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Analysis of Immune Escape Variants from Antibody-Based Therapeutics against COVID-19: A Systematic Review.


ABSTRACT: 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.

SUBMITTER: Focosi D 

PROVIDER: S-EPMC8744556 | biostudies-literature | 2021 Dec

REPOSITORIES: biostudies-literature

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Analysis of Immune Escape Variants from Antibody-Based Therapeutics against COVID-19: A Systematic Review.

Focosi Daniele D   Maggi Fabrizio F   Franchini Massimo M   McConnell Scott S   Casadevall Arturo A  

International journal of molecular sciences 20211221 1


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 c  ...[more]

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