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. 2022 Apr 14;386(15):1477-1479.
doi: 10.1056/NEJMc2120219. Epub 2022 Mar 9.

Resistance Mutations in SARS-CoV-2 Delta Variant after Sotrovimab Use

Rebecca Rockett  1 , Kerri Basile  2 , Susan Maddocks  3 , Winkie Fong  3 , Jessica E Agius  4 , Jessica Johnson-Mackinnon  4 , Alicia Arnott  2 , Shona Chandra  3 , Mailie Gall  2 , Jenny Draper  2 , Elena Martinez  2 , Eby M Sim  2 , Clement Lee  2 , Christine Ngo  2 , Marc Ramsperger  2 , Andrew N Ginn  2 , Qinning Wang  2 , Michael Fennell  2 , Danny Ko  2 , H Ling Lim  3 , Nicky Gilroy  3 , Matthew V N O'Sullivan  2 , Sharon C-A Chen  2 , Jen Kok  2 , Dominic E Dwyer  2 , Vitali Sintchenko  5
Affiliations

Resistance Mutations in SARS-CoV-2 Delta Variant after Sotrovimab Use

Rebecca Rockett et al. N Engl J Med. .
No abstract available

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Figures

Figure 1
Figure 1. SARS-CoV-2 Viral-Load Dynamics and Acquisition of Resistance Mutations after Sotrovimab Treatment.
The acquisition of mutations conferring a high level of resistance to sotrovimab and the dynamics of the viral load of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are shown. Panel A shows the N-terminal domain (NTD), receptor-binding domain (RBD), and receptor-binding motif (RBM) of the SARS-CoV-2 spike protein and the protein sequence and coordinates of mutations that were acquired in the RBD of the spike protein after sotrovimab treatment. We found five mutations (S:E340K/A/V and S:P337L/T) that have been reported to reduce susceptibility to sotrovimab by factors of 297, 100, 200, 192, and 10, respectively., Panel B shows the global phylogeny of subsampled isolates of the SARS-CoV-2 delta variant, a variant of concern, with the geographic region of sequences indicated in the outer ring. Panel C shows the findings in four patients with SARS-CoV-2 infection who received sotrovimab. The acquisition and read frequency of mutations conferring high levels of resistance to sotrovimab and the SARS-CoV-2 load at each sampling point are shown. The asterisks indicate two sampling time points in which a high-quality SARS-CoV-2 genome could not be recovered (in Patient R002 on day 7 and in Patient R004 on day 19) and potential resistance mutations could not be revealed. All the patients in whom resistance mutations developed (Patients R001 through R004) were hospitalized during the sampling periods.
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References

    1. Cameroni E, Bowen JE, Rosen LE, et al. Broadly neutralizing antibodies overcome SARS-CoV-2 omicron antigenic shift. Nature 2022;602:664-670. - PMC - PubMed
    1. Gupta A, Gonzalez-Rojas Y, Juarez E, et al. Early treatment for Covid-19 with SARS-CoV-2 neutralizing antibody sotrovimab. N Engl J Med 2021;385:1941-1950. - PubMed
    1. Chen RE, Zhang X, Case JB, et al. Resistance of SARS-CoV-2 variants to neutralization by monoclonal and serum-derived polyclonal antibodies. Nat Med 2021;27:717-726. - PMC - PubMed
    1. Choi B, Choudhary MC, Regan J, et al. Persistence and evolution of SARS-CoV-2 in an immunocompromised host. N Engl J Med 2020;383:2291-2293. - PMC - PubMed
    1. Cathcart AL, Havenar-Daughton C, Lempp FA, et al. The dual function monoclonal antibodies VIR-7831 and VIR-7832 demonstrate potent in vitro and in vivo activity against SARS-CoV-2. March 10, 2021. (https://www.biorxiv.org/content/10.1101/2021.03.09.434607v1). preprint.

MeSH terms

Supplementary concepts