Increased neurovirulence of omicron BA.5 over BA.1 in human brain organoids and K18-hACE2 mice

Abstract

AbstractThe reduced pathogenicity of the omicron BA.1 sub-lineage compared to earlier variants is well described, although whether such attenuation is retained for later variants like BA.5 remains controversial. We show that a BA.5 isolate was significantly more pathogenic in K18-hACE2 mice than a BA.1 isolate, with BA.5 infections showing increased neuroinvasiveness, resulting in brain infection and mortality, similar to that seen for original ancestral isolates. BA.5 also infected human cortical brain organoids to a greater extent than the BA.1 and original ancestral isolates. In the brains of mice neurons were the main target of infection, and in human organoids neuronal progenitor cells and immature neurons were infected. Evidence for brain infection and brain damage in certain COVID-19 patients is becoming compelling, with the results herein illustrating the increasing intrinsic neuropathogenic potential of evolving omicron variants.