Resistance analysis following sotrovimabtreatment in participants with COVID-19during the phase III COMET-ICE study: supplementary material

Aim: Sotrovimab is an engineered human monoclonal antibody that binds a conserved region of the
SARS-CoV-2 spike protein. The COMET-ICE phase III study evaluated sotrovimab for treatment of mild to
moderate COVID-19 in nonhospitalized participants with ≥1 risk factor for severe disease progression.
Materials & methods: We evaluated the presence of circulating SARS-CoV-2 variants of concern or
interest (VOCs/VOIs) and characterized the presence of baseline, post-baseline and emergent amino acid
substitutions detected in the epitope of sotrovimab in SARS-CoV-2. Results: None of the sotrovimabtreated
participants with baseline epitope substitutions, and 1 of 48 sotrovimab-treated participants
with post-baseline epitope substitutions, met the primary clinical endpoint for progression. Conclusion:
Overall, progression was not associated with identified VOC/VOI or the presence of epitope substitutions
in sotrovimab-treated participants.