Understanding the JN.1 COVID Variant: Symptoms, Spread, and Prevention
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A highly mutated version of the COVID-19 virus called JN.1 is currently driving a surge of infections in the United States. The extremely transmissible variant now accounts for about 86 percent of COVID cases — a major jump from Thanksgiving, when fewer than 8 percent of infections were caused by JN.1.
While the variant is spreading fast, there is no evidence that JN.1 — a subvariant of the omicron strain that first appeared in late 2021— is causing symptoms that are any different from or more severe than other circulating strains, according to the Centers for Disease Control and Prevention (CDC).
“JN.1 is fairly similar to the other omicron variants, causing run-of-the mill symptoms like sore throat, congestion and runny nose, fevers, chills, cough, and fatigue,” says Minji Kang, MD, an assistant professor and infectious-disease specialist in the department of internal medicine at UT Southwestern Medical Center in Dallas.
Pavitra Roychoudhury, PhD, an associate in the vaccine and infectious disease division of the Fred Hutchinson Cancer Center and a research assistant at the University of Washington in Seattle, adds that some changes to COVID-19 symptoms may be expected over time as the virus continues to mutate and evolve.
“The symptoms can really vary person-to-person,” she says, “but I am not aware of any major changes in symptoms in JN.1 just yet.”
Is Diarrhea More Common With the New JN.1 Variant?
In updated information from the end of December, the CDC lists the following symptoms of COVID-19:
While some people hit by JN.1 have said on social media and elsewhere that the variant triggers more digestive turmoil, such as diarrhea, than previous variants, there is no data yet to confirm it.
“There have been speculations that JN.1 can cause more GI [gastrointestinal] troubles, including diarrhea, but there really haven’t been any definitive studies demonstrating that,” says Dr. Kang.
COVID-19 Symptoms Can Evolve as New Variants Appear
Certainly it’s possible that a new COVID-19 variant could bring with it a change in symptoms. For instance, before omicron, loss of smell and taste was thought to be a reliable way to identify a coronavirus infection. That symptom now appears to be declining.
Findings published last year in the journal Otolaryngology–Head and Neck Surgery indicated that loss of smell and taste from omicron variants was only 6 to 7 percent of what it was during the early stages of the outbreak.
“Initially, at the beginning of the pandemic, loss of taste and smell were pretty common,” says Kang. “Now these symptoms are much less common, especially since the omicron variants [such as JN.1] have taken over.”
JN.1 Is Highly Mutated, Very Contagious, and Spreading Widely
What is certain about JN.1 is its ability to easily spread. JN.1 is a descendant of variant BA.2.86 (also called Pirola). These two members of the omicron family are closely related and highly mutated. JN.1, however, has evolved to have an additional mutation (L455S) in its so-called spike proteins — the parts of the virus that attach to human cells — which may make it much more transmissible, according to public health officials.
“JN.1 is rising in frequency really quickly, and that usually suggests that it’s either really good at evading people’s preexisting immunity, or it has some sort of infectiousness advantage as a result of the mutations that it carries,” says Dr. Roychoudhury.
The latest data from the CDC show that COVID activity remains “high” or “very high” throughout most of the country, with weekly hospital admissions up 3.2 percent and deaths climbing by over 14 percent.
“COVID-19 surveillance data, hospital admission forecasts, and growth estimates indicate that COVID-19 activity has increased and is likely to continue increasing into January,” says Jasmine Reed, a CDC spokesperson.
COVID-19 Is Sending More People to the Hospital Than Other Respiratory Viruses
In most cases, COVID-19 causes mild illness that you can treat at home, but the virus still remains the primary cause of respiratory-virus-associated hospitalizations nationally, per the CDC.
Most of these hospitalizations are among the most vulnerable populations. Older adults have the highest odds of getting very sick from COVID-19. More than 81 percent of COVID-19 deaths occur in people over age 65.
COVID-19 targets the lungs, and those with chronic underlying health conditions such as chronic obstructive pulmonary disease (COPD), heart disease, diabetes, and obesity are more likely to develop serious illness.
Infants and pregnant people are also among those who are most vulnerable.
Vaccination and Antiviral Treatments Like Paxlovid Can Help Prevent Severe Disease
Infectious-disease specialists suggest that everyone, but especially those at high risk for severe illness, may want to take extra precautions at this time of year to prevent the spread of JN.1. These measures include wearing masks, washing hands frequently, avoiding crowded indoor spaces, and getting the most recent updated COVID vaccine.
“Besides protecting against hospitalization and severe illness, the vaccine has been shown to reduce the duration of illness in some, and in some people, it can also reduce the risk of getting long COVID,” says Roychoudhury.
Unfortunately, vaccination rates are abysmally low. As of January 5, 2024, the portion of the U.S. population reporting they’d received the updated COVID-19 vaccine was 8 percent for children and just over 19 percent for adults.
The CDC also recommends antiviral treatments, such as Paxlovid (nirmatrelvir and ritonavir), for some individuals who are at high risk of becoming very sick and needing to be hospitalized. A 2023 National Institutes of Health study involving more than one million COVID-19 patients found that Paxlovid treatment within five days of a positive COVID-19 test reduced 28-day hospitalization by 26 percent and death by 73 percent compared with no Paxlovid treatment.
But based on the study, only about 15 percent of high-risk patients eligible for the drug are taking it.
Are More Variants on the Way That Could Increase the Odds of Serious Illness?
Roychoudhury says it’s an open question whether a more contagious variant that causes more serious symptoms could still be coming.
“We’re interested to see how this JN.1 lineage may diversify, and whether it will lead to a more infectious variant that causes more severe disease,” she says. “We can also not rule out the possibility that there’s a completely novel variant out there, so it’s important that we continue to monitor to see how the virus evolves.”
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