2022
DOI: 10.1101/2022.04.12.22273675
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SARS-CoV-2 evolution and immune escape in immunocompromised patients treated with exogenous antibodies

Abstract: BackgroundSARS-CoV-2 mutations conferring escape from neutralizing antibodies can arise in immunocompromised patients with prolonged infection, but the conditions that facilitate immune escape are still not fully understood.MethodsWe characterized endogenous immune responses, within-host SARS-CoV-2 evolution, and autologous neutralization of the viral variants that arose in five immunocompromised patients with prolonged infection and B cell deficiencies.ResultsIn two patients treated with the monoclonal antibo… Show more

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Cited by 5 publications
(3 citation statements)
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References 52 publications
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“…The COVID-19 disease risk in the general population has improved with the development of highly effective vaccines. However, many individuals with immunodeficiency are still at risk of developing severe and refractory COVID-19 infection, potentially leading to the development of SARS-CoV-2 variants of concern (27). This study aimed to evaluate the vaccine response and COVID-19 disease severity of a group of 71 individuals with immunodeficiency.…”
Section: Discussionmentioning
confidence: 99%
“…The COVID-19 disease risk in the general population has improved with the development of highly effective vaccines. However, many individuals with immunodeficiency are still at risk of developing severe and refractory COVID-19 infection, potentially leading to the development of SARS-CoV-2 variants of concern (27). This study aimed to evaluate the vaccine response and COVID-19 disease severity of a group of 71 individuals with immunodeficiency.…”
Section: Discussionmentioning
confidence: 99%
“…The synthetic variant sequences share similar mutations with the chronic SARS-COV-2 infections. A reverse mutation, R493Q, for example, was found in a persistently infected, immunocompromised individual 44 . Other mutations found by our model, like E340K 45 , E484T 33 , G485R 46 , and F490L/E484G 47 , are also found in immunocompromised patients treated with monoclonal antibodies.…”
Section: Resultsmentioning
confidence: 99%
“…Time courses demonstrate that sequential samples can be conveniently collected for the study of viral dynamics and monitoring within-host virus evolution. This may be particularly useful for identifying mutations in immunocompromised patients or following antiviral treatment (22).…”
Section: Discussionmentioning
confidence: 99%