COVID-19 analysis of August 02, 2022

Sotrovimab linked to treatment-resistant SARS-CoV-2 Omicron mutations

According to a Dutch study published yesterday in JAMA.

Researchers at Amsterdam University Medical Centers evaluated samples of Omicron COVID-19 from 18 patients with compromised immune systems in January and February 2022. Participants were treated with an infusion of 500 milligrams of sotrovimab 1 to 23 days after diagnosis and tested for viral mutations nasally. – throat swabs on the day of treatment and 7 and 28 days later. Swabs from 14 patients were also tested 4 days before infusion and up to 52 days after.

The average patient age was 60.9 years and 83% had a weakened immune system due to underlying medical conditions or use of an immunosuppressive drug. According to genomic analysis, 17 patients were infected with the Omicron BA.1 subvariant, while 1 had BA.2.

Ten patients (56%) developed a total of nine receptor-binding domain mutations at two spike protein positions 3 to 31 days after receiving sotrovimab, whereas no such mutations were observed in Omicron samples from the general population. Participants with mutations took significantly longer to clear the virus than those without mutations (mean, 32.0 versus 19.6 days; hazard ratio, 0.11).

The authors noted that sotrovimab is one of the few monoclonal antibody treatments that still has neutralizing activity against Omicron BA.1 and can be used to treat COVID-19 patients at high risk for prolonged infection.

Spike protein mutations at the positions found in this study were linked to a 27- to 279-fold decrease in susceptibility to sotrovimab, the researchers said. “Further studies investigating combination monoclonal antibody therapy and ongoing genomic monitoring in immunocompromised patients are warranted to address the increasing antigenic diversity and subsequent emergence of resistance during COVID-19 treatment,” they said. writing.
August 1 JAMA search letter

US BA.5 The dominance of the Omicron subvariant increases

The proportion of the more transmissible BA.5 Omicron subvariant continued to increase in the United States last week, rising to 85.5% of samples sequenced, from 81.6% the previous week, according to the latest update from the Centers for Disease Control and Prevention. (CDC).

Meanwhile, the proportion of the BA.4 subvariant accounted for 7.7% of the samples, down from 9.6% the previous week.

Additionally, the number of COVID-19 cases among children rose last week for the third week in a row, according to a regular update from the American Academy of Pediatrics (AAP). Over 95,000 cases have been reported. The rise in cases comes ahead of the start of the new school year in some parts of the country.
Proportion of CDC variants update
August 1 AAP

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