Evidence map›Paper›PMID 39362845›Full record

ArticleNature communications2024

Immune escape and attenuated severity associated with the SARS-CoV-2 BA.2.86/JN.1 lineage.

Joseph A Lewnard, Parag Mahale, Debbie Malden, Vennis Hong, Bradley K Ackerson, Bruno J Lewin, Ruth Link-Gelles, Leora R Feldstein, Marc Lipsitch, Sara Y Tartof

Abstract read
In one paragraph

Article in Nature communications, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
21citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

21 citing papers in PubMed, 1 synthesis or guideline pooled it.

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  16. The importance of playing the long game when it comes to pandemic surveillance.Proceedings of the National Academy of Sciences of the United States of America · 2025
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  18. Monitoring SARS-CoV-2 variants with complementary surveillance systems: risk evaluation of the Omicron JN.1 variant in France, August 2023 to January 2024.Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin · 2025
    Article
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

10 authors.

Joseph A LewnardSchool of Public Health, University of California, Berkeley, Berkeley, CA, USA. jLewnard@berkeley.edu.ORCID 0000-0002-8505-8839
Parag MahaleDepartment of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, CA, USA.
Debbie MaldenDepartment of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, CA, USA.ORCID 0000-0003-0567-8294
Vennis HongDepartment of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, CA, USA.
Bradley K AckersonDepartment of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, CA, USA.ORCID 0000-0002-0816-7345
Bruno J LewinDepartment of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, CA, USA.ORCID 0000-0003-1483-2791
Ruth Link-GellesCoronavirus and Other Respiratory Viruses Division, National Center for Immunization and Respiratory Diseases, US Centers for Disease Control & Prevention, Atlanta, GA, USA.ORCID 0000-0002-9617-806X
Leora R FeldsteinCOVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA, USA.ORCID 0000-0002-4430-6760
Marc LipsitchCOVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA, USA.
Sara Y TartofDepartment of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, CA, USA.ORCID 0000-0003-2336-8476

Funding

Integrating Epidemiologic and Environmental Approaches to Understand and Predict Coccidioides Exposure and Coccidioidomycosis EmergenceR01AI148336 · NIAID · UNIVERSITY OF CALIFORNIA BERKELEY · PI REMAIS, JUSTIN V · 2020 to 2024
$4.5M
NIAID NIH HHS R01 AI148336U.S. Department of Health & Human Services | National Institutes of Health (NIH) R01-AI148336
6 · The paper itself

Abstract

The SARS-CoV-2 BA.2.86 lineage, and its sublineage JN.1 in particular, achieved widespread transmission in the US during winter 2023-24. However, this surge in infections was not accompanied by COVID-19 hospitalizations and mortality commensurate with prior waves. To understand shifts in COVID-19 epidemiology associated with JN.1 emergence, we compared characteristics and clinical outcomes of time-matched cases infected with BA.2.86 lineages (predominantly representing JN.1) versus co-circulating XBB-derived lineages in December, 2023 and January, 2024. Cases infected with BA.2.86 lineages received greater numbers of COVID-19 vaccine doses, including XBB.1.5-targeted boosters, in comparison to cases infected with XBB-derived lineages. Additionally, cases infected with BA.2.86 lineages experienced greater numbers of documented prior SARS-CoV-2 infections. Cases infected with BA.2.86 lineages also experienced lower risk of progression to severe clinical outcomes requiring emergency department consultations or hospital admission. Sensitivity analyses suggested under-ascertainment of prior infections could not explain this apparent attenuation of severity. Our findings implicate escape from immunity acquired from prior vaccination or infection in the emergence of the JN.1 lineage and suggest infections with this lineage are less likely to experience clinically-severe disease. Monitoring of immune escape and clinical severity in emerging SARS-CoV-2 variants remains a priority to inform responses.

Indexed as

COVID-19COVID-19 VaccinesImmune EvasionSARS-CoV-2AdultAgedFemaleHospitalizationHumansMaleMiddle AgedSeverity of Illness IndexUnited StatesCOVID-19 Vaccines

Identifiers

PMID39362845
PMCPMC11450198

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.