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