UK expert looks at what lies ahead for COVID-19

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LEXINGTON, Kentucky (May 10, 2022) — Ilhem Messaoudi, Ph.D., president of the University of Kentucky medical college‘s Department of Microbiology, Immunology, and Molecular Genetics, is one of many UK experts who have been at the forefront of COVID-19 research throughout the pandemic.

As a virologist and immunologist, Messaoudi’s research focuses on better understanding viruses and the wide range of factors affecting the immune system. She recently spoke to UKNow to give us the latest on SARS-CoV-2 – including what we know about the latest Omicron variants and what we might expect in the future.

UKNow: What’s the latest in COVID-19 variants?

Although we are seeing the emergence of new cases of Omicron sub-variants (BA.2 and BA.2.BA.4 and BA.5 sub-lines) with a slight increase, there is also no evidence that this new variant is causing disease that is more severe and we are not seeing an increase in hospitalizations, so that’s good news.

And even this new recombinant, XE, is very interesting. Recombination occurs when genetic material from two different variants is combined into a single virus, which happens very often in influenza, but is unusual in coronaviruses. Yet there is no evidence that this new recombinant will pose any more risk than any of the current variants that have been in circulation.

UKNow: While recent variants like Omicron have been more transmissible, they have been less harmful than the original strain of SARS-CoV-2. Do you think this trend will continue?

It’s really hard to predict what’s going to happen, but I would definitely caution against saying that the newer variants are more harmful. We are seeing fewer hospitalizations due to vaccination and natural immunity, but breakthrough infections (those in vaccinated people) continue to occur, especially in the elderly and immunocompromised.

It’s unclear how many more variants we’ll see. I don’t know how many more mutations this virus can undergo before it begins to lose its physical form. As the virus infects and replicates better in human cells, it will be more transmissible. But at the same time, he may lose some of the attributes that cause him to cause serious illness.

If you think about it, it is in the interest of the virus to adapt to its host and not kill it, because then it has a better chance of being transmitted and spreading through the population.

UKNow: Why didn’t vaccines eradicate SARS-CoV-2?

It is almost impossible to eradicate a virus, especially a virus like SARS-CoV-2 which can replicate in multiple reservoirs and infect other animal species. The goal of the vaccine is not to eradicate the virus, but to arm the immune system to respond quickly before the virus can replicate at levels high enough to cause severe illness and organ damage. . The vaccine helps ensure that when we are infected, we don’t end up in hospital or die.

UKNow: We have heard a lot about how we are in the endemic phase of the pandemic. What does that mean?

An endemic pathogen is something we will continue to live with. H1N1 is a good example: when it appeared in 2009, it caused a pandemic. Today, H1N1 is endemic because it is now circulating and we account for it in seasonal flu vaccines. Again, due to the fact that SARS-CoV-2 can replicate and infect other animal species, we expect it to be with us for the foreseeable future.

UKNow: Does that mean it could become a seasonal respiratory virus?

Not necessarily. The reason influenza is a seasonal virus is actually related to the migratory patterns of birds. Birds are the reservoir for influenza, so the disease moves around as they migrate from different hemispheres at specific times of the year. Tracking birds is how scientists track the flu and predict which strains will circulate each year.

SARS-CoV-2 can infect different animal reservoirs that live alongside humans, not just migrating animals, so it won’t necessarily be seasonal like the flu. However, when the weather gets colder and people are more likely to congregate indoors, it’s likely we’ll see spikes in cases.

UKNow: Do you think there will be variant-specific booster shots in the future?

Again, I think the virus is reaching a balance where potentially more mutations will make it less fit. However, once things stabilize, we could reach a point where there could be a variant every year that scientists could plan and predict. In this case, we can consider making a new vaccine that is more suitable for whatever is in circulation at that time.

UKNow: As a researcher, what do you think are some of the crucial things we now know about COVID-19 that we didn’t know two years ago?

At first, researchers had knowledge about SARS-CoV-2 based on what we already knew about other coronaviruses. But looking back to March 2020, we didn’t know that compared to what we know today.

One of the biggest mysteries was why some people got serious illnesses and others didn’t. We now know that excessive inflammation prevents a proper immune response from occurring and wreaks havoc on organ systems. So, in addition to antivirals, anti-inflammatories like dexamethasone have become a standard of care. Today we have many more tools in our toolbox to prevent people from ending up in intensive care and dying.

Also, mRNA technology was in the background before COVID-19. Now people are investing in it and talking about using it for many other viruses including HIV. mRNA vaccines have enormously energized the field of vaccinology.

Because we have diverted so many resources to understanding this single pathogen, we also understand so much more about the immune system, particularly pulmonary immunology, the differences between the upper and lower respiratory tract, and how age and disease metabolic disrupt immunity. I think we now have hopefully a better roadmap to deal with any new outbreaks should they occur.

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