Covid antiviral drug Molnupiravir linked to mutations in SARS CoV 2 genome

Molnupiravir, an antiviral medication widely employed against SARS-CoV-2, has shown the ability to induce mutations in the virus's genome during replication. A team, including researchers from the Francis Crick Institute and the University of Cambridge in the UK, noted that molnupiravir works by inducing mutations in the virus's genetic information, or genome, during replication.

While most of these mutations are likely harmful to the virus, some could potentially affect its transmission. Researchers have discovered extensive evidence of molnupiravir-induced mutagenesis in SARS-CoV-2 sequencing databases, sparking concerns about its implications.

The study, which sheds light on these concerns, identifies a specific category of long phylogenetic branches characterized by a high proportion of G-to-A and C-to-T mutations. Remarkably, these branches predominantly appear in sequences from 2022, following the introduction of molnupiravir treatment. They are also associated with countries and age groups where the drug is widely used.

Researchers further delineate a mutational spectrum with preferred nucleotide contexts that match those seen in the long branches. Importantly, they find evidence of onward transmission of molnupiravir-derived lineages. The analysis of treatment records strengthens the link between these high G-to-A branches and the administration of molnupiravir.

Reference: Sanderson, T., Hisner, R., Donovan-Banfield, I. et al. A molnupiravir-associated mutational signature in global SARS-CoV-2 genomes. Nature (2023). DOI: https://doi.org/10.1038/s41586-023-06649-6