A Possible Role of Remdesivir and Plasma Therapy in the Selective Sweep and Emergence of New SARS-CoV-2 Variants.

A Possible Role of Remdesivir and Plasma Therapy in the Selective Sweep and Emergence of New SARS-CoV-2 Variants.
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DOI:
10.3390/jcm10153276
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发表时间:
2021-07-24
影响因子:
3.9
通讯作者:
Raoult D
Raoult D
中科院分区:
医学2区
文献类型:
--
作者:
Colson P;Devaux CA;Lagier JC;Gautret P;Raoult D

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自2020年夏季以来,COVID-19大流行起源的SARS-CoV-2毒株突然被新的SARS-CoV-2变种所取代,其中一些具有高传染性和高传播率。这些变种包括马赛-4世系(Nextclade 20A)。EU2)在欧洲,20I/501Y。V1型首先在英国被发现,20H/501Y。V2型首先在南非被发现,和20J/501Y型。V3变异首先在巴西发现。这些变异的特点是病毒刺突蛋白发生多重突变,在感染或疫苗免疫反应中,病毒刺突蛋白被中和抗体靶向。仅凭遗传漂变导致的冠状病毒突变率无法解释如此迅速的变化。最近有报道称,在接受瑞德西韦和/或恢复期血浆或单克隆抗体治疗长期SARS-CoV-2感染的免疫功能低下患者中发生了这种突变,这使我们假设,未能治愈COVID-19患者的实验性疗法可能有利于免疫逃逸SARS-CoV-2变体的出现。我们在此回顾了支持这一假设的数据,并敦促医生和临床试验发起人通过对接受这些治疗的患者进行全基因组测序来系统地监测病毒突变。
Since summer 2020, SARS-CoV-2 strains at the origin of the COVID-19 pandemic have suddenly been replaced by new SARS-CoV-2 variants, some of which are highly transmissible and spread at a high rate. These variants include the Marseille-4 lineage (Nextclade 20A.EU2) in Europe, the 20I/501Y.V1 variant first detected in the UK, the 20H/501Y.V2 variant first detected in South Africa, and the 20J/501Y.V3 variant first detected in Brazil. These variants are characterized by multiple mutations in the viral spike protein that is targeted by neutralizing antibodies elicited in response to infection or vaccine immunization. The usual coronavirus mutation rate through genetic drift alone cannot account for such rapid changes. Recent reports of the occurrence of such mutations in immunocompromised patients who received remdesivir and/or convalescent plasma or monoclonal antibodies to treat prolonged SARS-CoV-2 infections led us to hypothesize that experimental therapies that fail to cure the patients from COVID-19 could favor the emergence of immune escape SARS-CoV-2 variants. We review here the data that support this hypothesis and urge physicians and clinical trial promoters to systematically monitor viral mutations by whole-genome sequencing for patients who are administered these treatments.
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