A 72-year-old immunocompromised man infected with severe acute respiratory syndrome coronavirus 2 received bamlanivimab monotherapy. Viral evolution was monitored in nasopharyngeal and blood samples by melting curve analysis of single-nucleotide polymorphisms and whole-genome sequencing. Rapid emergence of spike receptor binding domain mutations was found, associated with a compartmentalization of viral populations.
Keywords: COVID-19; SARS-CoV-2; bamlanivimab; compartmentalization; coronavirus disease; coronaviruses; immunotherapy; monoclonal antibody; monotherapy; respiratory infections; selection; severe acute respiratory syndrome coronavirus 2; variants; viruses; whole-genome sequencing; zoonoses.