Neutralizing Antispike Monoclonal Antibody Therapies Highly Efficacious in Preventing COVID-19 Hospitalization

Strategic Insights -

Researchers from the Division of Public Health have conducted a case-control study to investigate the effectiveness of neutralizing antispike monoclonal antibody (mAb) therapies in preventing COVID-19 hospitalization among solid organ transplant recipients. The study found that these therapies were highly efficacious in preventing hospitalization, despite the presence of spike protein mutations that could confer reduced in vitro susceptibility to the antibodies.

Key Takeaways:

  • The study involved 41 solid organ transplant recipients who received an antispike mAb for treatment of mild-to-moderate COVID-19 and had an available sample from initial COVID-19 diagnosis for genotypic sequencing.
  • Overall, 22% of patients (9 out of 41) had at least one spike codon mutation that confers reduced susceptibility to the antispike mAb used for treatment.
  • Among patients who received sotrovimab, 9 out of 12 patients had the S371L mutation, which was predicted to confer a 9.7-fold reduced susceptibility.
  • However, among 22 patients who required hospitalization, 5 had virus with resistance mutation, whereas among 19 control patients who did not require hospitalization, 4 also had virus-containing resistance mutations (p 0.99).
  • The study concluded that spike codon mutations were common, but mutations that conferred a 9.7-fold reduced susceptibility did not predict subsequent hospitalization after treatment with antispike mAb.

Statistics:

  • 22% of patients (9 out of 41) had at least one spike codon mutation that confers reduced susceptibility to the antispike mAb used for treatment.
  • 9 out of 12 patients who received sotrovimab had the S371L mutation, which was predicted to confer a 9.7-fold reduced susceptibility.
  • 5 out of 22 patients who required hospitalization had virus with resistance mutation.
  • 4 out of 19 control patients who did not require hospitalization had virus-containing resistance mutations (p 0.99).

Sources:

  • "SARS-CoV-2 spike codon mutations and risk of hospitalization after antispike monoclonal antibody therapy in solid organ transplant recipients." Journal of Medical Virology, 2023, 95(6).
  • https://doi-org.sdpl.idm.oclc.org/10.1002/jmv.28885
  • Mayo Clinic. Division of Public Health. Infectious Diseases and Occupational Medicine, Department of Medicine.