparable to those of the earlier variants.

The BA.5 subvariant is currently the dominant strain worldwide and the most transmissible. 
&nbsp;

Signs and Symptoms

The intensity of the Omicron variant&#39;s infection has sparked much discussion and significantly influenced public policies. Increasing evidence suggests that Omicron infections cause fewer symptoms in patients than a previous variant of COVID outbreaks did. Moreover, the Omicron type is less likely to induce lung infection and much more likely to affect the upper respiratory tract.

According to an analysis of several COVID studies, the most typical signs and symptoms of Omicron infection are: 
&nbsp;

<ul>
	<li>Runny nose</li>
	<li>Sneezing</li>
	<li>Fatigue (mild to severe)</li>
	<li><a href="https://merisehat.pk/disease/cluster-headaches">Headache</a></li>
	<li>Sore throat 
	&nbsp;</li>
</ul>

In general, there aren&#39;t many distinctions between the symptom profiles of Omicron and Delta, with Omicron-infected patients experiencing fewer of the common symptoms like fever, coughing, or losing one&#39;s sense of taste or smell. Moreover, Omicron is believed to cause less severe disease than Delta and other previous variants. Convulsions in children have been reported in a small number of instances, but there aren&#39;t enough of them to draw any firm conclusions. 
&nbsp;

Causes

The Omicron variation is thought to have developed as a result of several mutations in the virus&#39;s spike protein. However, its precise origins are still unknown.

Changes in the spike protein can affect the virus&#39;s interactions with human cells, affecting how well the virus can resist the immune system and penetrate cells. It is believed that the Omicron variant&#39;s alterations may have made it more contagious and, maybe, more resistant to vaccinations and acquired immunity. 
&nbsp;

The Omicron variety may have emerged as a result of mutations that occurred in a person who had a prolonged virus infection, which gave the virus a chance to develop genetic modifications over time. It is also possible that the alterations might have happened in a population whose vaccination rates were low or in people with compromised immune systems who were unable to effectively eliminate the virus.

It is crucial to remember that all viruses naturally undergo viral mutations as they multiply and change over time. The introduction of novel variations emphasizes the necessity of continual surveillance as well as the creation of efficient treatments and vaccines. 
&nbsp;

While there are no specific screening tests for Omicron, doctors base their suspicion on an individual&rsquo;s symptoms, exposure to infection, and whether they reside in an area where Omicron is common. The doctor may then order a PCR or antigen-based rapid diagnostic test. 
&nbsp;

Individuals can also take an at-home COVID-19 test if they suspect the infection. In case of a positive test, the person should isolate themselves, especially if they are experiencing symptoms of COVID-19. However, if the person has no symptoms and tests positive, a molecular test may be conducted to confirm the diagnosis. In case of a negative test in the presence of symptoms, doctors may recommend additional testing. It is best to consult a doctor when deciding on tests for COVID-19. 
&nbsp;

Diagnosis

A patient&#39;s viral sample is genetically sequenced to look for certain mutations that are distinctive to the Omicron variant. Sequencing can be done using a variety of techniques, including PCR-based techniques and next-generation sequencing. Sequencing, however, is normally only utilized in circumstances when a variant of concern is being considered as a cause. It&#39;s crucial to abide by the recommendations of regional health authorities and healthcare professionals because testing requirements can change based on the place and situation.

Both PCR and antigen-based rapid diagnostic tests continue to detect Omicron infections. 
&nbsp;

Treatment

Current COVID-19 medications are still being studied to see how effectively they can treat Omicron instances. Some medications will continue to work whereas others might be less helpful due to the genetic changes in the Omicron version. Based on the likelihood of a severe infection, the doctor may advise antiviral medications or monoclonal antibody therapies.

Serious COVID-19 infections can still be treated with corticosteroids and IL6 receptor blockers.

The Omicron variant has proven to be less responsive to antibody treatments. Nevertheless, the response to antiviral medications appears to be different. Omicron is confirmed to be sensitive to the majority of antiviral medications now being tested, including:

<ul>
	<li>Ribavirin</li>
	<li>Favipiravir</li>
	<li>Nafamostat</li>
	<li>Camostat</li>
	<li>PF-07304814 (nirmatrelvir, a crucial component of paxlovid)</li>
	<li>Molnupiravir</li>
	<li>Remdesivir</li>
	<li>Aprotinin 
	&nbsp;</li>
</ul>

Further clinical outcomes are required to back up these findings, as the focus of current research is still at the cellular level. Also, it is yet unknown whether certain medications work against Omicron. In response to evolving viruses and the existing shortage of vaccinations and medications, it is vital to develop new broad-spectrum antiviral medications<a href="#accordion">[3]</a>. 
&nbsp;

<h5>Home Remedies </h5>

As per the CDC, mild infections can be treated at home. Also, patients should keep an eye on their conditions and notify their doctors in case of worsening symptoms. A doctor can advise a patient on whether to visit the emergency department and what particular at-home remedies could be most effective for them. 
&nbsp;

A COVID-19 carrier should also:

<ul>
	<li>Remain at home until a doctor gives the all-clear to interact with others.</li>
	<li>Wear a proper mask that covers their mouth and nasal passages when in interaction or enclosed spaces with other people.</li>
	<li>Limit other members of the household as much as possible.</li>
	<li>Constantly wash their hands.</li>
	<li>Cover their mouth when coughing to prevent spreading the sickness to everyone else in the house.</li>
</ul>

&nbsp;

Many at-home remedies can aid in controlling COVID-19 symptoms. Although they may not cure the symptoms, some treatments might make a patient more comfortable.

A medical expert can advise on how to treat a patient&#39;s symptoms. Though, the CDC advises:

<ul>
	<li>Getting lots of sleep</li>
	<li>Maintaining hydration</li>
	<li>Taking OTC drugs like acetaminophen or other similar over-the-counter (OTC) drugs 
	&nbsp;</li>
</ul>

Acetaminophen and nonsteroidal anti-inflammatory medications, such as ibuprofen, can be taken to reduce fever and ease muscle aches and pains. Previously, ibuprofen was believed to worsen COVID-19. However, no scientific evidence has been found for this assertion.

To prevent dehydration, one should make sure to drink plenty of liquids. 
&nbsp;

<h5>Cough </h5>

The body uses coughing as a means of trying to open the airways. The National Health Service (NHS) of the United Kingdom advises avoiding lying on one&#39;s back while one has a cough. They should instead stand up or lie on their side.

The following can help lessen coughing:

<ul>
	<li>Consuming plenty of warm liquids, such as water, to ease the throat.</li>
	<li>Avoiding dehydration</li>
	<li>Using cough drops.</li>
	<li>Using a nighttime humidifier.</li>
</ul>

Inhaling steam may also provide relief for some persons. They can do this while a hot shower is flowing in the bathtub or on the shower floor. 
&nbsp;

<h5>Shortness Of Breath </h5>

The NHS note that breathlessness can be a sign of a more severe SARS-CoV-2 infection.

If a person is feeling breathless, they should try to remain calm. Shortness of breath is a symptom that can be frightening, but panicking can cause hyperventilation, which can make it worse.

Those who are having trouble breathing should take the following actions:

<ul>
	<li>Holding the lips together while slowly exhaling from the mouth and inhaling via the nose.</li>
	<li>Resting with a high, straight spine in a chair.</li>
	<li>Avoid bending down the upper back and lowering the shoulders.</li>
	<li>Putting the hands for supporting on the knees while stooping forward. 
	&nbsp;</li>
</ul>

According to research, lying on one&#39;s stomach may increase oxygen intake. This is so that the heart and stomach won&#39;t press against the lungs when lying on the front and the air sacs can then fully expand. A healthcare professional should be sought in case of worsening breathlessness despite the above measures. 
&nbsp;

There are four positions a person can try:

<ol>
	<li>&nbsp;Position One</li>
</ol>

Turning the head to the side while lying on the front. Then wrap the arms around the shoulders and chest. To assist the hamstrings and toes, one can place more cushions beneath the shins. 
&nbsp;

<ol start="2">
	<li>&nbsp;Position Two</li>
</ol>

Turning the head to the side while lying on the stomach. The arms should be turned outwards and up toward the head. A pillow can be kept underneath the stomach. 
&nbsp;

<ol start="3">
	<li>&nbsp;Position Three</li>
</ol>

The head should be moved to one side, and the leg on that side should be bent at a 90-degree angle as the individual lies on their stomach. The arms can be placed wherever it is most comfortable for the person, and the leg can be supported with a cushion or blanket. 
&nbsp;

<ol start="4">
	<li>&nbsp;Position Four</li>
</ol>

Putting a pillow under the torso and knees, while lying on the side. 
&nbsp;

<h5>Supplements</h5>

Whether supplements can help COVID-19 patients perform better is unclear at this time. There have been some investigations, however, the conclusions vary.

<ul>
	<li>
	<a href="https://merisehat.pk/disease/vitamin-d">Vitamin D</a>
	</li>
</ul>

According to a study published in 2020, people who were vitamin D deficient and got a high dose of vitamin D treatment had no significant SARS-CoV-2 RNA. However, the evidence is insufficient to support the use of vitamin D to treat or prevent COVID-19 because of the small sample size <a href="#accordion">[4]</a>.

<ul>
	<li>
	Vitamin C
	</li>
</ul>

According to a 2020 study, 50 individuals in China who received high intravenous vitamin C doses had their COVID-19 symptoms minimized<a href="#accordion">[5]</a>. A 2019 meta-analysis and earlier studies suggest vitamin C may shorten the time patients stay in the intensive care unit<a href="#">[6]</a>.

Studies are still being conducted to examine if high doses of vitamin C help reduce some of the excessive inflammatory responses that doctors observe in patients with severe or critical illnesses. Unfortunately, there is not enough evidence to support the use of vitamin C to treat COVID-19. 
&nbsp;

Recent studies suggest that the Omicron variant of the COVID-19 virus might not be as severe as earlier variants. However, long COVID is still a possible complication of Omicron infection. Moreover, severe cases may require hospitalization and may even result in death due to complications, such as pneumonia, acute kidney injury, acute respiratory distress syndrome (ARDS), acute liver injury, etc.

In South Africa, where the Omicron variant was first identified, researchers found that during the fourth wave of infections, which was mostly caused by Omicron, fewer people needed to go to the hospital. The number was about 4.9%, which is much lower than in previous waves caused by the Beta or Delta variants<a href="#accordion">[3]</a>. The study also found that the chances of getting severely ill from Omicron were reduced by 73%3. Similar results were found in another province in South Africa, where the risk of severe illness or death from Omicron was reduced by about 25%<a href="#accordion">[3]</a>. Thus, suggesting that Omicron might not be as dangerous as once imagined. Nevertheless, precautions should be taken to avoid infection and people should continue to get vaccinated. 
&nbsp;

The Omicron variant&#39;s strong capacity for immune evasion is what causes the gravest concern. Due to its ability to bypass immune defenses built up from vaccination or prior infection with another version, the Omicron variant may be highly transmissible.

A COVID-19 infection increases the risk of severe illness or death in older persons. A person is also more likely to become ill from COVID-19 if they have not received their vaccinations, suffer from a disability, have a compromised immune system, or have certain medical disorders.

Immunocompromised individuals (those with weakened immune systems) may be more susceptible to COVID-19 infection or may experience more severe symptoms. Individuals might be immunocompromised either because of a health issue or from receiving immunosuppressive drugs or therapies. 
&nbsp;

The following factors can cause mild to severe immunosuppression:

<ul>
	<li>Hematologic and solid tumor cancers are actively being treated.</li>
	<li><a href="https://merisehat.pk/disease/hiv-61">HIV </a>infection that is advanced or untreated.</li>
	<li>Steroid use.</li>
	<li>Moderate or severe primary immunodeficiency.</li>
	<li>Organ transplant 
	&nbsp;</li>
</ul>

The following factors increase one&rsquo;s risk of developing Omicron infection:

<ol>
	<li>&nbsp;If the individual or their family member&nbsp; has risk factors for severe illness</li>
	<li>&nbsp;Residing or visiting a region with a high COVID-19 Community Level.</li>
	<li>&nbsp;Pregnant or recently delivered individuals, as well as those who reside with or visit them</li>
	<li>&nbsp;Giving in-home care to a virus-infected person</li>
	<li>&nbsp;Close contact with an infected individual 
	&nbsp;</li>
</ol>

<ol>
	<li>
	<h5>&nbsp;Interruption Of SARS-CoV-2 Variant Spread</h5>
	</li>
</ol>

Scientists are still trying to figure out the Omicron variant of the COVID-19 virus, but they&#39;re worried it might spread more easily and be harder to treat with current medicines. To stop this variant from spreading, it is important to continue

<ul>
	<li>Wearing masks.</li>
	<li>Staying away from others.</li>
	<li>Frequently washing hands.</li>
	<li>Making sure rooms have good airflow. 
	&nbsp;</li>
</ul>

Note: If you think you might have been around someone with the virus, it&#39;s important to get tested quickly and stay away from others if you test positive. 
&nbsp;

<ol start="2">
	<li>
	<h5>&nbsp;Improving COVID-19 Vaccine Coverage</h5>
	</li>
</ol>

It is critical to increase immunization rates across the nation as the Omicron variant is highly transmissible. The immunizations nevertheless guard against serious illness, hospitalization, and death. Low antibody levels in people who have been immunized or infected may encourage the emergence of new variations. According to studies, antibodies start to wane after six months, but an additional booster dosage can increase the effectiveness of the vaccine<a href="#accordion">[8]</a>. A second booster shot could be added to the immunization schedule to assist in stopping the spread of Omicron and its illness.

As per the CDC, bivalent mRNA booster vaccines protect against Omicron and its sub variants<a href="#accordion">[12]</a>. It is important to stay up to date with the recommended COVID-19 vaccines. 
&nbsp;

Key Points

<ul>
	<li>The Omicron variant was discovered for the first time in November 2021 in South Africa.</li>
	<li>Its spike protein has undergone numerous changes, which may have an impact on the virus&#39;s capacity to spread, its severity, and how well it evades the immune system.</li>
	<li>The Omicron variant is highly transmissible. However, it does not result in a severe infection like the previous variants.</li>
	<li>Omicron&#39;s clinical and epidemiological characteristics are still little understood, but preliminary research indicates that it can sometimes result in less severe sickness, even if more severe cases have also been documented.</li>
	<li>Omicron&#39;s spike protein alterations may make vaccines and monoclonal antibodies less efficient against it, but a certain degree of immunity may still be offered.</li>
	<li>To stop the spread of Omicron and other viral types, it&#39;s critical to keep up with public health precautions like mask use, physical segregation, and vaccination. 
	&nbsp;</li>
</ul>

[1] Organization WH, others. Tracking SARS-CoV-2 Variants.

[2] He X, Hong W, Pan X, Lu G, Wei X. SARS-CoV-2 Omicron variant: characteristics and prevention. MedComm. 2021;2(4):838–45.

[3] Fan Y, Li X, Zhang L, Wan S, Zhang L, Zhou F. SARS-CoV-2 Omicron variant: recent progress and future perspectives. Signal Transduct Target Ther [Internet]. 2022;7(1):141.

[4] Rastogi A, Bhansali A, Khare N, Suri V, Yaddanapudi N, Sachdeva N, et al. Short term, high-dose vitamin D supplementation for COVID-19 disease: a randomised, placebo-controlled, study (SHADE study). Postgrad Med J. 2022;98(1156):87–90.

[5] Cheng RZ. Can early and high intravenous dose of vitamin C prevent and treat coronavirus disease 2019 (COVID-19)? Med drug Discov. 2020;5:100028.

[6] Hemilä H, Chalker E. Vitamin C can shorten the length of stay in the ICU: a meta-analysis. Nutrients. 2019;11(4):708.

[7] Jassat W, Karim SA, Mudara C, Welch R, Ozougwu L, Groome M, et al. Clinical severity of COVID-19 patients admitted to hospitals in Gauteng, South Africa during the Omicron-dominant fourth wave. SSRN [Preprint]. 2021 [cited 2022 Feb 1]

[8] Nunes B, Rodrigues AP, Kislaya I, Cruz C, Peralta-Santos A, Lima J, et al. mRNA vaccine effectiveness against COVID-19-related hospitalisations and deaths in older adults: a cohort study based on data linkage of national health registries in Portugal, February to August 2021. Eurosurveillance. 2021;26(38):2100833.

[9] Statement on the update of who's working definitions and tracking system for SARS-COV-2 variants of concern and variants of interest. World Health Organization.

[10] What we know about the omicron variant. UNICEF.

[11] The Omicron variant of covid-19. WebMD.

[12] Link-Gelles R, Ciesla AA, Fleming-Dutra KE, et al. Effectiveness of Bivalent mRNA Vaccines in Preventing Symptomatic SARS-CoV-2 Infection — Increasing Community Access to Testing Program, United States, September–November 2022. MMWR Morb Mortal Wkly Rep 2022;71:1526–1530. DOI:

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