Abstract
We report in vivo selection of a severe acute respiratory syndrome coronavirus 2 spike mutation (Q493R) conferring simultaneous resistance to bamlanivimab and etesivimab. This mutation was isolated from a patient who had coronavirus disease and was treated with these drugs.
Highlights
We report in vivo selection of a severe acute respiratory syndrome coronavirus 2 spike mutation (Q493R) conferring simultaneous resistance to bamlanivimab and etesivimab
Emergency use remains authorized for the bamlanivimab/etesevimab cocktail, targeting overlapping epitopes [2], for which no completely resistant variant has been reported to date
We report an in vivo case of a spike protein escape mutation conferring combined resistance to bamlanivimab and etesevimab
Summary
Bamlanivimab treatment leads to rapid selection of immune escape variant carrying E484K mutation in a B.1.1.7 infected and immunocompromised patient. 5. Baum A, Fulton BO, Wloga E, Copin R, Pascal KE, Russo V, et al Antibody cocktail to SARS-CoV-2 spike protein prevents rapid mutational escape seen with individual antibodies. 7. Focosi D, Novazzi F, Genoni A, Dentali F, Dalla Gasperina D, Baj A, et al Emergence of SARS-CoV-2 spike protein escape mutation Q493R after treatment for COVID-19.
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