Prolonged COVID-19 may generate new viral variants. We report an immunocompromised patient treated with monoclonal antibodies who experienced rebound of viral RNA and emergence of an antibody-resistant (>1000-fold) variant containing 5 mutations in the Spike gene. The mutant virus was isolated from respiratory secretions suggesting the potential for secondary transmission.

By Jana L. Jacobs, Ghady Haidar, Asma Naqvi, Kevin D. McCormick, Michele Sobolewski, Benjamin R. Treat, Amy L. Heaps, Jordan Simpson, Kailey Hughes Kramer, Erin McCreary, J. Ryan Bariola, Cynthia Klamar-Blain, Bernard J.C. Macatangay, Dimiter Dimitrov, Wei Li, Christopher C. Marino, Anastasios Raptis, Rahil Sethi, Uma Chandran, Simon Barratt-Boyes, Urvi M. Parikh, John W. Mellors