Newly emerging SARS-CoV-2 variants may escape monoclonal antibodies (mAbs) and antiviral drugs.
By using live virus assays, we assessed the ex vivo inhibition of the B.1 wild-type (WT), delta and omicron BA.1 and BA.2 lineages by post-infusion sera from 40 individuals treated with bamlanivimab/etesevimab (BAM/ETE), casirivimab/imdevimab (CAS/IMD), and sotrovimab (SOT) as well as the activity of remdesivir, nirmatrelvir and molnupiravir. mAbs and drug activity were defined as the serum dilution (ID50) and drug concentration (IC50), respectively, showing 50% protection of virus-induced cytopathic effect.
BAM/ETE, CAS/IMD, and SOT showed activity against the WT and the delta. Notably, only SOT was active against BA.1, whereas BA.2 was neutralized by CAS/IMD and SOT, but not by BAM/ETE. No significant inter-variant IC50 differences were observed for molnupiravir, nirmatrelvir or remdesivir.
The results indicate that continued evolution of SARS-CoV-2 requires updating the mAbs arsenal, although antivirals have so far remained unaffected. https://www.mdpi.com/1999-4915/14/7/1374