@article{Holtz_A-2024_191488,
title = {Emergence of the B.1.214.2 SARS-CoV-2 lineage with an Omicron-like spike insertion and a unique upper airway immune signature},
author = {Holtz, A. and Van Weyenbergh, J. and Hong, S. and Cuypers, L. and O’Toole, Á. and Dudas, G. and Gerdol, M. and Potter, B. and Ntoumi, F. and Mapanguy, C. and Vanmechelen, B. and Wawina-Bokalanga, T. and Van Holm, B. and Menezes, S. and Soubotko, K. and Van Pottelbergh, G. and Wollants, E. and Vermeersch, P. and Jacob, A. and Maes, B. and Obbels, D. and Matheeussen, V. and Martens, G. and Gras, J. and Verhasselt, B. and Laffut, W. and Vael, C. and Goegebuer, T. and van der Kant, R. and Rousseau, F. and Schymkowitz, J. and Serrano, L. and Delgado, J. and Wenseleers, T. and Bours, V. and André, E. and Suchard, M. and Rambaut, A. and Dellicour, S. and Maes, P. and Durkin, K. and Baele, G.},
month = {oct},
year = {2024},
abstract = {We investigate the emergence, mutation profile, and dissemination of SARS-CoV-2 lineage B.1.214.2, first identified in Belgium in January 2021. This variant, featuring a 3-amino acid insertion in the spike protein similar to the Omicron variant, was speculated to enhance transmissibility or immune evasion. Initially detected in international travelers, it substantially transmitted in Central Africa, Belgium, Switzerland, and France, peaking in April 2021. Our travel-aware phylogeographic analysis, incorporating travel history, estimated the origin to the Republic of the Congo, with primary European entry through France and Belgium, and multiple smaller introductions during the epidemic. We correlate its spread with human travel patterns and air passenger data. Further, upon reviewing national reports of SARS-CoV-2 outbreaks in Belgian nursing homes, we found this strain caused moderately severe outcomes (8.7% case fatality ratio). A distinct nasopharyngeal immune response was observed in elderly patients, characterized by 80% unique signatures, higher B- and T-cell activation, increased type I IFN signaling, and reduced NK, Th17, and complement system activation, compared to similar outbreaks. This unique immune response may explain the variant's epidemiological behavior and underscores the need for nasal vaccine strategies against emerging variants.},
volume = {24},
journal = {BMC Infectious Diseases},
publisher = {Springer Nature},
url = {https://doi.org/10.1186/s12879-024-09967-w},
}
