Susceptibility of SARS-CoV-2-nsp5T169Insp12V792I virus to nirmatrelvir and remdesivir in vitro. Credit: Natural communications (2024). DOI: 10.1038/s41467-024-51924-3
Two studies have found that the virus that causes COVID-19 is becoming resistant to two drugs used to treat infected patients.
In the first study, a combined team from Cornell University and the National Institutes of Health studied treatment outcomes for patients with weakened immune systems who received the drug remdesivir. They published their results in the journal Natural communications.
In the second study, a team of researchers from the University of Pittsburgh, Brigham and Women’s Hospital, Stanford University, and Harvard University studied outcomes for COVID-19 patients who received antiviral drugs during the years 2021 to 2023. They published their results in the journal Open JAMA Network.
Zhuo Zhou and Peng Hong, respectively of the Chinese Academy of Medical Sciences, Peking Union Medical College and the VA New York Harbor Healthcare System, published a commentary in the same Open JAMA Network number describing the work of the second team.
In the years since the peak of the COVID-19 pandemic, medical researchers have continued to study SARS-CoV-2, as well as new vaccine options. They have also worked to develop new treatments for people who have been infected with the virus but have not been immunized or have weakened immune systems.
As part of this effort, two such therapies, called remdesivir and nirmatrelvir, have become the go-to drugs for patients whose immune systems are unable to fight the virus. But because they are antiviral, they run the risk of becoming obsolete as the virus mutates.
In the first study, researchers sequenced the DNA of the virus infecting 15 COVID patients and found that the virus had developed reduced sensitivity to remdesivir and nirmatrelvir. They also discovered that the mutated viruses could infect other people nearby. One positive note: Researchers found that giving both antivirals to patients eliminated the virus.
In the second study, the research team studied the treatment of 156 COVID-19 patients over two years. As part of this effort, the researchers divided the patients into two groups: those who received the antiviral drugs and those who did not. Viruses with antiviral-resistant mutations were more likely to be detected in patients who received antiviral drugs. The effect was more evident in immunocompromised people and in those who received nirmatrelvir.
More information:
Mohammed Nooruzzaman et al, Emergence of transmissible SARS-CoV-2 variants with reduced sensitivity to antivirals in immunocompromised patients with persistent infections, Natural communications (2024). DOI: 10.1038/s41467-024-51924-3
Trevor J. Tamura et al, Emerging resistance to SARS-CoV-2 after antiviral treatment, Open JAMA Network (2024). DOI: 10.1001/jamanetworkopen.2024.35431
Zhuo Zhou et al, SARS-CoV-2 resistance to nirmatrelvir: a concern for immunocompromised populations? Open JAMA Network (2024). DOI: 10.1001/jamanetworkopen.2024.35439
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