Genetic Study of SARS-CoV-2 Nonstructural Protein 12 in COVID-19 Patients Nonresponsive to Remdesivir

Remdesivir (RDV) was the first antiviral to treat COVID-19 patients. This antiviral molecule inhibits SARS-CoV-2 replication by stalling the nonstructural protein 12 (nsp12) subunit of the RNA-dependent RNA polymerase (RdRp). The main goal of this study is defining genetic pathways to RDV resistance and determining emergent mutations prior and subsequent antiviral therapy in clinical settings. Monitoring antiviral resistance mutations is highly important for health surveillance to determine the benefit of RDV retreatment, especially in immunosuppressed patients and in those with persistent replication.