
Antibodies targeting the spike protein of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)
present a promising approach to combat the coronavirus disease 2019 (COVID-19) pandemic; however,
concerns remain that mutations can yield antibody resistance. We investigated the development of
resistance against four antibodies to the spike protein that potently neutralize SARS-CoV-2, individually as
well as when combined into cocktails. These antibodies remain effective against spike variants that have
arisen in the human population. However, novel spike mutants rapidly appeared after in vitro passaging
in the presence of individual antibodies, resulting in loss of neutralization; such escape also occurred
with combinations of antibodies binding diverse but overlapping regions of the spike protein. Escape
mutants were not generated after treatment with a noncompeting antibody cocktail.