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SARS-CoV-2 May Become Resistant, Mutate After Sotrovimab Treatment

(Reuters) – COVID-19 patients who receive one of the few antibody treatments that works against the Omicron variant must be carefully monitored because after the drug is infused, the virus may mutate and become resistant to it, researchers warned after seeing such cases with Delta variant patients.

They studied 100 patients infected with the Delta variant who were treated with an intravenous dose of sotrovimab from GlaxoSmithKline and Vir Biotechnology. Eight of the patients continued to shed infectious virus for longer than doctors expected, and tests showed that four of the eight had virus particles with mutations that are known to reduce the drug’s effectiveness. The mutations had developed within six to 13 days after the patients started receiving the drug, the research team reported in The New England Journal of Medicine.

The same mutations were seen in four of 45 participants in a clinical trial of the drug, said Rebecca Rockett of the University of Sydney, Australia, the report’s lead author.

Genetic studies of virus samples are warranted when patients do not recover as expected after sotrovimab treatment, she said. “It’s important to bear in mind that these treatment-resistance mutations are uncommon,” Rockett added. “However, our study highlights the need for better surveillance and further research to ensure that novel antiviral treatments remain effective and if resistance develops, it is not transmitted into the community.”

SOURCE: The New England Journal of Medicine, online March 9, 2022.

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