treatments, potential diagnostic impact or predicted increase in transmissibility of disease severity. This class also requires increased sequence surveillance, increased laboratory characterization and epidemiological analysis to check the disease transmissibility and severity, the risk of reinfection and protection against vaccination. The current variants included in the variant of interest by the USA are B.1.526, B.1.525, and P.2. All these variants share a common mutation D614G; and evidence shows that the variants with this mutation spread disease faster than that of the variants without it. In late January, early February 2020 the then circulating strain was replaced by the D614G mutation carrying strain. The codon 614 replaces aspartic acid with glycine in the amino acid at this S protein site [16]. Variant of concern This class includes variants which demonstrated high disease transmissibility, more disease severity including hospitalizations and deaths, remarkable decrease in antibody neutralization, decreased effectiveness of treatments, and diagnostic detection failure. This class also requires increased efforts to control spread by developing testing kits, increased research to ascertain the vaccine and treatments efficacy against the variant. The current variants included in the variant of concern by the USA are B.1.1.7, P.1, B.1.351, B.1.427, and B.1.429. Figure 1. SARS-CoV-2 genome. SARS-CoV-2: severe acute respiratory syndrome coronavirus 2; N: nucleocapsid; M: membrane; S: spike; E: envelope; RdRp: RNA-dependent RNA polymerase; ORF: open reading frame. Articles © The authors | Journal compilation © J Clin Med Res and Elmer Press Inc™ | www.jocmr.org 319 Vasireddy et al J Clin Med Res. 2021;13(6):317-325 Similar to variant of interest class, the variants in this class also share a common mutation D614G, which spreads rapidly than variants without the mutation. Variant of high consequence This class includes variants which have evidence that the preventive and medical measures have a significantly decreased effectiveness compared to previously circulating variants. There are no variants in this class [17]. The COVID-19 Variants The following are the different variants identified in different countries. Of these, the three important variants which have rapidly become dominant are B.1.1.7, B.1.351, and P.1. UK variant (B.1.1.7 or 20I/501Y.V1) B.1.1.7, also known as VOC202012/01 was detected in September, 2020 in the UK. It has 23 mutations compared to the original strain found in Wuhan, China. Eight of these mutations were found to be in the S protein. Its notable mutations are N501Y, 69/70 deletion and P681H. The N501Y mutation appears to allow for the S protein to bind more tightly to the ACE2 receptor [18]. It is 40-80% more transmissible [19]. According to the report by Davies et al, nearly 5,000 out of 17,452 COVID-19 deaths during the months September to February were due to this variant. They also estimated that the mortality was approximately 55% higher when compared to other variants [20]. Similarly, the scientific reports in January 2021 indicated that there was an increased rate of death with this variant [21]. As of April 1, 2021, there were 12,505 reported cases across 51 jurisdictions [22]. It has been identified in 82 countries [23]. Table 1. SARS-CoV-2 Mutations [12] Mutation Mutation location Role of the mutation Variant S:N501 RDB May increase ACE2 binding. Tests in PfizerBioNTech and Moderna vaccinated individuals suggest reduction in neutralisation. UK (20I/501Y.V1) South Africa (20H/501Y.V2) Brazil (20J/501Y.V3) S:E484 RDB May increase ACE2 binding. South Africa (20H/501Y.V2) Brazil (20J/501Y.V3) Brazil (20B/S.484K) S:H69- Spike N-terminal domain May alter recognition by antibodies. UK (20I/501Y.V1)/B.1.1.7 S:Q677 Near to both outside the furin building pocket; important for S1/S2 cleavage Hypothetically thought to influence the S1/S2 cleavage. 20G (20C-US clade) S:Y453F RDB May increase ACE2 binding. Cluster 5 “mink” variant seen in minks in the Netherlands Confer resistance to the antibody in the Regeneron cocktail. S:S477 RDB Slight increase in ACE2 binding. Confer resistance to antibody and some convalescent sera and a modest increase in infectivity. S:L18F Spike N-terminal domain Reduction in binding for monoclonal antibody. South Africa (20H/501Y.V2) Brazil (20J/501Y.V3) S:Y144- Spike N-terminal domain Associated with antibody escape. UK (20I/501Y.V1), 20A/S:484K S:H655 Brazil (20J/501Y.V3) S:P681 Near the furin cleavage site It may reduce antibody recognition. UK (20I/501Y.V1) S:K417 RDB It may escape antibody binding and decrease binding to ACE2 receptor. South Africa (20H/501Y.V2) Brazil (20J/501Y.V3) ORF1a:S3675 It is a three amino acids deletion in ORF1a at positions 3675-5677. 20C/S:484K and 20A/S:484K RDB: receptor binding domain; ACE2: angiotensin-converting enzyme 2; ORF: open reading frame. 320 Articles © The authors | Journal compilation © J Clin Med Res and Elmer Press Inc™ | www.jocmr.org COVID-19 Vaccines Versus the Variants J Clin Med Res. 2021;13(6):317-325 There are studies going on to determine the effectiveness of antivirals and anti-inflammatory medication in the treatment of UK strain [24]. South African variant (B.1.351or 20H/501Y.V2) The B.1.351 variant, also known as 501Y.V2 was first identified as early as