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TRENDING OPEN SCIENCE
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Prospective mapping of viral mutations that escape antibodies used to
treat COVID-19
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By
Tyler N. Starr
Allison J. Greaney
Amin Addetia
William H. Hannon
Manish C. Choudhary
Adam S. Dingens
Jonathan Z Li
Jesse Bloom
DOI: 10.1101/2020.11.30.405472
On bioRxiv: https://biorxiv.org/content/10.1101/2020.11.30.405472v1
Antibodies are becoming a frontline therapy for SARS-CoV-2, but the
risk of viral evolutionary escape remains unclear. Here we map how all
mutations to SARS-CoV-2's receptor-binding domain (RBD) affect binding
by the antibodies in Regeneron's REGN-COV2 cocktail and Eli Lilly's
LY-CoV016. These complete maps uncover a single amino-acid mutation
that fully escapes the REGN-COV2 cocktail, which consists of two
antibodies targeting distinct structural epitopes. The maps also
identify viral mutations that are selected in a persistently infected
patient treated with REGN-COV2, as well as in lab viral escape
selections. Finally, the maps reveal that mutations escaping each
individual antibody are already present in circulating SARS-CoV-2
strains. Overall, these complete escape maps enable immediate
interpretation of the consequences of mutations observed during viral
surveillance.
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