Maddox, Robert
Mayo Clinic
Department of Pathology and Laboratory Medicine , 3170 UW Medical Foundation Centennial Building (MFCB), 1685 Highland Avenue, Madison, WI 53705, USA
Citations 1
Evolution of a globally unique SARS-CoV-2 Spike E484T monoclonal antibody escape mutation in a persistently infected, immunocompromised individual
Halfmann, Peter , Minor, Nicholas R. , Haddock, Luis A. , Maddox, Robert James, Riemersa, Kasen K., Prasad, A. Mallikarjuna, Alman, Kirsten J., Florek, Kelsey R. , Bateman, Allen , Safdar, Nasia , Andes, David R. , Kawaoka, Yoshihiro , Yao, Joseph D. , O’Connor, David H. , Halfmann, Peter J , Haddock Iii, Luis A , Florek, Kelsey , O'Connor, David H , Maddox, Robert, Moreno, Gage K. , Braun, Katarina M. , Baker, David , Prasad, Ankur, Lambert, Matthew C, Westergaard, Ryan P. , Fida, Madiha , Friedrich, Thomas C.
Virus Evolution | November 5, 2022 | Volume: 9 | Issue: 2 | Pages: No page available
Abstract Prolonged infections in immunocompromised individuals may be a source for novel Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) variants, particularly when both the immune system and antiviral therapy fail to clear the infection and enable within-host evolution. Here we describe a 486-day case of SARS-CoV-2 infection in an immunocompromised individual. Following monotherapy with the monoclonal antibody Bamlanivimab, the individual’s virus acquired resistance, likely via the earliest known occurrence of Spike amino acid variant E484T. Recently, E484T has arisen again as a derivative of E484A in the Omicron Variant of Concern, supporting the hypothesis that prolonged infections can give rise to novel variants long before they become prevalent in the human population.