What the Longest COVID Case Can Teach Us

Medscape Staff

October 20, 2021

Editor's note: Find the latest COVID-19 news and guidance in Medscape's Coronavirus Resource Center.

Certain immunocompromised patients who have had the virus for months – or even close to a year – give insights into its mutations in the wider population.

What to know:

  • A patient who had previously been treated with CAR T-cell therapy for lymphoma was hospitalized with COVID-19 in spring 2020. She continued to have symptoms several months afterward.

  • COVID tests continued to show trace amounts of the virus, and in March 2021, her virus levels jumped. Sequencing revealed that it was the same virus that the patient had had 10 months earlier, not a case of reinfection, according to Veronique Nussenblatt, MD, an infectious disease specialist at the National Institutes of Health.

  • Similarly, a case study published in The New England Journal of Medicine describes a 45-year-old man who was infected with the virus for about 5 months, during which time the virus developed mutations similar to those that later occurred among the general population in the Alpha, Gamma, and Delta variants.

  • An analysis of case reports of chronic infections and reinfections that was published in Clinical Infectious Diseases suggests that in cases such as these, similar genetic deletions occur as the virus mutates.

  • Work by Ravindra Gupta, BMBCh, an infectious disease specialist at the University of Cambridge, suggests that the Alpha variant may first have appeared in an immunocompromised individual and that convalescent plasma appeared to drive viral evolution.

This is a summary of the article, "A Cancer Survivor Had the Longest Documented COVID-19 Infection. Here’s What Scientists Learned," published in Science on October 19. The full article can be found on science.org.

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