Les études scientifiques se multiplient depuis la fin de l’année 2021 pour confirmer que le variant Omicron du Sars-CoV-2 provoque moins de formes graves de la maladie que le Delta. Ces recherches donnent aussi des clés pour comprendre pourquoi cette souche s’attaque moins aux poumons.
Études après études, les scientifiques semblent confirmer l’impression que le variant Omicron entraîne des formes moins sévères du Covid-19 que la souche Delta. Depuis le 23 décembre, il y a même eu quatre publications allant dans le même sens : plus grande transmissibilité du virus, mais moins dangereux que Delta.
Des chercheurs de l’université de Liverpool ont conclu, dans un article mis en ligne le 26 décembre, que des souris contaminées par le variant Omicron perdaient moins de poids et avaient des formes moins sévères de pneumonie que des souris soumises à d’autres mutations du Sars-CoV-2.
Des hamsters dorés, utilisés par des scientifiques de l’université de Louvain (Belgique), ont eu une réaction similaire aux rongeurs de Liverpool, dans les résultats publiés également le 26 décembre d’une autre expérience pour évaluer la dangerosité du variant détecté en novembre 2021.
Loin des voies respiratoires inférieures
Des travaux de chercheurs américains soumis quelques jours avant la fin de l’année à la revue scientifique Nature et que le Guardian a pu consulter confirment que les souris contaminées par le variant Omicron ont des formes moins graves du Covid-19. Enfin, les données britanniques de fin décembre “démontrent qu’une personne affectée par le variant Omicron semble avoir entre 50 % et 70 % moins de risques d’être hospitalisée”, souligne Ian Jones, virologue à l’université de Reading, contacté par France 24.
“On peut donc dire que d’un point de vue épidémiologique, c’est un variant qui est moins sévère que le précédent”, conclut Björn Meyers, virologue à la faculté de médecine de l’université de Magdebourg, joint par France 24. “Il semble y avoir non seulement moins de cas d’hospitalisation, mais les personnes qui sont admises restent aussi moins longtemps et avec des symptômes moins forts”, ajoute Lawrence Young, virologue et professeur d’oncologie moléculaire à la Warwick Medical School, contacté par France 24.
Les nouvelles études scientifiques suggèrent aussi que cette apparente moindre sévérité d’Omicron aurait à voir avec la manière dont le virus infecte les cellules dans le corps humain. “Il emprunte la même porte pour entrer dans la cellule mais sans utiliser la même clé”, résume Lawrence Young de manière métaphorique.
Omicron s’accroche toujours à la cellule avec sa fameuse protéine Spike, mais les nombreuses mutations sur cette partie du virus font qu’il préfère se multiplier au niveau du nez, de la gorge et des bronches, sans s’aventurer autant vers les poumons comme c’était le cas avec les précédentes souches du Sars-CoV-2.
Cette différence primordiale lui permet d’être plus résistant aux vaccins, tout en étant potentiellement moins dangereux car “dans toutes les maladies respiratoires, le risque pour la santé est plus important quand le virus s’attaque aux voies respiratoires inférieures, comme les poumons. C’est ce qui se passe avec les agents de la grippe aviaire H5N1 qui viennent se loger au niveau des voies respiratoires inférieures”, explique Ian Jones, de l’université de Reading.
Début de la phase endémique ?
“C’est probablement pourquoi on a affaire à un virus qui entraîne des formes moins sévères de la maladie tout en étant plus transmissible puisqu’il y a une plus forte concentration virale au niveau du nez et de la gorge, ce qui augmente le risque de contamination”, résume Jonathan Stoye, virologue et responsable de recherche au Francis Crick Institute de Londres, contacté par France 24.
Mais pour cet expert, il ne faut pas non plus surestimer la baisse de dangerosité d’Omicron. “On constate qu’il se multiplie plus facilement et plus vite au niveau des voies respiratoires supérieures que les souches précédentes, et il y aura toujours une proportion d’agents pathogènes qui vont finir par trouver leur chemin vers les poumons. C’est là que la vaccination est importante car elle permet de limiter le risque de contracter des formes graves du Covid-19”, précise ce spécialiste.
“S’il est vrai qu’il semble être moins ‘sévère’ que le variant Delta, Omicron apparaît tout de même plus dangereux que le variant Alpha [dominant dans une partie de l’Europe à la fin de 2020, NDLR] dont il est un descendant plus direct”, précise, quant à lui, Björn Meyer, le virologue de l’université de Magdebourg.
ll y a donc deux manières de considérer Omicron. D’un côté, c’est une forme plus grave que son ancêtre – Alpha –, mais de l’autre, il apparaît plus bénin que le variant Delta qu’il est en train de supplanter au niveau mondial. Et d’un point de vue sanitaire, c’est ce dernier aspect qui importe aux yeux d’Ian Jones, car “c’est peut-être avec ce variant que l’on est entré dans la phase endémique de l’épidémie [c’est-à-dire que la maladie s’enracine, mais dans des formes plus anodines pour la santé, NDLR].”
“Ce serait en tout cas en phase avec ce que nous savons de l’histoire des coronavirus”, reconnaît Jonathan Stoye, le responsable de recherche au Francis Crick Institute de Londres. Certains précédents – comme la pandémie de grippe Russe de 1889 – suggèrent que ces virus ont tendance à commencer à s’atténuer au bout de deux ans environ.
Là encore, “c’est logique d’un point de vue évolutionnaire, puisque les variants qui vont s’imposer sont ceux qui sont les plus contagieux, c’est-à-dire ceux qui sont plutôt présents dans les voies respiratoires supérieures, là où ils sont généralement moins dangereux pour la santé”, résume Ian Jones. En clair, une sorte de darwinisme viral pourrait donner un coup de pouce à l’effort vaccinal pour surmonter la pandémie.
En attendant, le propagation fulgurante d’Omicron contribue à mettre le système de santé sous forte pression. Car même si le variant est moins virulent, les hôpitaux doivent “gérer un fort absentéisme au quotidien [du personnel soignant] lié à la rapide progression des contaminations avec l’arrivée d’Omicron”, explique à France 24
source:France24FR
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