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Molnupiravir, an oral direct‐acting antiviral effective in vitro against SARS‐CoV‐2, has been largely employed during the COVID‐19 pandemic, since December 2021. After marketing and widespread usage, a progressive increase in SARS‐CoV‐2 lineages characterized by a higher transition/transversion ratio, a characteristic signature of molnupiravir action, appeared in the Global Initiative on Sharing All Influenza Data (GISAID) and International Nucleotide Sequence Database Collaboration (INSDC) databases. Here, we assessed the drug effects by SARS‐CoV‐2 whole‐genome sequencing on 38 molnupiravir‐treated persistently positive COVID‐19 outpatients tested before and after treatment. Seventeen tixagevimab/cilgavimab‐treated outpatients served as controls. Mutational analyses confirmed that SARS‐CoV‐2 exhibits an increased transition/transversion ratio seven days after initiation of molnupiravir. Moreover we observed an increased G‐>A ratio compared to controls, which was not related to apolipoprotein B mRNAediting enzyme, catalytic polypeptide‐like (APOBEC) activity. In addition, we demonstrated for the first time an increased diversity and complexity of the viral quasispecies. [ABSTRACT FROM AUTHOR]

The article discusses the efficacy of the XBB.1.5-monovalent boost COVID-19 vaccine in generating neutralizing antibodies against the JN.1 variant of the virus. The study involved 14 healthcare workers and 11 people with HIV who received a dose of the vaccine. The results showed that the vaccine induced neutralizing antibody titers against JN.1 in the majority of participants, with a significant increase in antibody levels observed after vaccination. The study suggests that the XBB.1.5 vaccine may be effective against the JN.1 variant, but further research is needed to confirm its efficacy. [Extracted from the article]

Whole‐genome sequencing (WGS) has been widely used for the genomic characterization and the phylogenesis of mpox virus (MPXV) 2022 multi‐country outbreak. To date, no evidence has been reported on intra‐host evolution within samples collected over time from a single patient with long‐term infection. Fifty‐one samples were collected from five patients at different time points post‐symptom onset. All samples were confirmed as MPXV DNA positive, amplified by a multiplexed PCR amplicon, and sequenced by WGS. Complete MPXV genomes were assembled by reference mapping and then aligned to perform phylogenetic and hierarchical clustering analysis. Large intra‐host variability was observed among the MPXV genomes sequenced from samples of two immunocompromised with advanced HIV‐1 infection patients with prolonged MPXV shedding. Overall, 20 nucleotide mutations were identified in the 32 genomes from HIV patients, differently distributed in samples collected from different tissues and at different time points. No sequence compartmentalization nor variation was observed in the three patients with rapid viral clearance. MPXV exhibits adaptation to changing environments within the infected host and consequently demonstrates tissue compartmentalization. Further studies are needed to elucidate the role of this adaptation in forming a pool of genetic variability and contributing to viral persistence and its clinical implications. [ABSTRACT FROM AUTHOR]