1. Introduction
COVID-19, caused by the SARS-CoV-2 virus, is an unprecedented infectious disease responsible for numerous cases and fatalities worldwide [
1]. The virus has undergone successive mutations [
2], and understanding these mutations is crucial for predicting its future behavior.
The purpose of the study is twofold. Firstly, to understand the characteristics of the Omicron variant and how it has evolved. Previously, the WHO has distinguished variants, particularly those with high transmissibility and widespread infections, by assigning them Greek letters starting with Alpha. However, the Omicron variant, which emerged at the end of 2021, has proven to be more transmissible than any previous variant, persisting and dominating the virus's brief history for about half of its duration.
Secondly, to compare the changes in the SARS-CoV-2 virus with those of influenza H1N1 virus. Influenza viruses, which are similarly highly transmissible and cause annual outbreaks, are often equated with COVID-19. However, is this a valid comparison? Or might these have entirely different natures? Those were investigated by using principal component analysis (PCA) [
3].
PCA offers several compelling advantages over more prevalent clustering methods. Its primary strength lies in its ability to provide a comprehensive overview. While clusters primarily indicate the proximity between adjacent samples, PCA offers a holistic perspective, revealing the inter-group distances and the degree of divergence exhibited by new variants. Furthermore, PCA elucidates sequential differences between individual variants through PCitem, a level of detail often obscured in clustering analyses. Importantly, PCA results are highly reproducible across calculations, ensuring consistency in outcomes. Additionally, PCA facilitates the straightforward positioning of new samples along the identified axes, a task that necessitates recalibration in clustering methods for each new sample. This attribute proves advantageous for classification tasks.
4. Discussion
The Omicron variant exhibited significant mutations at sites not previously mutated in earlier strains (
Figure 1), resulting in a different direction of change. This likely facilitated infection of previously inaccessible people, leading to a surge in patients. JN.1 similarly emerged with substantial changes at previously unmutated sites (
Figure 3), with many mutations inherited from BA.1 lost, indicating a new direction of mutation.
COVID-19 and influenza were quite different in their epidemics. Influenza saw a continuous evolution of a single variant from 1975 to 2009, with mutations accumulating over time. If mutations accumulate in this manner (similar to a random walk), each PC appears as a sin wave, PC1 as a half-wavelength, PC2 as a cycle, PC3 as 1.5 cycles, and so on; lower levels of PCs cover recurrent mutations and frequently replaced mutations. This scenario was observed in influenza [
7]. PC1 monotonically increased (
Figure S1A), and PC2 demonstrated mutations and reversions, resulting in a clockwise rotation of PC1 and PC2 when compared annually (S1B). Perhaps influenza infects nearly everyone (though only a small portion become symptomatic) due to its ability to bind to common sialic acid receptors in humans. Therefore, there is basically only one variant of influenza that is prevalent each year. Many people will be immune, so the variant cannot spread again the following year. The following year it will be prevalent elsewhere and mutate a little. After a few years, when enough mutations have accumulated, it returns and causes an epidemic again.
Figure 4B and
Figure S1 show the result of this accumulation after about 35 years.
In contrast, a certain variant of SARS-CoV-2 infects far fewer individuals [
14,
15]. For instance, the XBC.1.3 strain had a short-lived prevalence with a limited number of cases (
Figure 1B). Consequently, infection rates fluctuate, and the number of cases per wave remains substantially smaller relative to the total population. These minor outbreaks characterize individual variants, leading PCA to detect them along one of its axes. Consequently, the contribution of each axis is markedly small (
Figure S2). This is likely due to the spike protein of SARS-CoV-2 binding to ACE2, a protein presented by human cells; naturally, ACE2 exhibits polymorphism, affecting the efficiency of viral binding and resulting in multiple strains circulating simultaneously [
16,
17]. As each variant undergoes mutations independently, these mutations do not necessarily accumulate. New variants appear suddenly, irrespective of previous variants (
Figure 1,
Figure 2 and
Figure 3, S). Consequently, many individuals may lack immunity to a particular mutation, increasing the likelihood of recurrent appearances of the mutation. Moreover, ample room for further mutations remains evident (
Figure 4), suggesting a continued potential for this protein to evade immunity.
SARS-Cov-2 mutates so quickly that primers for PCR to detect it are sometimes disabled [
10]. Additionally, mRNA vaccines, which were initially effective, quickly lost their efficacy [
14]. The rapid and continuous mutations observed especially in the S protein (
Figure 2A) show that it is impractical to target the protein that mutates at such a fast pace for detection or immune response purposes. There are health concerns associated with repeated vaccinations [18-20], and this has been confirmed by an increase in IgG4 [21-23]. Alternatively, although the effectiveness of suppressing infection may be lower, a vaccine targeting ORF3a, E, and certain regions of N may prevent severe illness, with longer-lasting efficacy. All ORFs of influenza mutate at the same rate [
7], so every viral component could be a target for immunity. Of course, similar effects could be achieved using attenuated viruses derived from animal variants, which could be produced without sophisticated technology [
24].
The differences in mutations between influenza and SARS-CoV-2, such as the presence of conserved ORFs and the lack of mutation accumulation, suggest distinct selective pressures governing their evolution. Influenza faces selection pressure aimed at evading acquired immunity, allowing only sufficiently mutated variants to drive subsequent outbreaks. Consequently, mutations accumulate. In contrast, humans had no immunity against SARS-CoV-2; only those who had received the mRNA vaccine were immune to the S protein. Thus, the S protein underwent concentrated mutations. Above all, the change in this protein allowed people with a different ACE2 to be infected, which would have created a selection pressure. So several variants were prevalent at the same time, and new mutations occurred independently of each other. This is probably why the mutations have not accumulated. The protein still has a lot of room for mutation (
Figure 4). Likely, epidemics will continue, mainly among people who have not been previously infected. Until a convergence of the epidemic is confirmed, public health measures should not be abandoned.
The JN.1 variant, which emerged relatively recently, demonstrates distinct characteristics compared to earlier iterations of Omicron. Notably, it harbors a mutation not found in either the historical record of Omicron or its precursor variants (
Figure 3B). Moreover, JN.1 abolishes many mutations typical of BA.1 and other Omicron variants, showing greater similarity to earlier variants (see
Figure 1A). Previous observations have indicated low virulence in early Omicron variants [
14], likely due to these mutations. Indeed, an increase in hospitalizations has been observed since the emergence of JN.1 [
25], possibly linked to the abolition of these mutations. Some report no significant difference in symptoms [
26], while others report significantly higher infectivity [
27]. This variant appears to have surpassed previous Omicron outbreaks, following a trajectory similar to that of BA.1 (see
Figure 1B). If derivatives of this variant continue to replace Omicron and trigger outbreaks, it may be prudent to designate it as Pi for precautionary purposes.