Cell, Making Sense of Mutation: What D614G Means for the COVID-19 Pandemic Remains Unclear

https://www.cell.com/cell/pdf/S0092-8...

https://www.sciencedaily.com/releases...

The SARS-CoV-2 virus has a low mutation rate overall

Much lower than the viruses that cause influenza and HIV-AIDS

Emergence of SARS-CoV-2 in China in late 2019

Virus mutations

A virus mutation can become common through fitness or by chance

Emerged early during the pandemic

Aspartate to glycine, D614G mutation

https://www.biorxiv.org/content/10.11...

Dominant mutational variant at the 614 position of S protein

Old version D614 (Aspartate)

New version G614 (Glycine)

G614 is most prevalent in many places around the world

Korber et al. (2020) hypothesized that the rapid spread of G614 was because it is more infectious than D614

Will D614G Make Outbreaks Harder to Control?

The great majority of SARS-CoV-2 lineages in the United States arrived from Europe

Over the period that G614 became the global majority variant, the number of introductions from China where D614 was still dominant were declining

As numbers in Europe were going up

If G614 truly is more transmissible in equivalently mixing populations

Not enough in vivo data just now

Will D614G Make Infections More Severe?

Patients infected with G614 had higher levels of virus RNA

But no differences identified in hospital outcomes

Will D614G Impact Therapeutic and Vaccine Designs?

Unlikely

D614G is not in the receptor-binding domain (RBD) of the spike protein

Antibodies generated from natural infection with viruses containing D614 or G614 can cross-neutralize

Suggesting that the locus is not critical for antibody - mediated immunity

Conclusions

The G614 variant now is the pandemic