{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T21:36:27Z","timestamp":1790804187235,"version":"4.1.0"},"reference-count":72,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2024,1,31]],"date-time":"2024-01-31T00:00:00Z","timestamp":1706659200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Ministero della Salute: Ricerca Corrente\u2014linea 1"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Viruses"],"abstract":"<jats:p>Among the anti-Spike monoclonal antibodies (mAbs), the S-309 derivative sotrovimab was the most successful in having the longest temporal window of clinical use, showing a high degree of resiliency to SARS-CoV-2 evolution interrupted only by the appearance of the BA.2.86* variant of interest (VOI). This success undoubtedly reflects rational selection to target a highly conserved epitope in coronavirus Spike proteins. We review here the efficacy of sotrovimab against different SARS-CoV-2 variants in outpatients and inpatients, discussing both randomized controlled trials and real-world evidence. Although it could not be anticipated at the time of its development and introduction, sotrovimab\u2019s use in immunocompromised individuals who harbor large populations of variant viruses created the conditions for its eventual demise, as antibody selection and viral evolution led to its eventual withdrawal due to inefficacy against later variant lineages. Despite this, based on observational and real-world data, some authorities have continued to promote the use of sotrovimab, but the lack of binding to newer variants strongly argues for the futility of continued use. The story of sotrovimab highlights the power of modern biomedical science to generate novel therapeutics while also providing a cautionary tale for the need to devise strategies to minimize the emergence of resistance to antibody-based therapeutics.<\/jats:p>","DOI":"10.3390\/v16020217","type":"journal-article","created":{"date-parts":[[2024,1,31]],"date-time":"2024-01-31T09:41:59Z","timestamp":1706694119000},"page":"217","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":42,"title":["Sotrovimab: A Review of Its Efficacy against SARS-CoV-2 Variants"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8811-195X","authenticated-orcid":false,"given":"Daniele","family":"Focosi","sequence":"first","affiliation":[{"name":"North-Western Tuscany Blood Bank, Pisa University Hospital, via Paradisa 2, 56124 Pisa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9402-9167","authenticated-orcid":false,"given":"Arturo","family":"Casadevall","sequence":"additional","affiliation":[{"name":"Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8795-0580","authenticated-orcid":false,"given":"Massimo","family":"Franchini","sequence":"additional","affiliation":[{"name":"Department of Transfusion Medicine and Hematology, Carlo Poma Hospital, 46100 Mantua, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7489-5271","authenticated-orcid":false,"given":"Fabrizio","family":"Maggi","sequence":"additional","affiliation":[{"name":"National Institute for Infectious Diseases \u201cLazzaro Spallanzani\u201d IRCCS, 00149 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,1,31]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"290","DOI":"10.1038\/s41586-020-2349-y","article-title":"Cross-neutralization of SARS-CoV-2 by a human monoclonal SARS-CoV antibody","volume":"583","author":"Pinto","year":"2020","journal-title":"Nature"},{"key":"ref_2","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_3","doi-asserted-by":"crossref","unstructured":"Finkelstein, M.T., Mermelstein, A.G., Parker Miller, E., Seth, P.C., Stancofski, E.D., and Fera, D. (2021). Structural Analysis of Neutralizing Epitopes of the SARS-CoV-2 Spike to Guide Therapy and Vaccine Design Strategies. Viruses, 13.","DOI":"10.3390\/v13010134"},{"key":"ref_4","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_5","doi-asserted-by":"crossref","first-page":"189","DOI":"10.1038\/s41577-022-00784-3","article-title":"Broadly neutralizing antibodies to SARS-CoV-2 and other human coronaviruses","volume":"23","author":"Chen","year":"2023","journal-title":"Nat. Rev. Immunol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"382","DOI":"10.1038\/s41577-021-00542-x","article-title":"Neutralizing monoclonal antibodies for treatment of COVID-19","volume":"21","author":"Taylor","year":"2021","journal-title":"Nat. Rev. Immunol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"3086","DOI":"10.1016\/j.cell.2021.05.005","article-title":"Tackling COVID-19 with neutralizing monoclonal antibodies","volume":"184","author":"Corti","year":"2021","journal-title":"Cell"},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Bartel, A., Grau, J.H., Bitzegeio, J., Werber, D., Linzner, N., Schumacher, V., Garske, S., Liere, K., Hackenbeck, T., and Rupp, S.I. (2024). Timely Monitoring of SARS-CoV-2 RNA Fragments in Wastewater Shows the Emergence of JN.1 (BA.2.86.1.1, Clade 23I) in Berlin, Germany. Viruses, 16.","DOI":"10.3390\/v16010102"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"e2314730121","DOI":"10.1073\/pnas.2314730121","article-title":"High-resolution map of the Fc functions mediated by COVID-19-neutralizing antibodies","volume":"121","author":"Paciello","year":"2024","journal-title":"Proc. Natl. Acad. Sci. USA"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"E82","DOI":"10.1016\/S1473-3099(23)00813-7","article-title":"Virological characteristics of the SARS-CoV-2 JN.1 variant","volume":"24","author":"Kaku","year":"2023","journal-title":"Lancet Infect. Dis."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"E70","DOI":"10.1016\/S1473-3099(23)00744-2","article-title":"Fast evolution of SARS-CoV-2 BA.2.86 to JN.1 under heavy immune pressure","volume":"24","author":"Yang","year":"2023","journal-title":"Lancet Infect. Dis."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"975","DOI":"10.2217\/fvl-2023-0146","article-title":"Resistance analysis following sotrovimab treatment in participants with COVID-19 during the phase III COMET-ICE study","volume":"18","author":"Subramanian","year":"2023","journal-title":"Future Virol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1941","DOI":"10.1056\/NEJMoa2107934","article-title":"Early Treatment for COVID-19 with SARS-CoV-2 Neutralizing Antibody Sotrovimab","volume":"385","author":"Gupta","year":"2021","journal-title":"N. Engl. J. Med."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1236","DOI":"10.1001\/jama.2022.2832","article-title":"Effect of Sotrovimab on Hospitalization or Death Among High-risk Patients with Mild to Moderate COVID-19: A Randomized Clinical Trial","volume":"327","author":"Gupta","year":"2022","journal-title":"JAMA"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"e29310","DOI":"10.1002\/jmv.29310","article-title":"Outpatient randomized controlled trials to reduce COVID-19 hospitalization: Systematic review and meta-analysis","volume":"95","author":"Sullivan","year":"2023","journal-title":"J. Med. Virol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"e79639","DOI":"10.7554\/eLife.79639","article-title":"Exploratory data on the clinical efficacy of monoclonal antibodies against SARS-CoV-2 Omicron variant of concern","volume":"11","author":"Mazzaferri","year":"2022","journal-title":"eLife"},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Siripongboonsitti, T., Nontawong, N., Tawinprai, K., Suptawiwat, O., Soonklang, K., Poovorawan, Y., and Mahanonda, N. (2023). Efficacy of combined COVID-19 convalescent plasma with oral RNA-dependent RNA polymerase inhibitor treatment versus neutralizing monoclonal antibody therapy in COVID-19 outpatients: A multi-center, non-inferiority, open-label randomized controlled trial (PlasMab). Microbiol. Spectr., 11.","DOI":"10.1128\/spectrum.03257-23"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"100","DOI":"10.1186\/s40814-023-01325-y","article-title":"Safety and tolerability study of sotrovimab (VIR-7831) prophylaxis against COVID-19 infection in immunocompromised individuals with impaired SARS-CoV-2 humoral immunity","volume":"9","author":"Beluch","year":"2023","journal-title":"Pilot. Feasibility Stud."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"622","DOI":"10.1016\/S1473-3099(21)00751-9","article-title":"Efficacy and safety of two neutralising monoclonal antibody therapies, sotrovimab and BRII-196 plus BRII-198, for adults hospitalised with COVID-19 (TICO): A randomised controlled trial","volume":"22","author":"Self","year":"2022","journal-title":"Lancet Infect. Dis."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"499","DOI":"10.1016\/j.mayocpiqo.2023.09.001","article-title":"Rates among Hospitalized Patients with COVID-19 Treated with Convalescent Plasma: A Systematic Review and Meta-Analysis","volume":"7","author":"Senefeld","year":"2023","journal-title":"Mayo Clin. Proc. Innov. Qual. Outcomes"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1590","DOI":"10.1056\/NEJMoa2209502","article-title":"Convalescent Plasma for COVID-19\u2013Induced ARDS in Mechanically Ventilated Patients","volume":"389","author":"Misset","year":"2023","journal-title":"N. Engl. J. Med."},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Focosi, D., Spezia, P.G., Gueli, F., and Maggi, F. (2024). The Era of the FLips: How Spike Mutations L455F and F456L (and A475V) Are Shaping SARS-CoV-2 Evolution. Viruses, 16.","DOI":"10.3390\/v16010003"},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Focosi, D., Spezia, P.G., and Maggi, F. (2023). SARS-CoV-2 BA.2.86 (\u201cPirola\u201d): Is it Pi or Just Another Omicron Sublineage?. Vaccines, 11.","DOI":"10.3390\/vaccines11111634"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1477","DOI":"10.1056\/NEJMc2120219","article-title":"Resistance mutations in SARS-CoV-2 Delta variant after sotrovimab use","volume":"386","author":"Rockett","year":"2021","journal-title":"N. Engl. J. Med."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1104","DOI":"10.1001\/jama.2022.13854","article-title":"Development of Resistance-Associated Mutations after Sotrovimab Administration in High-risk Individuals Infected with the SARS-CoV-2 Omicron Variant","volume":"328","author":"Birnie","year":"2022","journal-title":"JAMA"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"100097","DOI":"10.1016\/j.jcvp.2022.100097","article-title":"Sotrovimab-emergent resistance in SARS-CoV-2 Omicron: A series of three cases","volume":"2","author":"Focosi","year":"2022","journal-title":"J. Clin. Virol. Plus"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1297","DOI":"10.1016\/j.cmi.2022.05.002","article-title":"Resistance mutations in SARS-CoV-2 Omicron variant in patients treated with sotrovimab","volume":"28","author":"Vellas","year":"2022","journal-title":"Clin. Microbiol. Infect."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"e507","DOI":"10.1093\/cid\/ciac601","article-title":"Sotrovimab resistance and viral persistence after treatment of immunocompromised patients infected with the SARS-CoV-2 Omicron variant","volume":"76","author":"Huygens","year":"2023","journal-title":"Clin. Infect. Dis."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"240","DOI":"10.1016\/j.cmi.2022.08.021","article-title":"Emergence of Delta and Omicron variants carrying resistance-associated mutations in immunocompromised patients undergoing sotrovimab treatment with long-term viral excretion","volume":"29","author":"Esperalba","year":"2023","journal-title":"Clin. Microbiol. Infect."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"E559","DOI":"10.1016\/S2666-5247(22)00120-3","article-title":"Sotrovimab drives SARS-CoV-2 Omicron variant evolution in immunocompromised patients","volume":"3","author":"Destras","year":"2022","journal-title":"Lancet. Microbe"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"e166032","DOI":"10.1172\/JCI166032","article-title":"Host immunological responses facilitate development of SARS-CoV-2 2 mutations in patients receiving monoclonal antibody treatments","volume":"133","author":"Gupta","year":"2023","journal-title":"J. Clin. Investig."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"3334","DOI":"10.1038\/s41467-023-37826-w","article-title":"Generation of SARS-CoV-2 escape mutations by monoclonal antibody therapy","volume":"14","author":"Nutalai","year":"2023","journal-title":"Nat. Commun."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"e0026623","DOI":"10.1128\/aac.00266-23","article-title":"Frequent emergence of resistance mutations following complex intra-host genomic dynamics in SARS-CoV-2 patients receiving Sotrovimab","volume":"67","author":"Tejerina","year":"2023","journal-title":"Antimicrob. Agents Chemother."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"100149","DOI":"10.1016\/j.jcvp.2023.100149","article-title":"SARS-CoV-2 evolution during persistent infection in a CAR-T recipient shows an escape to both sotrovimab and T-cell responses","volume":"3","author":"Mazzetti","year":"2023","journal-title":"J. Clin. Virol. Plus"},{"key":"ref_35","first-page":"100991","article-title":"Analysis of SARS-CoV-2 mutations associated with resistance to therapeutic monoclonal antibodies that emerge after treatment","volume":"71","author":"Focosi","year":"2023","journal-title":"Drug Resist. Updates Rev. Comment. Antimicrob. Anticancer. Chemother."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"2129","DOI":"10.1093\/infdis\/jiac206","article-title":"Real-World Evidence of the Neutralizing Monoclonal Antibody Sotrovimab for Preventing Hospitalization and Mortality in COVID-19 Outpatients","volume":"226","author":"Aggarwal","year":"2022","journal-title":"J. Infect. Dis."},{"key":"ref_37","doi-asserted-by":"crossref","unstructured":"Ong, S.W.X., Ren, D., Lee, P.H., Sutjipto, S., Dugan, C., Khoo, B.Y., Tay, J.X., Vasoo, S., Young, B.E., and Lye, D.C. (2022). Real-World Use of Sotrovimab for Pre-Emptive Treatment in High-Risk Hospitalized COVID-19 Patients: An Observational Cross-Sectional Study. Antibiotics, 11.","DOI":"10.3390\/antibiotics11030345"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"310","DOI":"10.1016\/j.ijid.2022.10.002","article-title":"Change in effectiveness of sotrovimab for preventing hospitalization and mortality for at-risk COVID-19 outpatients during an Omicron BA.1 and BA.1.1-predominant phase","volume":"128","author":"Aggarwal","year":"2023","journal-title":"Int. J. Infect. Dis."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"607","DOI":"10.1007\/s40121-022-00755-0","article-title":"Real-World Effectiveness of Sotrovimab for the Early Treatment of COVID-19 During SARS-CoV-2 Delta and Omicron Waves in the USA","volume":"12","author":"Cheng","year":"2023","journal-title":"Infect. Dis. Ther."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"352","DOI":"10.1016\/j.jinf.2023.02.012","article-title":"Real-world effectiveness of molnupiravir, nirmatrelvir-ritonavir, and sotrovimab on preventing hospital admission among higher-risk patients with COVID-19 in Wales: A retrospective cohort study","volume":"86","author":"Evans","year":"2023","journal-title":"J. Infect."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"100741","DOI":"10.1016\/j.lanepe.2023.100741","article-title":"Comparative effectiveness of nirmatrelvir\/ritonavir versus sotrovimab and molnupiravir for preventing severe COVID-19 outcomes in non-hospitalised high-risk patients during Omicron waves: Observational cohort study using the OpenSAFELY platform","volume":"34","author":"Zheng","year":"2023","journal-title":"Lancet Reg. Health Eur."},{"key":"ref_42","doi-asserted-by":"crossref","unstructured":"Drysdale, M., Berktas, M., Gibbons, D.C., Rolland, C., Lavoie, L., and Lloyd, E.J. (2023). Real-world effectiveness of sotrovimab for the treatment of SARS-CoV-2 infection during Omicron BA.2 and BA.5 subvariant predominance: A systematic literature review. medRxiv.","DOI":"10.1101\/2023.12.04.23299370"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"e2228997","DOI":"10.1001\/jamanetworkopen.2022.28997","article-title":"Administration of Anti\u2013SARS-CoV-2 Monoclonal Antibodies After US Food and Drug Administration Deauthorization","volume":"5","author":"Anderson","year":"2022","journal-title":"JAMA Netw. Open"},{"key":"ref_44","doi-asserted-by":"crossref","unstructured":"Focosi, D., and Tuccori, M. (2022). Prescription of Anti-Spike Monoclonal Antibodies in COVID-19 Patients with Resistant SARS-CoV-2 Variants in Italy. Pathogens, 11.","DOI":"10.3390\/pathogens11080823"},{"key":"ref_45","doi-asserted-by":"crossref","unstructured":"Coelho, C.H., Bloom, N., Ramirez, S.I., Parikh, U.M., Heaps, A., Sieg, S.F., Greninger, A., Ritz, J., Moser, C., and Eron, J.J. (2023). SARS-CoV-2 monoclonal antibody treatment followed by vaccination shifts human memory B cell epitope recognition suggesting antibody feedback. bioRxiv.","DOI":"10.1101\/2023.11.21.567575"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"485","DOI":"10.1038\/s41586-020-2838-z","article-title":"Fc-optimized antibodies elicit CD8 immunity to viral respiratory infection","volume":"588","author":"Bournazos","year":"2020","journal-title":"Nature"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"3952","DOI":"10.1172\/JCI128437","article-title":"Antibodies targeting sialyl Lewis A mediate tumor clearance through distinct effector pathways","volume":"129","author":"Weitzenfeld","year":"2019","journal-title":"J. Clin. Investig."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"813","DOI":"10.1016\/j.medj.2023.08.001","article-title":"Multidrug-resistant mutations to antiviral and antibody therapy in an immunocompromised patient infected with SARS-CoV-2","volume":"4","author":"Hirotsu","year":"2023","journal-title":"Med."},{"key":"ref_49","doi-asserted-by":"crossref","unstructured":"Qu, P., Xu, K., Faraone, J.N., Goodarzi, N., Zheng, Y.-M., Carlin, C., Bednash, J.S., Horowitz, J.C., Mallampalli, R.K., and Saif, L.J. (2023). Immune Evasion, Infectivity, and Fusogenicity of SARS-CoV-2 Omicron BA.2.86 and FLip Variants. bioRxiv.","DOI":"10.1101\/2023.09.11.557206"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"e460","DOI":"10.1016\/S1473-3099(23)00575-3","article-title":"Transmissibility, infectivity, and immune evasion of the SARS-CoV-2 BA.2.86 variant","volume":"23","author":"Uriu","year":"2023","journal-title":"Lancet Infect. Dis."},{"key":"ref_51","doi-asserted-by":"crossref","unstructured":"Cathcart, A.L., Havenar-Daughton, C., Lempp, F.A., Ma, D., Schmid, M., Agostini, M.L., Guarino, B., Di Iulio, J., Rosen, L., and Tucker, H. (2021). The dual function monoclonal antibodies VIR-7831 and VIR-7832 demonstrate potent in vitro and in vivo activity against SARS-CoV-2. bioRxiv.","DOI":"10.1101\/2021.03.09.434607"},{"key":"ref_52","doi-asserted-by":"crossref","unstructured":"Planas, D., Staropoli, I., Michel, V., Lemoine, F., Donati, F., Prot, M., Porrot, F., Benhassine, F.G., Jeyarajah, B., and Brisebarre, A. (2023). Distinct evolution of SARS-CoV-2 Omicron XBB and BA.2.86 lineages combining increased fitness and antibody evasion. bioRxiv.","DOI":"10.1101\/2023.11.20.567873"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"657","DOI":"10.1038\/s41586-021-04385-3","article-title":"Omicron escapes the majority of SARS-CoV-2 neutralizing antibodies of diverse epitopes","volume":"602","author":"Cao","year":"2021","journal-title":"Nature"},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"942","DOI":"10.1016\/S1473-3099(22)00365-6","article-title":"Neutralisation sensitivity of SARS-CoV-2 omicron subvariants to therapeutic monoclonal antibodies","volume":"22","author":"Yamasoba","year":"2022","journal-title":"Lancet Infect. Dis."},{"key":"ref_55","doi-asserted-by":"crossref","unstructured":"Wang, Q., Li, Z., Guo, Y., Mellis, I.A., Iketani, S., Liu, M., Yu, J., Valdez, R., Lauring, A.S., and Sheng, Z. (2023). Evolving antibody evasion and receptor affinity of the Omicron BA.2.75 sublineage of SARS-CoV-2. bioRxiv.","DOI":"10.1101\/2023.03.22.533805"},{"key":"ref_56","doi-asserted-by":"crossref","unstructured":"Liu, L., Casner, R.G., Guo, Y., Wang, Q., Iketani, S., Chan, J.F.-W., Yu, J., Dadonaite, B., Nair, M.S., and Mohri, H. (2023). Antibodies that neutralize all current SARS-CoV-2 variants of concern by conformational locking. bioRxiv.","DOI":"10.1101\/2023.04.08.536123"},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"130","DOI":"10.1038\/s41586-021-03398-2","article-title":"Antibody resistance of SARS-CoV-2 variants B.1.351 and B.1.1.7","volume":"593","author":"Wang","year":"2021","journal-title":"Nature"},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"747","DOI":"10.1016\/j.chom.2021.04.007","article-title":"Increased Resistance of SARS-CoV-2 Variant P.1 to Antibody Neutralization","volume":"29","author":"Wang","year":"2021","journal-title":"Cell Host Microbe"},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"E462","DOI":"10.1016\/S1473-3099(23)00588-1","article-title":"Sensitivity of BA.2.86 to prevailing neutralising antibody responses","volume":"23","author":"Sheward","year":"2023","journal-title":"Lancet Infect. Dis."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"e457","DOI":"10.1016\/S1473-3099(23)00573-X","article-title":"Antigenicity and infectivity characterization of SARS-CoV-2 BA.2.86","volume":"23","author":"Yang","year":"2023","journal-title":"Lancet Infect. Dis."},{"key":"ref_61","doi-asserted-by":"crossref","unstructured":"Jian, F., Feng, L., Yang, S., Yu, Y., Wang, L., Song, W., Yisimayi, A., Chen, X., Xu, Y., and Wang, P. (2023). Convergent evolution of SARS-CoV-2 XBB lineages on receptor-binding domain 455\u2013456 synergistically enhances antibody evasion and ACE2 binding. PLoS Pathog., 19.","DOI":"10.1101\/2023.08.30.555211"},{"key":"ref_62","doi-asserted-by":"crossref","unstructured":"Pochtovyi, A.A., Kustova, D.D., Siniavin, A.E., Dolzhikova, I.V., Shidlovskaya, E.V., Shpakova, O.G., Vasilchenko, L.A., Glavatskaya, A.A., Kuznetsova, N.A., and Iliukhina, A.A. (2023). In Vitro Efficacy of Antivirals and Monoclonal Antibodies against SARS-CoV-2 Omicron Lineages XBB.1.9.1, XBB.1.9.3, XBB.1.5, XBB.1.16, XBB.2.4, BQ.1.1.45, CH.1.1, and CL.1. Vaccines, 11.","DOI":"10.3390\/vaccines11101533"},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"113193","DOI":"10.1016\/j.celrep.2023.113193","article-title":"Continued evasion of neutralizing antibody response by Omicron XBB.1.16","volume":"42","author":"Faraone","year":"2023","journal-title":"Cell Rep."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"655","DOI":"10.1016\/S1473-3099(23)00278-5","article-title":"Virological characteristics of the SARS-CoV-2 omicron XBB.1.16 variant","volume":"23","author":"Yamasoba","year":"2023","journal-title":"Lancet Infect. Dis."},{"key":"ref_65","unstructured":"(2023, February 22). Fact Sheet for Healthcare Providers Emergency Use Authorization (EUA) of Sotrovimab, Available online: https:\/\/www.fda.gov\/media\/149534\/download."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"408","DOI":"10.1093\/cid\/ciac802","article-title":"Rapid selection of sotrovimab escape variants in SARS-CoV-2 Omicron infected immunocompromised patients","volume":"76","author":"Gliga","year":"2023","journal-title":"Clin. Infect. Dis."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"164","DOI":"10.1186\/s13073-021-00985-w","article-title":"Comprehensive mapping of binding hot spots of SARS-CoV-2 RBD-specific neutralizing antibodies for tracking immune escape variants","volume":"13","author":"Yi","year":"2021","journal-title":"Genome Med."},{"key":"ref_68","doi-asserted-by":"crossref","unstructured":"Zhou, H., Dcosta, B.M., Landau, N.R., and Tada, T. (2022). Resistance of SARS-CoV-2 Omicron BA.1 and BA.2 Variants to Vaccine-Elicited Sera and Therapeutic Monoclonal Antibodies. Viruses, 14.","DOI":"10.3390\/v14061334"},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"553","DOI":"10.1038\/s41586-022-04594-4","article-title":"Antibody Evasion Properties of SARS-CoV-2 Omicron Sublineages","volume":"604","author":"Iketani","year":"2022","journal-title":"Nature"},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"1077","DOI":"10.1016\/j.chom.2022.05.001","article-title":"Antibody evasion of SARS-CoV-2 Omicron BA.1, BA.1.1, BA.2, and BA.3 sub-lineages","volume":"30","author":"Ai","year":"2022","journal-title":"Cell Host Microbe"},{"key":"ref_71","doi-asserted-by":"crossref","unstructured":"Leducq, V., Zafilaza, K., Fauchois, A., Ghidaoui, E., Sayon, S., Dorival, C., Meledje, M.L., Lusivika-Nzinga, C., Yordanov, Y., and Martin-Blondel, G. (2023). Spike protein genetic evolution in patients at high-risk of severe COVID-19 treated by monoclonal antibodies. J. Infect. Dis.","DOI":"10.1093\/infdis\/jiad523"},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"1735","DOI":"10.1093\/bioinformatics\/btab856","article-title":"CoV-Spectrum: Analysis of globally shared SARS-CoV-2 data to identify and characterize new variants","volume":"38","author":"Chen","year":"2021","journal-title":"Bioinformatics"}],"container-title":["Viruses"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1999-4915\/16\/2\/217\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T13:52:16Z","timestamp":1760104336000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1999-4915\/16\/2\/217"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,1,31]]},"references-count":72,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2024,2]]}},"alternative-id":["v16020217"],"URL":"https:\/\/doi.org\/10.3390\/v16020217","relation":{},"ISSN":["1999-4915"],"issn-type":[{"value":"1999-4915","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,1,31]]}}}