Is Orthrus the Next Top-Dog COVID Variant?

The Omicron subvariant XBB.1.5 — aka “Kraken” — has climbed to more than 66% of new COVID-19 cases in the U.S., but a relatively new Omicron subvariant named after a two-headed dog may be nipping at its tentacles.

Over the last several weeks, CH.1.1 — deemed “Orthrus” after a monster canine in Greek mythology — accounted for less than 2% of new COVID cases in the U.S. as of January, per the CDC. However, Orthrus has a mutation, L452R, previously seen in the highly pathogenic Delta variant, and highly transmissible BA.4 and BA.5 variants, according to researchers from the Ohio State University in Columbus.

In a BioRxiv preprint, Shan-Lu Liu, MD, PhD, and colleagues said Orthrus emerged in Southeast Asia in November 2022, and now accounts for about a quarter of cases in the U.K. and New Zealand. At other times in the pandemic, the U.K. has served as a bellwether of what could hit the U.S. in terms of new variants and potential surges.

They also explained that Orthrus, along with another new variant, CA.3.1, possess a “consistently stronger neutralization resistance than XBB, XBB.1, and XBB.1.5, which is astonishing and warrants continuous monitoring and further investigations.” Liu’s group called for continuing current vaccination strategies, or the investigation of new ones, and the ongoing surveillance of emerging variants.

The February 2023 COVID epidemiological update from the World Health Organization (WHO) lists Orthrus among the top three most prevalent variants in Europe, clocking in at 12.3%, slightly behind BQ.1 at 13% and BQ.1.1 at 31.3%.