RESISTANCE CONFERRING MUTATIONS IN SARS-CoV-2 DELTA FOLLOWING SOTROVIMAB INFUSION

  1. Rebecca J Rockett
  2. Kerri Basile
  3. Susan Maddocks
  4. Winkie Fong
  5. Jessica E Agius
  6. Jessica Johnson Mackinnon
  7. Alicia Arnott
  8. Shona Chandra
  9. Mailie Gall
  10. Jenny Draper
  11. Elena Martinez
  12. Eby M Sim
  13. Clement Lee
  14. Christine Ngo
  15. Marc Ramsperger
  16. Andrew N Ginn
  17. Qinning Wang
  18. Michael Fennell
  19. Danny Ko
  20. H Ling Lim
  21. Nicky Gilroy
  22. Matthew V N O’Sullivan
  23. Sharon C-A Chen
  24. Jen Kok
  25. Dominic E Dwyer
  26. Vitali Sintchenko
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Abstract

Several Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) neutralising monoclonal antibodies (mAbs) have received emergency use authorisation by regulatory agencies for treatment and prevention of Coronavirus Disease 2019 (COVID-19), including in patients at risk for progression to severe disease. Here we report the persistence of viable SARS-CoV-2 in patients treated with sotrovimab and the rapid development of spike gene mutations that have been shown to confer high level resistance to sotrovimab in vitro . We highlight the need for SARS-CoV-2 genomic surveillance in at risk individuals to inform stewardship of mAbs use and prevent potential treatment failures.

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