2022
DOI: 10.1101/2022.05.25.22275533
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SARS-CoV-2 variants in the making: Sequential intrahost evolution and forward transmissions in the context of persistent infections

Abstract: Persistent SARS-CoV-2 infections have been reported in immune-compromised individuals and people undergoing immune-modulatory treatments. It has been speculated that the emergence of antigenically diverse SARS-CoV-2 variants such as the Omicron variant may be the result of intra-host viral evolution driven by suboptimal immune responses, which must be followed by forward transmission. However, while intrahost evolution has been documented, to our knowledge no direct evidence of subsequent forward transmission … Show more

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Cited by 13 publications
(11 citation statements)
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“…In contrast, the mutation L455W which reduces ACE2 affinity in Wuhan-Hu-1 is affinityenhancing in Omicron RBDs. While L455W is accessible via single-nucleotide mutation from the position TTG codon present in Wuhan-Hu-1 and Omicron, mutations to site 455 have not yet been important in SARS-CoV-2 variant evolution (but see [29]). This may be because all such mutations previously decreased ACE2 affinity.…”
Section: Epistatic Shifts In the Omicron Mutational Landscapementioning
confidence: 99%
“…In contrast, the mutation L455W which reduces ACE2 affinity in Wuhan-Hu-1 is affinityenhancing in Omicron RBDs. While L455W is accessible via single-nucleotide mutation from the position TTG codon present in Wuhan-Hu-1 and Omicron, mutations to site 455 have not yet been important in SARS-CoV-2 variant evolution (but see [29]). This may be because all such mutations previously decreased ACE2 affinity.…”
Section: Epistatic Shifts In the Omicron Mutational Landscapementioning
confidence: 99%
“…Unfortunately, in vivo selection evidences are so far available for sotrovimab[40] but not for Evusheld™. It should be anyway noted that R346T[41,42] and R346I[43] have been reported to spontaneously develop and fix in 3 IC patients without any selective pressure.…”
Section: Introductionmentioning
confidence: 99%
“…). Onward transmission from such chronic infections has also been documented (Gonzalez-Reiche et al ., 2022). However, to date there is no direct evidence for the mode of emergence of any variant.…”
mentioning
confidence: 96%
“…The pre-dominant hypothesis for this cryptic emergence of highly mutated, transmissible and immune evasive variants are chronic infections that are common in patients with impaired immune systems, either through HIV-1 infection (Cele et al, 2022) or medical intervention (Choi et al, 2020;Kemp et al, 2021). Onward transmission from such chronic infections has also been documented (Gonzalez-Reiche et al, 2022). However, to date there is no direct evidence for the mode of emergence of any variant.…”
mentioning
confidence: 99%
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