tetano
Editor, Senior Moderator
Open Forum Infect Dis
. 2022 Feb 21;9(4)
fac093.
doi: 10.1093/ofid/ofac093. eCollection 2022 Apr.
Impact of Casirivimab-Imdevimab on Severe Acute Respiratory Syndrome Coronavirus 2 Delta Variant Nasopharyngeal Virus Load and Spike Quasispecies
Camille Vellas[SUP] 1 2 3 [/SUP], Arnaud Del Bello[SUP] 2 3 4 [/SUP], Geraldine Gaube[SUP] 5 [/SUP], Pauline Tremeaux[SUP] 1 [/SUP], Nicolas Jeanne[SUP] 1 [/SUP], Noemie Ranger[SUP] 1 [/SUP], Guillaume Martin-Blondel[SUP] 2 3 5 [/SUP], Pierre Delobel[SUP] 2 3 5 [/SUP], Nassim Kamar[SUP] 2 3 4 [/SUP], Jacques Izopet[SUP] 1 2 3 [/SUP]
Affiliations
Abstract
Background: The increasing use of monoclonal antibodies (mAbs) to treat coronavirus disease 2019 raises questions about their impact on the emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) mAb-resistant variants. We assessed the impact of Casirivimab-Imdevimab on SARS-CoV-2 mutations associated with reduced mAb activity in treated patients.
Methods: We measured the nasopharyngeal (NP) viral load and sequenced the haplotypes of spike gene of 50 patients infected with the SARS-CoV-2 delta variant and treated with Casirivimab-Imdevimab using single-molecule real-time sequencing.
Results: The NP SARS-CoV-2 viral load of patients treated with Casirivimab-Imdevimab decreased from 8.13 (interquartile range [IQR], 7.06-8.59) log[SUB]10[/SUB] copies/mL pretreatment to 3.67 (IQR, 3.07-5.15) log[SUB]10[/SUB] copies/mL 7 days later (P < .001). Of the 36 patients for whom follow-up timepoints Spike sequencing were available, none of the Spike mutations that reduced mAb activity were detected.
Conclusions: Casirivimab-Imdevimab is an effective treatment for patients infected with the SARS-CoV-2 delta variant. Despite selective pressure on SARS-CoV-2 Spike quasispecies, we detected no key mutations that reduced mAb activity in our patients.
Keywords: COVID-19; casirivimab; imdevimab; quasispecies; spike protein.
. 2022 Feb 21;9(4)
fac093.doi: 10.1093/ofid/ofac093. eCollection 2022 Apr.
Impact of Casirivimab-Imdevimab on Severe Acute Respiratory Syndrome Coronavirus 2 Delta Variant Nasopharyngeal Virus Load and Spike Quasispecies
Camille Vellas[SUP] 1 2 3 [/SUP], Arnaud Del Bello[SUP] 2 3 4 [/SUP], Geraldine Gaube[SUP] 5 [/SUP], Pauline Tremeaux[SUP] 1 [/SUP], Nicolas Jeanne[SUP] 1 [/SUP], Noemie Ranger[SUP] 1 [/SUP], Guillaume Martin-Blondel[SUP] 2 3 5 [/SUP], Pierre Delobel[SUP] 2 3 5 [/SUP], Nassim Kamar[SUP] 2 3 4 [/SUP], Jacques Izopet[SUP] 1 2 3 [/SUP]
Affiliations
- PMID: 35299988
- PMCID: PMC8903465
- DOI: 10.1093/ofid/ofac093
Abstract
Background: The increasing use of monoclonal antibodies (mAbs) to treat coronavirus disease 2019 raises questions about their impact on the emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) mAb-resistant variants. We assessed the impact of Casirivimab-Imdevimab on SARS-CoV-2 mutations associated with reduced mAb activity in treated patients.
Methods: We measured the nasopharyngeal (NP) viral load and sequenced the haplotypes of spike gene of 50 patients infected with the SARS-CoV-2 delta variant and treated with Casirivimab-Imdevimab using single-molecule real-time sequencing.
Results: The NP SARS-CoV-2 viral load of patients treated with Casirivimab-Imdevimab decreased from 8.13 (interquartile range [IQR], 7.06-8.59) log[SUB]10[/SUB] copies/mL pretreatment to 3.67 (IQR, 3.07-5.15) log[SUB]10[/SUB] copies/mL 7 days later (P < .001). Of the 36 patients for whom follow-up timepoints Spike sequencing were available, none of the Spike mutations that reduced mAb activity were detected.
Conclusions: Casirivimab-Imdevimab is an effective treatment for patients infected with the SARS-CoV-2 delta variant. Despite selective pressure on SARS-CoV-2 Spike quasispecies, we detected no key mutations that reduced mAb activity in our patients.
Keywords: COVID-19; casirivimab; imdevimab; quasispecies; spike protein.