Some Spike Mutations of B.1.1.529 were Observed in Molnupiravir Patients

Some spike mutations of the new variant of concern B.1.1.529 were observed in patients receiving Molnupiravir with the frequency >5%: del143, del144, del145, N501Y, and P681H.

Two of them (del143 and del145) were not in any prior VOC, and the other two were only in Alpha.

Molnupiravir has been authorized in the UK. Some countries started using it without authorizing. Also, significant quantities of Molnupiravir have been manufactured and shipped all over the world.

Also from the FDA Briefing Document:

“Consistent with the MOV [Molnupiravir] mechanism of action, a greater proportion of participants in the MOV arms relative to the placebo arm had at least one treatment-emergent amino acid substitution or other structural nucleotide change (deletion, insertion) detected in the spike gene, and amino acid changes were scattered throughout the coding sequence.”

Nobody in his/her/their right mind will authorize the use of this drug for a respiratory disease!

November 30, 2021

AMDAC did approve it, although in a tight vote 13:10.

The most remarkable mutation in B.1.1.529 might be ORF1b:I1566V. This codes for Exon (in nsp14), the proofreading mechanism of the coronavirus. If this mutation makes proofreading less effective, the error rate increases. This might explain the large number of mutations already accumulated by this variant. It also threatens to spawn many new lineages and variants.

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