Trending Clinical Topic: B.1.1.7 Variant

Ryan Syrek


January 29, 2021

Each week, we identify one top search term, speculate about what caused its popularity, and provide an infographic on a related condition. If you have thoughts about what's trending and why, share them with us on Twitter or Facebook. Find the latest COVID-19 news and guidance in Medscape's Coronavirus Resource Center.

Since it was first identified by UK researchers in December, the B.1.1.7 variant of SARS-CoV-2 (see Infographic below) has emerged as a major concern and is this week's top trending clinical topic. Investigators from the Centers for Disease Control and Prevention (CDC) have warned that B.1.1.7 will become the predominant strain of coronavirus across the United States by March. Cases have been reported worldwide, including in many European countries, Australia, Brazil, and India. Whether the new variant is associated with a higher degree of mortality is still under investigation.

The increased transmissibility of B.1.1.7 suggests that vaccination coverage needed for disease control will now be higher than what was originally anticipated. Experts are arguing for a dramatic increase in the pace of vaccine rollouts. As of now, currently available vaccines still appear to be effective against B.1.1.7. Laboratory analysis of blood samples taken from 20 individuals who had received Pfizer's vaccine found that antibodies successfully warded off the virus variant.

Although the short-term outlook is good for current vaccines, mutations do pose a problem over a longer period. Still, such evolutions are to be expected for many viruses, such as seasonal influenza. One theory for how the new variant evolved with so many mutations is that one individual, perhaps immunocompromised, had a partial immune response to a chronic infection that provided a unique set of selective processes for the virus to mutate. The need to update COVID vaccines is already being assessed and approaches are under consideration.

Detection of the B.1.1.7 variant is another challenge. The US Food and Drug Administration (FDA) has issued an alert to clinical laboratory staff and clinicians, warning about the potential risk for false-negative results of virus testing. Molecular tests for SARS-CoV-2 may provide inaccurate findings if part of the virus's genome assessed by that test has mutated. In particular, the FDA found that the Accula SARS-CoV-2 test from Mesa Biotech Inc may be affected when a sample having a genetic variant at position 28881 (GGG to AAC) is tested. More encouragingly, the FDA said that the detection pattern that appears with the TaqPath and Linea diagnostic tests when certain genetic variants are present may help with early identification of new variants to reduce further spread of infection.

Given the impact that the increased transmissibility of the B.1.1.7 variant will have on disease spread and vaccination, the term understandably dominated searches this week, resulting in the top trending clinical topic.

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