Treatment of Omicron BA 2.75 Subvariant (September 2022)

As of the week ending September 3, 2022, Omicron BA.5 represent an estimated 89% of the SARS-CoV-2 variants currently circulating in the United States, according to the CDC. 

In India and Nepal, however, the prevalence of a subvariant of BA.2 (designated BA.2.75) is increasing rapidly and is now becoming dominant in Nepal (R). Moreover, BA.2.75 has been detected in at least 25 other countries, including the United States, Singapore, Canada, the United Kingdom, Japan, and Australia; as such, it has spread across multiple continents (R). The World Health Organization designated BA.2.75 as a “variant of concern lineage under monitoring.”

Using Prescription Drugs

Monoclonal antibodies significantly reduce the risk of severe disease, but they require an injection or infusion. And not every patient is eligible to get these treatments. Monoclonal antibodies have been authorized for people who are at higher risk of severe illness because of age (65 and older) or underlying health conditions such as high blood pressure or lung disease. To date, there is no evidence that these treatments benefit people who are young or otherwise healthy. Monoclonal antibodies are available by prescription or at Test to Treat sites nationwide for people who are eligible.

Older version of monoclonal antibodies, such as Regeneron’s treatment (Imdevimab + Casirivimab), could fail or partially fail because they target parts of the virus that have mutated. 

Based on a lab study (NEJM, September 2022) using the live-virus Focus Reduction Neutralization Testing (FRNT) method, bebtelovimab seems to be the most promising monoclonal antibody against the BA 2.75 subvariant.

REGN10987 (marketed as imdevimab) lost neutralizing activity against BA.2.75, whereas REGN10933 (marketed as casirivimab) retained some neutralizing activity against the isolate. REGN10987 in combination with REGN10933 (casirivimab–imdevimab) inhibited BA.2.75; however, the neutralizing activity against BA.2.75 with this combination was less than that against the ancestral strain (SARS-CoV-2/UT-NC002-1T/Human/2020/Tokyo) by a factor of 812.5. 

COV2-2196 (marketed as tixagevimab) and COV2-2130 (marketed as cilgavimab) neutralized BA.2.75. The COV2-2196 plus COV2-2130 combination (tixagevimab–cilgavimab) inhibited BA.2.75 with a low FRNT50 value (34.19 ng per milliliter), but the neutralizing activity was less than that against the ancestral strain by a factor of 5.3. The precursor of sotrovimab (S309) neutralized BA.2.75 weakly; however, its activity was less than that against the ancestral strain by a factor of 870.0. 

Of the monoclonal antibodies tested, only LY-CoV1404 (marketed as bebtelovimab) efficiently neutralized BA.2.75 (FRNT50 value, 6.21 ng per milliliter).

Overall, the study data also suggest that the three antiviral drugs remdesivir, molnupiravir, and nirmatrelvir may still have therapeutic value against the BA 2.75 of SARS-CoV-2 omicron variant.

Do take note of the limitation of this study as this is a non-clinical study (not in humans). There is lack of clinical data on the efficacy of these monoclonal antibodies and antiviral drugs for the treatment of patients infected with BA.2.75 subvariant. Therefore, the selection of monoclonal antibodies or anti-virals to treat patients who are infected should be carefully considered based on the potential risks as compared to its potential benefits.

To be effective, these medications must be started soon after symptoms begin (within five days and seven days, respectively). “[People who might be eligible] should call their provider right away,” says Raymund Razonable, an infectious disease specialist at the Mayo Clinic. “These treatments work best when the patients are not feeling so bad.” 

Other At-Home Treatments

You can find a listing of doctors who can prescribe necessary home isolation medications on Find a Provider post. 

There are many COVID-19 treatment protocols out there on the internet. We have reviewed many protocols and believe the FLCCC I-CARE protocol is the easiest and effective to follow. 

Always consult your trusted medical professional before you take any medication or supplement. 

Related: Treatment for Long COVID Syndrome    

Emergency warning signs

Individuals are reminded to seek immediate medical attention (go to a hospital’s emergency department) if they develop emergency warning signs of COVID-19 such as:
  • Difficulty breathing
  • Persistent pain or pressure in the chest
  • Bluish lips or face
  • New confusion or inability to arouse
Key Takeaway

As soon as you have symptoms, consult your healthcare provider and start treatment as early as possible. If treatment is delayed i.e. after 5 days of symptoms, your chances of severe COVID are higher.



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