De novo emergence of a remdesivir resistance mutation during treatment of persistent SARS-CoV-2 infection in an immunocompromised patient: a case report
Nature Communications·
- DOI
- 10.1038/s41467-022-29104-y
- PMID
- 35301314
- PMCID
- PMC8930970
- OpenAlex
- W4226163566
- Study type
- Genomic study
- Publisher
- Springer Science and Business Media LLC
- Article type
- journal-article
- Integrity
- current
Publication version
This article has a linked preprint
The relationship comes from Crossref version metadata. Compare both records because findings and wording may have changed between versions.
Open linked preprint →Why this research matters now
The case provides article-level evidence that a remdesivir resistance-associated mutation can emerge during treatment of persistent SARS-CoV-2 infection in an immunocompromised patient. The abstract identifies resistance monitoring and combination treatment as relevant considerations in this clinical context, but does not establish population frequency or broader risk.
Structured evidence summary
Research question
The report examined whether a remdesivir-associated resistance mutation emerged during treatment of persistent SARS-CoV-2 infection in an immunocompromised patient.
Study design
This was a single-patient case report combining clinical and virologic observations, whole-genome sequencing before and during treatment, and in vitro testing of the identified mutation.
Population and setting
The report concerned one immunocompromised patient with acquired B-cell deficiency and a prolonged SARS-CoV-2 infection treated with remdesivir.
Main findings
A previously absent E802D mutation in the nsp12 RNA-dependent RNA polymerase was detected after remdesivir treatment in the setting of renewed high-level viral shedding. In vitro, the mutation was associated with an approximately sixfold increase in remdesivir IC50 and reduced viral fitness without remdesivir; sustained clinical and virologic response followed casirivimab-imdevimab treatment.
Public-health relevance
The case provides article-level evidence that a remdesivir resistance-associated mutation can emerge during treatment of persistent SARS-CoV-2 infection in an immunocompromised patient. The abstract identifies resistance monitoring and combination treatment as relevant considerations in this clinical context, but does not establish population frequency or broader risk.
Important limitations
The evidence comes from a single case report with supporting in vitro experiments, so the findings do not establish how often the mutation occurs, its clinical effect across patients, or its population-level significance. This summary is limited to the supplied single-article abstract and metadata; the original paper is required for decision-grade interpretation.
GIDS interpretation
The article is discoverable under SARS-CoV-2, genomic epidemiology, outbreak investigation, and treatment-related classifications. It provides context for an individual treatment-emergent resistance event, but the supplied article does not constitute confirmation of a live surveillance signal.
Related GIDS surveillance
Literature context does not validate, explain, or change a surveillance signal. Exact and contextual relationships are shown separately.
Evidence relationships
This article has 12 auditable classifier relationships to diseases, places, topics, and study design.