Neutralising antibody escape of SARS-CoV-2 spike protein: Risk assessment for antibody-based Covid-19 therapeutics and vaccines

Rev Med Virol. 2021 Nov;31(6):e2231. doi: 10.1002/rmv.2231. Epub 2021 Mar 16.


The Spike protein is the target of both antibody-based therapeutics (convalescent plasma, polyclonal serum, monoclonal antibodies) and vaccines. Mutations in Spike could affect efficacy of those treatments. Hence, monitoring of mutations is necessary to forecast and readapt the inventory of therapeutics. Different phylogenetic nomenclatures have been used for the currently circulating SARS-CoV-2 clades. The Spike protein has different hotspots of mutation and deletion, the most dangerous for immune escape being the ones within the receptor binding domain (RBD), such as K417N/T, N439K, L452R, Y453F, S477N, E484K, and N501Y. Convergent evolution has led to different combinations of mutations among different clades. In this review we focus on the main variants of concern, that is, the so-called UK (B.1.1.7), South African (B.1.351) and Brazilian (P.1) strains.

Keywords: B.1.1.7; B.1.351; BNT162b2; COVID-19; LY-CoV555; LyCoV016; P.1; P.2; REGN10933; REGN10987; SARS-CoV-2; bamlanivimab; casirivimab; convalescent plasma; etesevimab; imdevimab; immune escape; mRNA-1273; mutations; neutralising antibody; polyclonal immunoglobulins.

Publication types

  • Review

MeSH terms

  • Antibodies, Monoclonal / chemistry
  • Antibodies, Monoclonal / metabolism
  • Antibodies, Monoclonal / therapeutic use*
  • Antibodies, Neutralizing / chemistry
  • Antibodies, Neutralizing / metabolism
  • Antibodies, Neutralizing / therapeutic use*
  • Antibodies, Viral / chemistry
  • Antibodies, Viral / metabolism
  • Antibodies, Viral / therapeutic use
  • Brazil / epidemiology
  • COVID-19 / epidemiology
  • COVID-19 / immunology
  • COVID-19 / therapy*
  • COVID-19 / virology
  • COVID-19 Serotherapy
  • COVID-19 Vaccines / administration & dosage
  • Gene Expression
  • Humans
  • Immune Evasion
  • Immunization, Passive / methods
  • Mutation
  • Phylogeny
  • Protein Binding
  • Risk Assessment
  • SARS-CoV-2 / classification
  • SARS-CoV-2 / drug effects
  • SARS-CoV-2 / genetics*
  • SARS-CoV-2 / immunology
  • South Africa / epidemiology
  • Spike Glycoprotein, Coronavirus / genetics*
  • Spike Glycoprotein, Coronavirus / immunology
  • United Kingdom / epidemiology


  • Antibodies, Monoclonal
  • Antibodies, Neutralizing
  • Antibodies, Viral
  • COVID-19 Vaccines
  • Spike Glycoprotein, Coronavirus
  • spike protein, SARS-CoV-2