SARS-CoV-2 Variants in Immunocompromised Patient Given Antibody Monotherapy.

Aurélie Truffot,Pascal Poignard,Olivier Epaulard,Alban Caporossi,Raphaele Germi,Marion Le Maréchal,Julien Andréani,Sylvie Larrat

doi:10.3201/eid2710.211509

Abstract

A 72-year-old immunocompromised man infected with severe acute respiratory syndrome coronavirus 2 received bamlanivimab monotherapy. Viral evolution was monitored in nasopharyngeal and blood samples by melting curve analysis of single-nucleotide polymorphisms and whole-genome sequencing. Rapid emergence of spike receptor binding domain mutations was found, associated with a compartmentalization of viral populations.

Highlights

SARS-CoV-2 Variants in Immunocompromised Patient Given Antibody Monotherapy
A72-year-old immunocompromised man in France who had chronic lymphocytic leukemia associated with hypogammaglobinemia for 4 years experienced diarrhea, asthenia, fever, and cough associated with coronavirus disease (COVID-19). He had received 1 injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) mRNA vaccine (BNT162b2; Pfizer/BioNTech, https://www.pfizer.com) 20 days earlier, we confirmed a diagnosis of COVID-19 by using a semiquantitative SARS-CoV-2 reverse transcription PCR (RT-PCR) viral load assay
SARS-CoV-2 carriage in a nasopharyngeal swab specimen decreased during treatment, and the patient was discharged from the infectious disease department and transferred to a rehabilitation center

Summary

Introduction

SARS-CoV-2 Variants in Immunocompromised Patient Given Antibody Monotherapy Viral evolution was monitored in nasopharyngeal and blood samples by melting curve analysis of single-nucleotide polymorphisms and whole-genome sequencing. He had received 1 injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) mRNA vaccine (BNT162b2; Pfizer/BioNTech, https://www.pfizer.com) 20 days earlier, we confirmed a diagnosis of COVID-19 by using a semiquantitative SARS-CoV-2 reverse transcription PCR (RT-PCR) viral load assay. Analysis of samples showed a high viral load in a nasopharyngeal swab specimen (Ct 20) and a blood sample (Ct 37) (Table).

Results

Conclusion