{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,27]],"date-time":"2026-09-27T01:10:07Z","timestamp":1790471407101,"version":"4.1.0"},"reference-count":82,"publisher":"MDPI AG","issue":"15","license":[{"start":{"date-parts":[[2021,7,24]],"date-time":"2021-07-24T00:00:00Z","timestamp":1627084800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001665","name":"Agence Nationale de la Recherche","doi-asserted-by":"publisher","award":["M\u00e9diterran\u00e9e-Infection 10-IAHU-03"],"award-info":[{"award-number":["M\u00e9diterran\u00e9e-Infection 10-IAHU-03"]}],"id":[{"id":"10.13039\/501100001665","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Since summer 2020, SARS-CoV-2 strains at the origin of the COVID-19 pandemic have suddenly been replaced by new SARS-CoV-2 variants, some of which are highly transmissible and spread at a high rate. These variants include the Marseille-4 lineage (Nextclade 20A.EU2) in Europe, the 20I\/501Y.V1 variant first detected in the UK, the 20H\/501Y.V2 variant first detected in South Africa, and the 20J\/501Y.V3 variant first detected in Brazil. These variants are characterized by multiple mutations in the viral spike protein that is targeted by neutralizing antibodies elicited in response to infection or vaccine immunization. The usual coronavirus mutation rate through genetic drift alone cannot account for such rapid changes. Recent reports of the occurrence of such mutations in immunocompromised patients who received remdesivir and\/or convalescent plasma or monoclonal antibodies to treat prolonged SARS-CoV-2 infections led us to hypothesize that experimental therapies that fail to cure the patients from COVID-19 could favor the emergence of immune escape SARS-CoV-2 variants. We review here the data that support this hypothesis and urge physicians and clinical trial promoters to systematically monitor viral mutations by whole-genome sequencing for patients who are administered these treatments.<\/jats:p>","DOI":"10.3390\/jcm10153276","type":"journal-article","created":{"date-parts":[[2021,7,25]],"date-time":"2021-07-25T22:06:21Z","timestamp":1627250781000},"page":"3276","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":24,"title":["A Possible Role of Remdesivir and Plasma Therapy in the Selective Sweep and Emergence of New SARS-CoV-2 Variants"],"prefix":"10.3390","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6285-0308","authenticated-orcid":false,"given":"Philippe","family":"Colson","sequence":"first","affiliation":[{"name":"IHU M\u00e9diterran\u00e9e Infection, 19-21 Boulevard Jean Moulin, 13005 Marseille, France"},{"name":"Microbes Evolution Phylogeny and Infections (MEPHI), Institut de Recherche pour le D\u00e9veloppement (IRD), Aix-Marseille University, 27 Boulevard Jean Moulin, 13005 Marseille, France"},{"name":"Assistance Publique-H\u00f4pitaux de Marseille (AP-HM), 264 rue Saint-Pierre, 13005 Marseille, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian A.","family":"Devaux","sequence":"additional","affiliation":[{"name":"IHU M\u00e9diterran\u00e9e Infection, 19-21 Boulevard Jean Moulin, 13005 Marseille, France"},{"name":"Microbes Evolution Phylogeny and Infections (MEPHI), Institut de Recherche pour le D\u00e9veloppement (IRD), Aix-Marseille University, 27 Boulevard Jean Moulin, 13005 Marseille, France"},{"name":"CNRS, 13009 Marseille, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean-Christophe","family":"Lagier","sequence":"additional","affiliation":[{"name":"IHU M\u00e9diterran\u00e9e Infection, 19-21 Boulevard Jean Moulin, 13005 Marseille, France"},{"name":"Microbes Evolution Phylogeny and Infections (MEPHI), Institut de Recherche pour le D\u00e9veloppement (IRD), Aix-Marseille University, 27 Boulevard Jean Moulin, 13005 Marseille, France"},{"name":"Assistance Publique-H\u00f4pitaux de Marseille (AP-HM), 264 rue Saint-Pierre, 13005 Marseille, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philippe","family":"Gautret","sequence":"additional","affiliation":[{"name":"IHU M\u00e9diterran\u00e9e Infection, 19-21 Boulevard Jean Moulin, 13005 Marseille, France"},{"name":"Assistance Publique-H\u00f4pitaux de Marseille (AP-HM), 264 rue Saint-Pierre, 13005 Marseille, France"},{"name":"Vecteurs-Infections Tropicales et M\u00e9diterran\u00e9ennes (VITROME), Institut de Recherche pour le D\u00e9veloppement (IRD), Aix-Marseille University, 27 Boulevard Jean Moulin, 13005 Marseille, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Didier","family":"Raoult","sequence":"additional","affiliation":[{"name":"IHU M\u00e9diterran\u00e9e Infection, 19-21 Boulevard Jean Moulin, 13005 Marseille, France"},{"name":"Microbes Evolution Phylogeny and Infections (MEPHI), Institut de Recherche pour le D\u00e9veloppement (IRD), Aix-Marseille University, 27 Boulevard Jean Moulin, 13005 Marseille, France"},{"name":"Assistance Publique-H\u00f4pitaux de Marseille (AP-HM), 264 rue Saint-Pierre, 13005 Marseille, France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,7,24]]},"reference":[{"key":"ref_1","first-page":"270","article-title":"A pneumonia outbreak associated with a new coronavirus of probable bat origin","volume":"579","author":"Zhou","year":"2020","journal-title":"Nat. Cell Biol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1464","DOI":"10.1126\/science.abe8499","article-title":"SARS-CoV-2 D614G variant exhibits efficient replication ex vivo and transmission in vivo","volume":"370","author":"Hou","year":"2020","journal-title":"Science"},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Long, S.W., Olsen, R.J., Christensen, P.A., Bernard, D.W., Davis, J.J., Shukla, M., Nguyen, M., Saavedra, M.O., Yerramilli, P., and Pruitt, L. (2020). Molecular Architecture of Early Dissemination and Massive Second Wave of the SARS-CoV-2 Virus in a Major Metropolitan Area. mBio, 11.","DOI":"10.1128\/mBio.02707-20"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"104585","DOI":"10.1016\/j.jcv.2020.104585","article-title":"SARS-CoV-2 exhibits intra-host genomic plasticity and low-frequency polymorphic quasispecies","volume":"131","author":"Karamitros","year":"2020","journal-title":"J. Clin. Virol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1560.e1","DOI":"10.1016\/j.cmi.2020.07.032","article-title":"Evolution of viral quasispecies during SARS-CoV-2 infection","volume":"26","author":"Jary","year":"2020","journal-title":"Clin. Microbiol. Infect."},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Colson, P., and Raoult, D. (2021). Global Discrepancies between Numbers of Available SARS-CoV-2 Genomes and Human Development Indexes at Country Scales. Viruses, 13.","DOI":"10.3390\/v13050775"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1176934320965149","DOI":"10.1177\/1176934320965149","article-title":"New Pathways of Mutational Change in SARS-CoV-2 Proteomes Involve Regions of Intrinsic Disorder Important for Virus Replication and Release","volume":"16","author":"Tomaszewski","year":"2020","journal-title":"Evol. Bioinform. Online"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"101980","DOI":"10.1016\/j.tmaid.2021.101980","article-title":"Introduction into the Marseille geographical area of a mild SARS-CoV-2 variant originating from sub-Saharan Africa: An investigational study","volume":"40","author":"Colson","year":"2021","journal-title":"Travel Med. Infect. Dis."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"228","DOI":"10.1016\/j.ijid.2021.03.068","article-title":"Emergence and outcomes of the SARS-CoV-2 \u2018Marseille-4\u2032 variant","volume":"106","author":"Fournier","year":"2021","journal-title":"Int. J. Infect. Dis."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"172","DOI":"10.1126\/science.abe5901","article-title":"Transmission of SARS-CoV-2 on mink farms between humans and mink and back to humans","volume":"371","author":"Munnink","year":"2020","journal-title":"Sci."},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Tchesnokova, V., Kulakesara, H., Larson, L., Bowers, V., Rechkina, E., Kisiela, D., Sledneva, Y., Choudhury, D., Maslova, I., and Deng, K. (2021). Acquisition of the L452R mutation in the ACE2-binding interface of Spike protein triggers recent massive expansion of SARS-Cov-2 variants. BioRxiv.","DOI":"10.1101\/2021.02.22.432189"},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Hodcroft, E.B., Domman, D.B., Snyder, D.J., Oguntuyo, K., Van Diest, M., Densmore, K.H., Schwalm, K.C., Femling, J., Carroll, J.L., and Scott, R.S. (2021). Emergence in late 2020 of multiple lineages of SARS-CoV-2 Spike protein variants affecting amino acid position 677. MedRxiv, 21251658.","DOI":"10.1101\/2021.02.12.21251658"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"2291","DOI":"10.1056\/NEJMc2031364","article-title":"Persistence and Evolution of SARS-CoV-2 in an Immunocompromised Host","volume":"383","author":"Choi","year":"2020","journal-title":"N. Engl. J. Med."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1155","DOI":"10.1126\/science.2479983","article-title":"Multiple mutations in HIV-1 reverse transcriptase confer high-level resistance to zidovudine (AZT)","volume":"246","author":"Larder","year":"1989","journal-title":"Sci."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"2571","DOI":"10.1080\/22221751.2020.1852058","article-title":"Prolonged shedding of severe acute respiratory syndrome coronavirus 2 in patients with COVID-19","volume":"9","author":"Li","year":"2020","journal-title":"Emerg. Microbes Infect."},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Drancourt, M., Cortaredona, S., Melenotte, C., Amrane, S., Eldin, C., La Scola, B., Parola, P., Million, M., Lagier, J.-C., and Raoult, D. (2021). SARS-CoV-2 Persistent Viral Shedding in the Context of Hydroxychloroquine-Azithromycin Treatment. Viruses, 13.","DOI":"10.3390\/v13050890"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"665","DOI":"10.21037\/atm-21-445","article-title":"Clinical features in coronavirus disease 2019 (COVID-19) patients with early clearance and prolonged shedding of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA","volume":"9","author":"Zhou","year":"2021","journal-title":"Ann. Transl. Med."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"104810","DOI":"10.1016\/j.micinf.2021.104810","article-title":"Prolonged viral shedding and antibody persistence in patients with COVID-19","volume":"23","author":"Fotouhi","year":"2021","journal-title":"Microbes Infect."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1069","DOI":"10.14336\/AD.2020.0630","article-title":"Clinical Factors Associated with Progression and Prolonged Viral Shedding in COVID-19 Patients: A Multicenter Study","volume":"11","author":"Feng","year":"2020","journal-title":"Aging Dis."},{"key":"ref_20","first-page":"277","article-title":"SARS-CoV-2 evolution during treatment of chronic infection","volume":"592","author":"Kemp","year":"2021","journal-title":"Nat. Cell Biol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1093\/infdis\/jiaa666","article-title":"Prolonged Severe Acute Respiratory Syndrome Coronavirus 2 Replication in an Immunocompromised Patient","volume":"223","author":"Baang","year":"2021","journal-title":"J. Infect. Dis."},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Hensley, M.K., Bain, W.G., Jacobs, J., Nambulli, S., Parikh, U., Cillo, A., Staines, B., Heaps, A., Sobolewski, M.D., and Rennick, L.J. (2021). Intractable Coronavirus Disease 2019 (COVID-19) and Prolonged Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Replication in a Chimeric Antigen Receptor-Modified T-Cell Therapy Recipient: A Case Study. Clin. Infect. Dis.","DOI":"10.1093\/cid\/ciab072"},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Sepulcri, C., Dentone, C., Mikulska, M., Bruzzone, B., Lai, A., Fenoglio, D., Bozzano, F., Bergna, A., Parodi, A., and Altosole, T. (2021). The longest persistence of viable SARS-CoV-2 with recurrence of viremia and relapsing symptomatic COVID-19 in an immunocompromized patient\u2014A case study. MedRxiv.","DOI":"10.1101\/2021.01.23.21249554"},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Weigang, S., Fuchs, J., Zimmer, G., Schnepf, D., Kern, L., Beer, J., Luxenburger, H., Ankerhold, J., Falcone, V., and Kemming, J. (2021). Within-host evolution of SARS-CoV-2 in an immunosuppressed COVID-19 patient: A source of immune escape variants. MedRxiv.","DOI":"10.1101\/2021.04.30.21256244"},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Khatamzas, E., Rehn, A., Muenchhoff, M., Hellmuth, J., Gaitzsch, E., Weiglein, T., Georgi, E., Scherer, C., Stecher, S., and Weigert, O. (2021). Emergence of multiple SARS-CoV-2 mutations in an immunocompromized host. MedRxiv.","DOI":"10.1101\/2021.01.10.20248871"},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Chen, L. (2021). Emergence of multiple SARS-CoV-2 antibody escape variants in an immunocompromized host undergoing convalescent plasma treatment. MedRxiv.","DOI":"10.1101\/2021.04.08.21254791"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1901","DOI":"10.1016\/j.cell.2020.10.049","article-title":"Case Study: Prolonged Infectious SARS-CoV-2 Shedding from an Asymptomatic Immunocompromised Individual with Cancer","volume":"183","author":"Avanzato","year":"2020","journal-title":"Cell"},{"key":"ref_28","first-page":"1198","article-title":"Spreading of a new SARS-CoV-2 N501Y spike variant in a new lineage","volume":"12","author":"Colson","year":"2021","journal-title":"Clin. Microbiol. Infect."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1540","DOI":"10.3201\/eid2705.210324","article-title":"Novel SARS-CoV-2 Variant Derived from Clade 19B, France","volume":"27","author":"Fourati","year":"2021","journal-title":"Emerg. Infect. Dis."},{"key":"ref_30","unstructured":"Davies, N.G., Barnard, R.C., Jarvis, C.I., Kucharski, A.J., Munday, J., Pearson, C.A.B., Russell, T.W., Tully, D.C., Abbott, S., and Gimma, A. (2020). Estimated Transmissibility and Severity of Novel SARS-CoV-2 Variant of Concern 202012\/01 in England. medRxiv."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"2002106","DOI":"10.2807\/1560-7917.ES.2020.26.1.2002106","article-title":"Early transmissibility assessment of the N501Y mutant strains of SARS-CoV-2 in the United Kingdom, October to November 2020","volume":"26","author":"Leung","year":"2021","journal-title":"Eurosurveillance"},{"key":"ref_32","unstructured":"Tegally, H., Wilkinson, E., Giovanetti, M., Iranzadeh, A., Fonseca, V., Giandhari, J., Doolabh, D., Pillay, S., San, E.J., and Msomi, N. (2020). Emergence and rapid spread of a new severe acute respiratory syndrome-related coronavirus 2 (SARS-CoV-2) line-age with multiple spike mutations in South Africa. medRxiv."},{"key":"ref_33","unstructured":"Faria, N.R., Claro, I.M., Candido, D., Moyses Franco, L.A., Andrade, P.S., Coletti, T.M., Silva, C.A.M., Sales, F.C., Manuli, E.R., and Aguiar, R.S. (2021). Genomic Characterisation of an Emergent SARS-CoV-2 Lineage in Manaus: Preliminary Findings. Virological, 1\u20139. Available online: https:\/\/virological.org\/t\/genomic-characterisation-of-an-emergent-sars-cov-2-lineage-in-manaus-preliminary-findings\/586."},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Cherian, S., Potdar, V., Jadhav, S., Yadav, P., Gupta, N., Das, M., Das, S., Agarwal, A., Singh, S., and Abraham, P. (2021). Convergent evolution of SARS-CoV-2 spike mutations, L452R, E484Q and P681R, in the second wave of COVID-19 in Maharashtra, India. MedRxiv.","DOI":"10.1101\/2021.04.22.440932"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"463","DOI":"10.1016\/j.chom.2021.02.003","article-title":"Comprehensive mapping of mutations in the SARS-CoV-2 receptor-binding domain that affect recognition by polyclonal human plasma antibodies","volume":"29","author":"Greaney","year":"2021","journal-title":"Cell Host Microbe"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"1024","DOI":"10.1016\/j.cell.2020.09.037","article-title":"Mapping Neutralizing and Immunodominant Sites on the SARS-CoV-2 Spike Receptor-Binding Domain by Structure-Guided High-Resolution Serology","volume":"183","author":"Piccoli","year":"2020","journal-title":"Cell"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"23652","DOI":"10.1073\/pnas.2008281117","article-title":"A SARS-CoV-2 vaccine candidate would likely match all currently circulating variants","volume":"117","author":"Dearlove","year":"2020","journal-title":"Proc. Natl. Acad. Sci. USA"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"24614","DOI":"10.1073\/pnas.2017726117","article-title":"Low genetic diversity may be an Achilles heel of SARS-CoV-2","volume":"117","author":"Rausch","year":"2020","journal-title":"Proc. Natl. Acad. Sci. USA"},{"key":"ref_39","doi-asserted-by":"crossref","unstructured":"Liu, Z., Van Blargan, L.A., Bloyet, L.M., Rothlauf, P.W., Chen, R.E., Stumpf, S., Zhao, H., Errico, J.M., Theel, E.S., and Liebeskind, M.J. (2020). Landscape analysis of escape variants identifies SARS-CoV-2 spike mutations that attenuate monoclonal and serum antibody neutralization. BioRxiv.","DOI":"10.1101\/2020.11.06.372037"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"221","DOI":"10.1016\/j.micinf.2020.03.003","article-title":"Predicting the angiotensin converting enzyme 2 (ACE2) utilizing capability as the receptor of SARS-CoV-2","volume":"22","author":"Qiu","year":"2020","journal-title":"Microbes Infect."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"682","DOI":"10.1038\/s41586-020-2852-1","article-title":"SARS-CoV-2 neutralizing antibody structures inform therapeutic strategies","volume":"588","author":"Barnes","year":"2020","journal-title":"Nature"},{"key":"ref_42","doi-asserted-by":"crossref","unstructured":"Nguyen, H.T., Zhang, S., Wang, Q., Anang, S., Wang, J., Ding, H., Kappes, J.C., and Sodroski, J. (2021). Spike Glycoprotein and Host Cell Determinants of SARS-CoV-2 Entry and Cytopathic Effects. J. Virol., 95.","DOI":"10.1128\/JVI.02304-20"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"622","DOI":"10.1038\/s41591-021-01285-x","article-title":"SARS-CoV-2 501Y.V2 escapes neutralization by South African COVID-19 donor plasma","volume":"27","author":"Wibmer","year":"2021","journal-title":"Nat. Med."},{"key":"ref_44","unstructured":"Collier, D.A., Meng, B., Ferreira, I., Datir, R., The CITIID-NIHR BioResource COVID-19 Collaboration, Temperton, N., Elmer, A., Kingston, N., Graves, B., and McCoy, L.E. (2021). Impact of SARS-CoV-2 B.1.1.7 Spike Variant on Neutralisation Potency of Sera from Individuals Vaccinated with Pfizer Vaccine BNT162b2. medRxiv."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"215","DOI":"10.1038\/s41586-020-2180-5","article-title":"Structure of the SARS-CoV-2 spike receptor-binding domain bound to the ACE2 receptor","volume":"581","author":"Lan","year":"2020","journal-title":"Nature"},{"key":"ref_46","doi-asserted-by":"crossref","unstructured":"Harrington, D., Kele, B., Pereira, S., Couto-Parada, X., Riddell, A., Forbes, S., Dobbie, H., and Cutino-Moguel, T. (2021). Confirmed Reinfection With Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Variant VOC-202012\/01. Clin. Infect. Dis.","DOI":"10.1093\/cid\/ciab014"},{"key":"ref_47","doi-asserted-by":"crossref","unstructured":"Zucman, N., Uhel, F., Descamps, D., Roux, D., and Ricard, J.-D. (2021). Severe Reinfection With South African Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Variant 501Y.V2. Clin. Infect. Dis.","DOI":"10.1093\/cid\/ciab129"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"1522","DOI":"10.3201\/eid2705.210191","article-title":"Genomic Evidence of SARS-CoV-2 Reinfection Involving E484K Spike Mutation, Brazil","volume":"27","author":"Nonaka","year":"2021","journal-title":"Emerg. Infect. Dis."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"e13537","DOI":"10.1111\/eci.13537","article-title":"COVID-19 re-infection","volume":"51","author":"Brouqui","year":"2021","journal-title":"Eur. J. Clin. Investig."},{"key":"ref_50","doi-asserted-by":"crossref","unstructured":"Andreano, E., Piccini, G., Licastro, D., Casalino, L., Johnson, N.V., Paciello, I., Monego, S.D., Pantano, E., Manganaro, N., and Manenti, A. (2020). SARS-CoV-2 escape in vitro from a highly neutralizing COVID-19 convalescent plasma. BioRxiv.","DOI":"10.1101\/2020.12.28.424451"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"483","DOI":"10.1016\/j.ijid.2020.09.015","article-title":"Antibody-dependent enhancement of coronavirus","volume":"100","author":"Wen","year":"2020","journal-title":"Int. J. Infect. Dis."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"12980","DOI":"10.1073\/pnas.1117201109","article-title":"A quantitative quasispecies theory-based model of virus escape mutation under immune selection","volume":"109","author":"Woo","year":"2012","journal-title":"Proc. Natl. Acad. Sci. USA"},{"key":"ref_53","first-page":"E162","article-title":"Structural and molecular basis of mismatch correction and ribavirin excision from coronavirus RNA","volume":"115","author":"Ferron","year":"2017","journal-title":"Proc. Natl. Acad. Sci. USA"},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1016\/bs.aivir.2016.08.008","article-title":"The Nonstructural Proteins Directing Coronavirus RNA Synthesis and Processing","volume":"96","author":"Snijder","year":"2016","journal-title":"Adv. Virus Res."},{"key":"ref_55","unstructured":"Jackson, B., Rambaut, A., Pybus, O.G., Robertson, D.L., Connor, T., and Loman, N.J. (2021, May 26). Recombinant SARS-CoV-2 Genomes Involving Lineage B.1.1.7 in the UK. Virological.org. Available online: https:\/\/virological.org\/t\/recombinant-sars-cov-2-genomes-Involving-lineage-b-1-1-7-in-the-uk\/658."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"812","DOI":"10.1016\/j.cell.2020.06.043","article-title":"Tracking Changes in SARS-CoV-2 Spike: Evidence that D614G Increases Infectivity of the COVID-19 Virus","volume":"182","author":"Korber","year":"2020","journal-title":"Cell"},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"450","DOI":"10.4103\/ijmr.IJMR_1125_20","article-title":"Analysis of RNA sequences of 3636 SARS-CoV-2 collected from 55 countries reveals selective sweep of one virus type","volume":"151","author":"Majumder","year":"2020","journal-title":"Indian J. Med Res."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"e61312","DOI":"10.7554\/eLife.61312","article-title":"Escape from neutralizing antibodies by SARS-CoV-2 spike protein variants","volume":"9","author":"Weisblum","year":"2020","journal-title":"eLife"},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"1284","DOI":"10.1016\/j.cell.2020.07.012","article-title":"The Impact of Mutations in SARS-CoV-2 Spike on Viral Infectivity and Antigenicity","volume":"182","author":"Li","year":"2020","journal-title":"Cell"},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"1171","DOI":"10.1016\/j.cell.2021.01.037","article-title":"Circulating SARS-CoV-2 spike N439K variants maintain fitness while evading antibody-mediated immunity","volume":"184","author":"Thomson","year":"2021","journal-title":"Cell"},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"108459","DOI":"10.1016\/j.clim.2020.108459","article-title":"Immunoglobulins in the treatment of COVID-19 infection: Proceed with caution!","volume":"216","author":"Nguyen","year":"2020","journal-title":"Clin. Immunol"},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"647","DOI":"10.1038\/s41423-020-0426-7","article-title":"Human monoclonal antibodies block the binding of SARS-CoV-2 spike protein to angiotensin converting enzyme 2 receptor","volume":"17","author":"Chen","year":"2020","journal-title":"Cell. Mol. Immunol."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"2290","DOI":"10.1182\/blood.2020008423","article-title":"Convalescent plasma therapy for B-cell\u2013depleted patients with protracted COVID-19","volume":"136","author":"Hueso","year":"2020","journal-title":"Blood"},{"key":"ref_64","doi-asserted-by":"crossref","unstructured":"Hoffmann, M., Arora, P., Gro\u00df, R., Seidel, A., H\u00f6rnich, B., Hahn, A., Kr\u00fcger, N., Graichen, L., Hofmann-Winkler, H., and Kempf, A. (2021). SARS-CoV-2 variants B.1.351 and B.1.1.248: Escape from therapeutic antibodies and antibodies induced by infection and vaccination. BioRxiv.","DOI":"10.1101\/2021.02.11.430787"},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"2348","DOI":"10.1016\/j.cell.2021.02.037","article-title":"Evidence of escape of SARS-CoV-2 variant B.1.351 from natural and vaccine-induced sera","volume":"184","author":"Zhou","year":"2021","journal-title":"Cell"},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"6785","DOI":"10.1074\/jbc.RA120.013679","article-title":"Remdesivir is a direct-acting antiviral that inhibits RNA-dependent RNA polymerase from severe acute respiratory syndrome coronavirus 2 with high potency","volume":"295","author":"Gordon","year":"2020","journal-title":"J. Biol. Chem."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"1499","DOI":"10.1126\/science.abc1560","article-title":"Su, H.; Wang, X.; Zhou, F.; Zhao, W.; Gao, M.; et al. Structural basis for inhibition of the RNA dependent RNA polymerase from SARS-CoV-2 by remdesivir","volume":"368","author":"Yin","year":"2020","journal-title":"Science"},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"e00221-18","DOI":"10.1128\/mBio.00221-18","article-title":"Coronavirus Susceptibility to the Antiviral Remdesivir (GS-5734) Is Mediated by the Viral Polymerase and the Proofreading Exoribonuclease","volume":"9","author":"Agostini","year":"2018","journal-title":"mBio"},{"key":"ref_69","doi-asserted-by":"crossref","unstructured":"Martinot, M., Jary, A., Fafi-Kremer, S., Leducq, V., Delagreverie, H., Garnier, M., Pacanowski, J., M\u00e9kinian, A., Pirenne, F., and Tiberghien, P. (2020). Remdesivir failure with SARS-CoV-2 RNA-dependent RNA-polymerase mutation in a B-cell immunodeficient patient with protracted Covid-19. Clin. Infect. Dis.","DOI":"10.1093\/cid\/ciaa1474"},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"26946","DOI":"10.1073\/pnas.2012294117","article-title":"Remdesivir targets a structurally analogous region of the Ebola virus and SARS-CoV-2 polymerases","volume":"117","author":"Lo","year":"2020","journal-title":"Proc. Natl. Acad. Sci. USA"},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12967-020-02344-6","article-title":"Emerging SARS-CoV-2 mutation hot spots include a novel RNA-dependent-RNA polymerase variant","volume":"18","author":"Pachetti","year":"2020","journal-title":"J. Transl. Med."},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1038\/s41467-020-18463-z","article-title":"Rapid incorporation of Favipiravir by the fast and permissive viral RNA polymerase complex results in SARS-CoV-2 lethal mutagenesis","volume":"11","author":"Shannon","year":"2020","journal-title":"Nat. Commun."},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"eabb5883","DOI":"10.1126\/scitranslmed.abb5883","article-title":"An orally bioavailable broad-spectrum antiviral inhibits SARS-CoV-2 in human airway epithelial cell cultures and multiple coronaviruses in mice","volume":"12","author":"Sheahan","year":"2020","journal-title":"Sci. Transl. Med."},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"104793","DOI":"10.1016\/j.antiviral.2020.104793","article-title":"Remdesivir and SARS-CoV-2: Structural requirements at both nsp12 RdRp and nsp14 Exonuclease active-sites","volume":"178","author":"Shannon","year":"2020","journal-title":"Antivir. Res."},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"28115","DOI":"10.1039\/D0CP05297C","article-title":"Role of different tautomers in the base-pairing abilities of some of the vital antiviral drugs used against COVID-19","volume":"22","author":"Jena","year":"2020","journal-title":"Phys. Chem. Chem. Phys."},{"key":"ref_76","doi-asserted-by":"crossref","unstructured":"Tchesnokov, E.P., Feng, J.Y., Porter, D.P., and G\u00f6tte, M. (2019). Mechanism of Inhibition of Ebola Virus RNA-Dependent RNA Polymerase by Remdesivir. Viruses, 11.","DOI":"10.3390\/v11040326"},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1261\/rna.048371.114","article-title":"Role of tautomerism in RNA biochemistry","volume":"21","author":"Singh","year":"2014","journal-title":"RNA"},{"key":"ref_78","doi-asserted-by":"crossref","unstructured":"Szemiel, A.M., Szemiel, A.M., Merits, A., Orton, R.J., MacLean, O., Pinto, R.M., Wickenhagen, A., Lieber, G., Turnbull, M.L., and Wang, S. (2021). In vitro evolution of remdesivir resistance reveals genome plasticity of SARS-CoV-2. BioRxiv.","DOI":"10.1101\/2021.02.01.429199"},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"52","DOI":"10.1038\/nrg1246","article-title":"The causes and consequences of HIV evolution","volume":"5","author":"Rambaut","year":"2004","journal-title":"Nat. Rev. Genet."},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"5986","DOI":"10.1038\/s41467-020-19818-2","article-title":"No evidence for increased transmissibility from recurrent mutations in SARS-CoV-2","volume":"11","author":"Richard","year":"2020","journal-title":"Nat. Commun."},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"663815","DOI":"10.3389\/fmicb.2021.663815","article-title":"Mink, SARS-CoV-2, and the Human-Animal Interface","volume":"12","author":"Fenollar","year":"2021","journal-title":"Front. Microbiol."},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"1522","DOI":"10.1093\/infdis\/jiab075","article-title":"Long-Term Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Infectiousness Among Three Immunocompromised Patients: From Prolonged Viral Shedding to SARS-CoV-2 Superinfection","volume":"223","author":"Tarhini","year":"2021","journal-title":"J. Infect. Dis."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/10\/15\/3276\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T06:34:33Z","timestamp":1760164473000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/10\/15\/3276"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,7,24]]},"references-count":82,"journal-issue":{"issue":"15","published-online":{"date-parts":[[2021,8]]}},"alternative-id":["jcm10153276"],"URL":"https:\/\/doi.org\/10.3390\/jcm10153276","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,7,24]]}}}