Cited by 1,290SARS-CoV-2 and COVID-19 Researchvaccines and immunoinformatics approachesAnimal Virus Infections Studies

The DOI matches its Crossref record; 51 of the 51 references it cites were found in a registry or an index; none of the 13 sources its claims cite is checked for support yet.

Striking antibody evasion manifested by the Omicron variant of SARS-CoV-2

Open access

Published version of a preprint

Abstract

The B.1.1.529/Omicron variant of SARS-CoV-2 was only recently detected in southern Africa, but its subsequent spread has been extensive, both regionally and globally 1. It is expected to become dominant in the coming weeks 2, probably due to enhanced transmissibility. A striking feature of this variant is the large number of spike mutations 3 that pose a threat to the efficacy of current COVID-19 vaccines and antibody therapies 4. This concern is amplified by the findings of our study. Here we found that B.1.1.529 is markedly resistant to neutralization by serum not only from patients who recovered from COVID-19, but also from individuals who were vaccinated with one of the four widely used COVID-19 vaccines. Even serum from individuals who were vaccinated and received a booster dose of mRNA-based vaccines exhibited substantially diminished neutralizing activity against B.1.1.529. By evaluating a panel of monoclonal antibodies against all known epitope clusters on the spike protein, we noted that the activity of 17 out of the 19 antibodies tested were either abolished or impaired, including ones that are currently authorized or approved for use in patients. Moreover, we also identified four new spike mutations (S371L, N440K, G446S and Q493R) that confer greater antibody resistance on B.1.1.529. The Omicron variant presents a serious threat to many existing COVID-19 vaccines and therapies, compelling the development of new interventions that anticipate the evolutionary trajectory of SARS-CoV-2.

Overview

AI snapshot

Written from the paper’s full text.

TL;DR

The Omicron (B.1.1.529) variant of SARS-CoV-2 shows marked resistance to neutralization by convalescent and vaccinee sera and by most tested monoclonal antibodies, including authorized therapies. The study identifies four spike mutations—S371L, N440K, G446S, and Q493R—that contribute to this antibody escape.

Key findings

  • Convalescent sera from 10 individuals showed a >32-fold drop in ID50 against B.1.1.529 versus D614G, with only 2 samples above the limit of detection.
  • Vaccinee sera showed substantial losses: >21-fold for BNT162b2 and >8.6-fold for mRNA-1273; all Ad26.COV2.S and ChAdOx1 nCoV-19 samples were below the limit of detection except two Ad26.COV2.S samples from previously infected individuals. Boosted mRNA vaccinees showed a mean 6.5-fold decrease against B.1.1.529.
  • Among 19 monoclonal antibodies, 17 lost neutralizing activity completely or partially; class 1 and class 2 RBD antibodies decreased by more than 100-fold, while S309 and Brii-198 were spared. All four combination monoclonal antibody drugs in clinical use lost substantial activity.
  • Four previously undescribed mutations—S371L, N440K, G446S, and Q493R—conferred greater antibody resistance; S371L broadly affected neutralization by monoclonal antibodies in all four RBD classes.

Methods

  • Serum neutralization was tested using pseudoviruses and authentic SARS-CoV-2 isolates. Convalescent samples were collected in spring 2020 (9–120 days after symptoms); vaccinee samples included BNT162b2, mRNA-1273, Ad26.COV2.S, ChAdOx1 nCoV-19, and boosted mRNA recipients.
  • A panel of 19 monoclonal antibodies (17 RBD-directed, 2 NTD-directed) was tested against B.1.1.529 and B.1.1.529+R346K pseudoviruses, and against pseudoviruses carrying each of 34 individual spike mutations.
  • Neutralization curves and IC50 values were derived by nonlinear five-parameter dose-response fitting; P values were determined using two-tailed Wilcoxon matched-pairs signed-rank tests.

Limitations

  • The paper states that no statistical methods were used to predetermine sample size, experiments were not randomized, and investigators were not blinded to allocation during experiments and outcome assessment.
  • The paper notes that for BNT162b2 and mRNA-1273 groups, samples with high titres were specifically chosen so fold changes could be better quantified, and the difference in samples above the limit of detection may therefore be favourably biased.
  • Evident from the text: the study reports in vitro neutralization only and does not measure clinical protection, in vivo efficacy, or reinfection/breakthrough outcomes directly.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.1038/s41586-021-04388-0

Cites

51 of 51 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Verification

Claims the paper makes

31 Own result · 11 Own method · 8 Not checked yet · 7 Own interpretation

Verify all 13 references — free account

Show all 36 claims

  • It may state two separate claims as one. 6
  • The quote only partly states this claim. 3
  • Probably not a substantial claim. 14
21 of 21
  • The authors state this as an assumption.

    Patients with COVID-19 in spring 2020 were infected with WT SARS-CoV-2.

    “who were presumably infected with the wild-type (WT) SARS-CoV-2”
  • The paper relies on this without support.

    In vitro neutralization activity of monoclonal antibodies predicts their clinical efficacy in patients.

    “probably abolishing or impairing their efficacy in patients”
  • The paper relies on this without support.

    Neutralizing antibody titres are a correlate of protection against SARS-CoV-2 infection.

    “Collectively, these results suggest that individuals who were previously infected or fully vaccinated remain at risk for B.1.1.529infection.”
  • The authors state this as an assumption.

    Convalescent plasma samples were infected by the WT strain of SARS-CoV-2.

    “These samples were collected at the beginning of the pandemic in early 2020 at Columbia University Irving Medical Center and are therefore assumed to be infection by the WT strain of SARS-CoV-2 (ref. 4 ).”
4 of 4

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Citations

Cites

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Research works printed but not linked: 1

  1. Grabowski, F., Kochańczyk, M. & Lipniacki, T. Omicron strain spreads with the doubling time of 3.2—3.6 days in South Africa province of Gauteng that achieved herd immunity to Delta variant. Preprint at https://doi.org/10.1101/2021.12.08.21267494 (2021). · DOI

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Metadata

Authors
Liu, L., Iketani, S., Guo, Y., Chan, J. F.-W., Wang, M., Liu, L., Luo, Y., Chu, H., Huang, Y., Nair, M. S., Yu, J., Chik, K. K.-H., Yuen, T. T.-T., Yoon, C., To, K. K.-W., Chen, H., Yin, M. T., Sobieszczyk, M. E., Huang, Y., Wang, H. H., Sheng, Z., Yuen, K.-Y., & Ho, D. D.
Affiliations
  • Aaron Diamond AIDS Research Center (US)
  • University of Hong Kong (HK)
  • Columbia University (US)
Corresponding author
Ho, David D.
Venue
Nature
Published
2021-12-23
Volume
602
Issue
7898
Pages
676-681
ISSN
  • 0028-0836 (ISSN-L)
  • 1476-4687
OpenAlex
W4220904663
Cited by
1,290
References
47
Citations by year
2026: 60 · 2025: 107 · 2024: 179 · 2023: 341 · 2022: 598 · 2021: 5
FWCI
89.00
Type
journal article
Language
en
Open access
Locations
  • Nature (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • National Science Foundation (2032259)
  • Bill and Melinda Gates Foundation
  • JPB Foundation
  • Regeneron Pharmaceuticals
  • Irving Medical Center, Columbia University
  • National Institute of Allergy and Infectious Diseases
Topics
  • Health Sciences › Medicine › Infectious Diseases › SARS-CoV-2 and COVID-19 Research
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › vaccines and immunoinformatics approaches
  • Life Sciences › Agricultural and Biological Sciences › Animal Science and Zoology › Animal Virus Infections Studies
Keywords
Omicron variant, SARS-CoV-2, antibody escape, neutralizing antibodies, spike protein mutations, vaccine escape, COVID-19 vaccines, monoclonal antibodies, booster vaccination, serum neutralization
MeSH terms
COVID-19, SARS-CoV-2, COVID-19 Vaccines, Antibodies, Monoclonal, Antibodies, Viral, Cell Line, Convalescence, Humans, Immune Sera, Models, Molecular, Mutation, Neutralization Tests, Evolution, Molecular, Inhibitory Concentration 50, Immune Evasion, Antibodies, Neutralizing, Spike Glycoprotein, Coronavirus

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Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

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