ArticleVirus evolution2023
Evolution of a globally unique SARS-CoV-2 Spike E484T monoclonal antibody escape mutation in a persistently infected, immunocompromised individual.
Article in Virus evolution, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 30 papers, 1 of them a synthesis that pooled it.
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Who cites it
30 citing papers in PubMed, 1 synthesis or guideline pooled it, 36 citations in OpenAlex.
- COVID-19 Convalescent Plasma for the Treatment of Immunocompromised Patients: A Systematic Review and Meta-analysis.JAMA network open · 2023Pooled it
- Molecular Characterization of Persistent SARS-CoV-2 Infections in Immunocompromised Patients.Viruses · 2026Article
- Pathology and viral evolutionary dynamics in a hamster model of persistent SARS-CoV-2 infection.Communications biology · 2026Article
- Genomic and epidemiologic characteristics of SARS-CoV-2 persistent infections in California, January 2021 - July 2023.PLoS pathogens · 2025Article
- The post-COVID-19 pulmonary sequelae: manifestations, mechanisms and treatment strategies.Journal of thoracic disease · 2025Review
- Population-level toggling of T cell immune escape at human leukocyte antigen anchor residues in SARS-CoV-2 Spike proteins, in an ethnically diverse population region.PLoS computational biology · 2025Article
- Strategies and efforts in circumventing the emergence of antiviral resistance against conventional antivirals.npj antimicrobials and resistance · 2025Review
- In-depth analysis of the risk factors for persistent severe acute respiratory syndrome coronavirus 2 infection and construction of predictive models: an exploratory research study.BMC infectious diseases · 2025Article
- Design, Synthesis, and Biological Evaluation of Peptidomimetic Tetrahydropyrrole Spirodihydroindolones as SARS-CoV-2 3CL Protease Inhibitors.ACS medicinal chemistry letters · 2025Article
- A global collaboration for systematic analysis of broad-ranging antibodies against the SARS-CoV-2 spike protein.Cell reports · 2025Article
- In depth sequencing of a serially sampled household cohort reveals the within-host dynamics of Omicron SARS-CoV-2 and rare selection of novel spike variants.PLoS pathogens · 2025Article
- Variable rates of SARS-CoV-2 evolution in chronic infections.PLoS pathogens · 2025Article
- Adaptive evolution of SARS-CoV-2 during a persistent infection for 521 days in an immunocompromised patient.NPJ genomic medicine · 2025Article
- Phylogenetic meta-analysis of persistent SARS-CoV-2 infections in immunocompromised individuals highlights the challenges of robust evolutionary rate estimation caused by low genetic diversity.Virus evolution · 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
- Intersecting SARS-CoV-2 spike mutations and global vaccine efficacy against COVID-19.Frontiers in immunology · 2025Article
- Monoclonal Antibody Therapies Against SARS-CoV-2: Promises and Realities.Current topics in microbiology and immunology · 2025Review
- The Intestine in Acute and Long COVID: Pathophysiological Insights and Key Lessons.The Yale journal of biology and medicine · 2024Review
- Characterisation of the antibody-mediated selective pressure driving intra-host evolution of SARS-CoV-2 in prolonged infection.PLoS pathogens · 2024Article
- Stuck in pandemic uncertainty: a review of the persistent effects of COVID-19 infection in immune-deficient people.Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases · 2024Review
Corrections and comments
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Authors and funding
21 authors at 4 institutions in 1 country.
Funding
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.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.