Paxrovid, an oral novel coronavirus infection (COVID-19, Corona 19) treatment developed by Pfizer, has been proven to be effective in suppressing severe COVID-19 patients, and is prescribed in countries around the world, including Korea. have. Scientists have raised concerns about the possibility that a mutant of the coronavirus may emerge that is resistant to antiviral treatments such as Paxrovid, although scientists expect that easily accessible Paxrovid will play an important role in the COVID-19 pandemic. .
As scientists fear, the international scientific journal Science reported on the 29th (local time) that a viral mutation that was resistant to the oral antiviral drug Paxrovide was reported in several laboratory studies. Such mutations have already been found among confirmed cases of COVID-19, and there are concerns that one of the treatments for COVID-19 may soon be lost.
David Ho, a professor of virology at Columbia University in the U.S., who first formulated the human immunodeficiency virus (HIV) treatment drug-resistant mutation, said, “The physiology of the virus is that it tries to escape when it is pressed. The prevalence of mutations is only a matter of time.”
In fact, according to several studies published in the media in the United States, among corona 19 confirmed patients who received Paxrovid for 5 days, their condition improved in the initial stage of taking Paxrovid, but then the symptoms of COVID-19 reappear one after another. There are also analyzes that are raising questions about whether Paxrovid is helpful for people who are not at high risk.
According to the U.S. Food and Drug Administration (FDA), up to mid-April in the U.S., about 40,000 prescriptions were issued for Paxrovid a week. Since April, the number of prescriptions per week has surged to more than 160,000, according to the latest data from the Centers for Disease Control and Prevention (CDC).
When the number of patients taking Paxrovid increases in the community due to such a surge in the number of prescriptions, the virus is subjected to selective pressure. It makes them more likely to develop mutations that help them survive in the presence of antiviral drugs. This is because, while the confirmed patient is taking Paxrovid, the COVID-19 virus in the confirmed patient can replicate itself and test various mutations that can survive Paxrovid. So far, it has been analyzed that there are no mutations that broadly interfere with the therapeutic effect of Paxrovid.
However, recent research suggests that the COVID-19 virus is preparing to develop resistance. Two papers published on ‘bioRxiv’, a pre-publication site for medical papers on June 7, revealed that a mutant virus with the ability to evade the attack of Paxrovid at the laboratory level was identified.
According to a study conducted by Adam Gozick, a bioinformatics professor at the University of California, Riverside (UC Riverside), people infected with this drug-resistant mutation were also identified. It is a research result found in the database (DB) of the International Influenza Information Sharing Organization (GISAID), where data analyzing the nucleotide sequence of a virus isolated from a confirmed patient is accumulated. However, it was considered highly likely to be a randomly occurring mutation in that a mutation that occurred before paxrovide was widely prescribed was identified as a paxrovid-resistant mutation. In particular, it was analyzed that the types of mutations that could potentially be resistant to Paxrovid are increasing in GISAID’s DB.
Professor Ho said, “Providing patients with multiple antiviral drugs can help suppress resistance mutations. This is a strategy that has been proven to be very effective in treating other viruses such as HIV and hepatitis C.” In this regard, it is possible to prescribe another oral treatment, ‘molnupiravir,’ together with Paxrovid, but it is known that there are concerns that other dangerous mutated viruses may be generated in this case.
