Abstract
The implementation of monoclonal antibody therapeutics during the COVID-19 pandemic altered the selective pressures encountered by SARS-CoV-2, raising the possibility of selection for resistant variants. Within-host viral evolution was reported in treated immunocompromised individuals but whether this signifies a real risk of onward transmission is unclear. We used a regional SARS-CoV-2 sequencing program to monitor lineages with clinically relevant variants in identified patients, which facilitated analysis of parameters potentially relevant to new variant emergence. Here we describe a newly acquired spike E484K mutation detected within the B.1.311 lineage. Multiple individuals in 2 households of the same extended family were infected. The timing and patterns of spread were consistent with de novo emergence of this E484K variant in the bamlanivimab-treated index patient. Our study suggests that the selective pressures introduced by the widespread administration of these antibodies may warrant increased genomic surveillance to identify and mitigate spread of therapy-induced variants.
Keywords: Antibody escape mutation; Drug resistance; SARS-CoV-2; Variant of concern.
【저자키워드】 SARS-CoV-2, variant of concern, drug resistance, Antibody escape mutation, 【초록키워드】 antibody, COVID-19 pandemic, monoclonal antibody, variant, risk, drug, variants, bamlanivimab, Spread, Viral, Surveillance, viral evolution, implementation, Patient, Lineage, E484K, SARS-CoV-2 sequencing, drug resistance, E484K mutation, genomic, lineages, patients, administration, Analysis, extended family, immunocompromised individuals, individual, selective pressures, onward transmission, Multiple, de novo, MONITOR, parameter, widespread, mitigate, selective pressure, identify, were infected, reported, clinically, treated, facilitated, introduced, immunocompromised individual, raising, 【제목키워드】 emergence, Patient, E484K, household contact,