ArticleTransplant infectious disease : an official journal of the Transplantation Society2022
De novo emergence of SARS-CoV-2 spike mutations in immunosuppressed patients.
Article in Transplant infectious disease : an official journal of the Transplantation Society, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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Who cites it
12 citing papers in PubMed, 20 citations in OpenAlex.
- Protracted SARS-CoV-2 Infection in B-cell Depleted Patients: Immunologic and Viral Characteristics and Response to Dual and Extended Antiviral Therapy.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2026Article
- Influence of COVID-19 on pediatric immunocompromised children: mechanism and implications for pathogenesis.Virusdisease · 2025Review
- Quasi-species prevalence and clinical impact of evolving SARS-CoV-2 lineages in European COVID-19 cohorts, January 2020 to February 2022.Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin · 2025Article
- The impact of remdesivir on SARS-CoV-2 evolution in vivo.JCI insight · 2025Article
- The Emergence of Escape Mutations in COVID-19 Following Anti-Spike Monoclonal Antibody Treatment: How Do We Tackle It?Infection and drug resistance · 2025Review
- Evolution of SARS-CoV-2 in the murine central nervous system drives viral diversification.Nature microbiology · 2024Article
- Integration of individualized and population-level molecular epidemiology data to model COVID-19 outcomes.Cell reports. Medicine · 2024Article
- SARS-CoV-2 genomics and impact on clinical care for COVID-19.The Journal of antimicrobial chemotherapy · 2023Article
- Resurgence of SARS-CoV-2 Delta after Omicron variant superinfection in an immunocompromised pediatric patient.Virology journal · 2023Article
- Host immunological responses facilitate development of SARS-CoV-2 mutations in patients receiving monoclonal antibody treatments.The Journal of clinical investigation · 2023Observational
- Article
- De novo emergence of SARS-CoV-2 spike mutations in immunosuppressed patients.Transplant infectious disease : an official journal of the Transplantation Society · 2022Article
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Authors and funding
13 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundThe continuing evolution of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants with decreased susceptibility to neutralizing antibodies is of clinical importance. Several spike mutations associated with immune escape have evolved independently in association with different variants of concern (VOCs). How and when these mutations arise is still unclear. We hypothesized that such mutations might arise in the context of persistent viral replication in immunosuppressed hosts.
methodsNasopharyngeal specimens were collected longitudinally from two immunosuppressed patients with persistent SARS-CoV-2 infection. Plasma was collected from these same patients late in disease course. SARS-CoV-2 whole genome sequencing was performed to assess the emergence and frequency of mutations over time. Select Spike mutations were assessed for their impact on viral entry and antibody neutralization in vitro.
resultsOur sequencing results revealed the intrahost emergence of spike mutations that are associated with circulating VOCs in both immunosuppressed patients (del241-243 and E484Q in one patient, and E484K in the other). These mutations decreased antibody-mediated neutralization of pseudotyped virus particles in cell culture, but also decreased efficiency of spike-mediated cell entry.
conclusionsThese observations demonstrate the de novo emergence of SARS-CoV-2 spike mutations with enhanced immune evasion in immunosuppressed patients with persistent infection. These data suggest one potential mechanism for the evolution of VOCs and emphasize the importance of continued efforts to develop antiviral drugs for suppression of viral replication in hospitalized settings.
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