Genetic Surveillance of SARS-CoV-2 M pro Reveals High Sequence and Structural Conservation Prior to the Introduction of Protease Inhibitor Paxlovid

Abstract

The recent authorization of oral severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antivirals, such as Paxlovid, has ushered in a new era of the COVID-19 pandemic. The emergence of new variants, as well as the selective pressure imposed by antiviral drugs themselves, raises concern for potential escape mutations in key drug binding motifs.