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Volume 30, Number 6—June 2024
Research Letter

Sporadic Occurrence of Ensitrelvir-Resistant SARS-CoV-2, Japan

Akihiro Doi1, Masayuki Ota, Masumichi Saito, and Shutoku MatsuyamaComments to Author 
Author affiliation: National Institute of Infectious Diseases, Tokyo, Japan

Main Article

Table

Number of mutations in NSP5 causing ensitrelvir resistance during March 31–December 31, 2023, in study of sporadic occurrence of ensitrelvir-resistant SARS-CoV-2, Japan*

Amino acid substitutions‡ No. cases from GISAID database†
Globally Japan China United States Europe Others
T45I 25 0 1 4 15 (60.0) 5
D48Y 0 0 0 0 0 0
M49I 90 6 0 77 (85.6) 5 2
M49L 277 256 (92.4) 2 15 0 4
M49T 1 0 0 0 0 1
M49V 1 0 0 1 0 0
L50F 85 6 2 31 26 20
P52L 4 2 0 0 0 2
Y54C 0 0 0 0 0 0
S144A 4 2 0 0 1 1
E166A 1 1 0 0 0 0
E166V 23 0 1 4 10 8
L167F 0 0 0 0 0 0
P168del 4 0 0 0 0 4
A173T 23 0 1 6 11 5
A173V 23 2 0 6 3 12 (52.2)
Q192R 2 0 0 0 1 1

*Numbers in parentheses are percentages of total global cases (if a particular mutation was found in >10 cases and was responsible for >50% of global cases). del, deletion; NSP5, nonstructural protein 5. †Sequences were extracted from the GISAID EpiCoV database (https://www.gisaid.org). ‡Amino acid substitutions in NSP5 that trigger emergence of ensitrelvir-resistant SARS-CoV-2 (5–8).

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References
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1Current affiliation: ACEL Inc., Kanagawa, Japan.

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