Authors: Moyo-Gwete T, Madzivhandila M, Makhado Z, Ayres F, Mhlanga D, Oosthuysen B, Lambson EB, Kgagudi P, Tegally H, Iranzadeh A, Doolabh D, Tyers L, Chinhoyi RL, Mennen M, Skelm S, Wibmer K C, Bhiman N J, Ueckermann V, Rossouw T, Boswell M, de Oliveira T, Williamson T, Burgers W, Ntusi N, Morris L, Moore P
Journal: NEJM, 2021. DOI: DOI: 10.1056/NEJMc2104192
The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) 501Y.V2 lineage (also known as B.1.351), first identified in South Africa in October 2020,1 has mutations that confer increased resistance to plasma from convalescent patients and vaccine recipients, as well as to some monoclonal antibodies.2-4 However, the immune response to 501Y.V2 is unknown. Similarly, the ability of antibodies elicited by 501Y.V2 infection to cross-react with other variants is unknown, but such cross-reactivity would have implications for the ability of second-generation vaccines based on the 501Y.V2 spike protein to protect against infection with the original and emerging SARS-CoV-2 lineages.5
We characterized the SARS-CoV-2 infections in a cohort of patients with coronavirus disease 2019 (Covid-19) who were hospitalized in the Groote Schuur Hospital, Cape Town (Table S1 in the Supplementary Appendix, available with the full text of this letter at NEJM.org), after the emergence and dominance of 501Y.V2 in South Africa. Blood samples were obtained from 89 patients between December 31, 2020, and January 15, 2021; of these patients, 28 (31%) were randomly selected for SARS-CoV-2 sequencing, all of whom were shown by phylogenetic analysis to be infected with 501Y.V2 (Fig. S1A). Furthermore, at this time, the epidemic in Cape Town (Fig. S1B) and in South Africa as a whole was dominated by 501Y.V2, which accounted for more than 90% of infections. No patient in our study reported previous SARS-CoV-2 infection.