We explored the molecular evolution of the spike gene after the administration of anti-spike monoclonal antibodies in patients with mild or moderate forms of COVID-19. Four out of the 13 patients acquired a mutation during follow-up; two mutations (G1204E and E406G) appeared as a mixture without clinical impact, while the Q493R mutation emerged in two patients (one receiving bamlanivimab and one receiving bamlanivimab/etesevimab) with fatal outcomes. Careful virological monitoring of patients treated with mAbs should be performed, especially in immunosuppressed patients.
All Keywords
【저자키워드】 COVID-19, SARS-CoV-2, monoclonal antibodies therapy, spike gene, immune escape mutation, Q493R, 【초록키워드】 Evolution, Mutation, molecular evolution, bamlanivimab, outcomes, spike gene, etesevimab, Patient, Mild, clinical impact, molecular, moderate, mAbs, immunosuppressed patients, mAb, administration, Immunosuppressed, anti-spike monoclonal antibody, Virological, mixture, two patients, anti-spike monoclonal antibodies, performed, form, receiving, patients treated, 【제목키워드】 spike, escape, form,
【저자키워드】 COVID-19, SARS-CoV-2, monoclonal antibodies therapy, spike gene, immune escape mutation, Q493R, 【초록키워드】 Evolution, Mutation, molecular evolution, bamlanivimab, outcomes, spike gene, etesevimab, Patient, Mild, clinical impact, molecular, moderate, mAbs, immunosuppressed patients, mAb, administration, Immunosuppressed, anti-spike monoclonal antibody, Virological, mixture, two patients, anti-spike monoclonal antibodies, performed, form, receiving, patients treated, 【제목키워드】 spike, escape, form,
우리는 경증 또는 중등도 형태의 COVID-19 환자에서 스파이크 방지 단일클론 항체를 투여한 후 스파이크 유전자의 분자 진화를 조사했습니다. 13명의 환자 중 4명은 추적 관찰 중에 돌연변이를 획득했습니다. 2개의 돌연변이(G1204E 및 E406G)는 임상적 영향 없이 혼합물로 나타난 반면 Q493R 돌연변이는 2명의 환자(밤라니비맙을 투여받은 1명 및 밤라니비맙/에테세비맙을 투여받은 1명)에서 치명적인 결과를 보였습니다. mAb로 치료받은 환자, 특히 면역억제 환자에 대한 주의 깊은 바이러스 모니터링을 수행해야 합니다.