Rapid Emergence of Potentially Transmissible Severe Acute Respiratory Syndrome Coronavirus 2 With Resistance to Combination Monoclonal Antibody Therapy

Abstract Prolonged coronavirus disease 2019 may generate new viral variants. We report an immunocompromised patient treated with monoclonal antibodies who experienced rebound of viral RNA and emergence of an antibody-resistant (>1000-fold) variant containing 5 mutations in the spike gene. The mut...

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Bibliographic Details
Published in:	Open forum infectious diseases Vol. 10; no. 5; p. ofad278
Main Authors:	Jacobs, Jana L, Haidar, Ghady, Naqvi, Asma, McCormick, Kevin D, Sobolewski, Michele, Treat, Benjamin R, Heaps, Amy L, Simpson, Jordan, Kramer, Kailey Hughes, McCreary, Erin, Bariola, J Ryan, Klamar-Blain, Cynthia, Macatangay, Bernard J C, Dimitrov, Dimiter, Li, Wei, Marino, Christopher C, Raptis, Anastasios, Sethi, Rahil, Chandran, Uma, Barratt-Boyes, Simon, Parikh, Urvi M, Mellors, John W
Format:	Journal Article
Language:	English
Published:	US Oxford University Press 01-05-2023
Subjects:	Brief Report
Online Access:	Get full text
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Summary:	Abstract Prolonged coronavirus disease 2019 may generate new viral variants. We report an immunocompromised patient treated with monoclonal antibodies who experienced rebound of viral RNA and emergence of an antibody-resistant (>1000-fold) variant containing 5 mutations in the spike gene. The mutant virus was isolated from respiratory secretions, suggesting the potential for secondary transmission.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 Potential conflicts of interest. J. W. M. is a consultant to AlloVir, Infectious Disease Connect, and Gilead Sciences; has received grant funding from Gilead Sciences to the University of Pittsburgh; receives compensation from Abound Bio (unrelated to the current work); and holds share options in Infectious Disease Connect and MingMed Biotechnology Co (unrelated to the current work). G. H. is a recipient of research grants from AlloVir, Karius, NIH, and AstraZeneca; reports consulting fees for serving on the advisory boards of Karius and AstraZeneca; and has received honoraria from MDOutlook. E. M. has served on advisory boards for Shionogi and AbbVie related to COVID-19 therapeutics and has received speaker honorarium from Shionogi related to COVID-19 therapeutics. U. M. P. reports consulting fees from Merck & Co. B. J. C. M. has received research funds from AstraZeneca. J. R. B. holds shares/share options in CarePoint Holdings. All other authors report no potential conflicts.
ISSN:	2328-8957 2328-8957
DOI:	10.1093/ofid/ofad278