The accelerated SARS-CoV-2 evolution under selective pressure by massive deployment of neutralizing antibody-based therapeutics is a concern with potentially severe implications for public health. We review here reports of documented immune escape after treatment with monoclonal antibodies and COVID-19-convalescent plasma (CCP). While the former is mainly associated with specific single amino acid mutations at residues within the receptor-binding domain (e.g., E484K/Q, Q493R, and S494P), a few cases of immune evasion after CCP were associated with recurrent deletions within the N-terminal domain of the spike protein (e.g., ΔHV69-70, ΔLGVY141-144 and ΔAL243-244). The continuous genomic monitoring of non-responders is needed to better understand immune escape frequencies and the fitness of emerging variants.
【저자키워드】 COVID-19, convalescent plasma, SARS-CoV-2, viral clearance, 【초록키워드】 Treatment, neutralizing antibody, public health, Mutation, monoclonal antibody, monoclonal antibodies, variants, Spike protein, immune evasion, Receptor-binding domain, Immune escape, Deletion, SARS-CoV-2 evolution, E484K, plasma, Neutralizing, fitness, genomic, N-terminal domain, Amino acid, Frequency, CCP, residue, responders, residues, selective, while, non-responder, implication, the spike protein, the receptor-binding domain, accelerated, 【제목키워드】 review, Therapeutics, escape,