De novo emergence of a remdesivir resistance mutation during treatment of persistent SARS-CoV-2 infection in an immunocompromised patient: a case report.


Journal

Nature communications
ISSN: 2041-1723
Titre abrégé: Nat Commun
Pays: England
ID NLM: 101528555

Informations de publication

Date de publication:
17 03 2022
Historique:
received: 26 11 2021
accepted: 28 02 2022
entrez: 18 3 2022
pubmed: 19 3 2022
medline: 5 4 2022
Statut: epublish

Résumé

SARS-CoV-2 remdesivir resistance mutations have been generated in vitro but have not been reported in patients receiving treatment with the antiviral agent. We present a case of an immunocompromised patient with acquired B-cell deficiency who developed an indolent, protracted course of SARS-CoV-2 infection. Remdesivir therapy alleviated symptoms and produced a transient virologic response, but her course was complicated by recrudescence of high-grade viral shedding. Whole genome sequencing identified a mutation, E802D, in the nsp12 RNA-dependent RNA polymerase, which was not present in pre-treatment specimens. In vitro experiments demonstrated that the mutation conferred a ~6-fold increase in remdesivir IC

Identifiants

pubmed: 35301314
doi: 10.1038/s41467-022-29104-y
pii: 10.1038/s41467-022-29104-y
pmc: PMC8930970
doi:

Substances chimiques

Antibodies, Monoclonal, Humanized 0
imdevimab 2Z3DQD2JHM
remdesivir 3QKI37EEHE
Adenosine Monophosphate 415SHH325A
Coronavirus RNA-Dependent RNA Polymerase EC 2.7.7.48
NSP12 protein, SARS-CoV-2 EC 2.7.7.48
casirivimab J0FI6WE1QN
Alanine OF5P57N2ZX

Types de publication

Case Reports Journal Article Research Support, N.I.H., Extramural Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

1547

Subventions

Organisme : NIAID NIH HHS
ID : T32 AI007517
Pays : United States
Organisme : U.S. Department of Health & Human Services | National Institutes of Health (NIH)
ID : 2T32AI007517-21A1

Commentaires et corrections

Type : UpdateOf

Informations de copyright

© 2022. The Author(s).

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Auteurs

Shiv Gandhi (S)

Section of Infectious Diseases, Department of Medicine, Yale University School of Medicine, New Haven, CT, USA. shiv.gandhi@yale.edu.

Jonathan Klein (J)

Department of Immunobiology, Yale University School of Medicine, New Haven, CT, USA.

Alexander J Robertson (AJ)

Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, USA.

Mario A Peña-Hernández (MA)

Department of Immunobiology, Yale University School of Medicine, New Haven, CT, USA.

Michelle J Lin (MJ)

Department of Laboratory Medicine, University of Washington School of Medicine, Seattle, WA, USA.

Pavitra Roychoudhury (P)

Department of Laboratory Medicine, University of Washington School of Medicine, Seattle, WA, USA.

Peiwen Lu (P)

Department of Immunobiology, Yale University School of Medicine, New Haven, CT, USA.

John Fournier (J)

Section of Infectious Diseases, Department of Medicine, Yale University School of Medicine, New Haven, CT, USA.

David Ferguson (D)

Center for Outcomes Research and Evaluation, Yale New Haven Hospital, New Haven, CT, USA.

Shah A K Mohamed Bakhash (SAK)

Department of Laboratory Medicine, University of Washington School of Medicine, Seattle, WA, USA.

M Catherine Muenker (M)

Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, USA.

Ariktha Srivathsan (A)

Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, USA.

Elsio A Wunder (EA)

Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, USA.

Nicholas Kerantzas (N)

Department of Laboratory Medicine, Yale School of Medicine, New Haven, CT, USA.

Wenshuai Wang (W)

Department of Molecular, Cellular and Developmental Biology, Yale University, New Haven, CT, USA.

Brett Lindenbach (B)

Department of Microbial Pathogenesis, Yale School of Medicine, New Haven, CT, USA.

Anna Pyle (A)

Department of Molecular, Cellular and Developmental Biology, Yale University, New Haven, CT, USA.
Department of Chemistry, Yale University, New Haven, CT, USA.
Howard Hughes Medical Institute, Chevy Chase, MD, USA.

Craig B Wilen (CB)

Department of Immunobiology, Yale University School of Medicine, New Haven, CT, USA.
Department of Laboratory Medicine, Yale School of Medicine, New Haven, CT, USA.

Onyema Ogbuagu (O)

Section of Infectious Diseases, Department of Medicine, Yale University School of Medicine, New Haven, CT, USA.

Alexander L Greninger (AL)

Department of Laboratory Medicine, University of Washington School of Medicine, Seattle, WA, USA.
Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA.

Akiko Iwasaki (A)

Department of Immunobiology, Yale University School of Medicine, New Haven, CT, USA.
Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, USA.
Department of Molecular, Cellular and Developmental Biology, Yale University, New Haven, CT, USA.
Howard Hughes Medical Institute, Chevy Chase, MD, USA.

Wade L Schulz (WL)

Center for Outcomes Research and Evaluation, Yale New Haven Hospital, New Haven, CT, USA.
Department of Laboratory Medicine, Yale School of Medicine, New Haven, CT, USA.

Albert I Ko (AI)

Section of Infectious Diseases, Department of Medicine, Yale University School of Medicine, New Haven, CT, USA. albert.ko@yale.edu.
Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, USA. albert.ko@yale.edu.

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Classifications MeSH