A 47-year-old cancer survivor tested positive for a record 335 days, becoming the longest ever documented case of COVID infection.
For most, a SARS-CoV-2 infection causes week and sometimes month-long symptoms. However, it is very rare that a person continues to test positive for almost a year. Now, a woman from Maryland has become the longest ever documented case of COVID infection. Previously, 72-year-old Dave Smith had held the record.
According to the study published on MedRxiv, the 47-year-old woman had first developed symptoms in the spring of 2020. As a result, she was hospitalized at the National Institutes of Health (NIH) campus in Bethesda, Maryland. However, as months passed, her symptoms continued to persist. Her cough and shortness of breath worsened to such an extent that she would require supplemental oxygen at home. Moreover, she continued to test positive for the virus.
Sometimes she felt better, sometimes she felt worse.
Dr. Veronique Nussenblatt, an infectious disease specialist at the National Institutes of Health
It wasn’t until April of this year that her symptoms began to die down and she started testing negative for COVID-19.
Virus Mutates Within Cancer Survivor
Initially, doctors suspected that the positive tests were due to nonviable viral fragments within the patient’s blood. Moreover, her alternating viral load levels made them suspect an infection with another strain. Thus, they decided to conduct a genome sequencing of the sample collected during the patient’s original infection and 10 months later.
What made this case unique was that the 47-year-old was a cancer survivor and had received CAR-T cell therapy 3 years earlier. As a result, she had extremely low levels of B cells, which help produce antibodies and evoke an immune response.
There’s very few systematic studies of immune-suppressed patients and how long they continue to shed virus. We need to study them so we can help these patients and prevent the virus from mutating further.
Dr. Jonathan Li, infectious disease specialist at Brigham and Women’s Hospital and Harvard Medical School
Sequencing revealed the virus to be similar to the one that infected her ten months prior. Moreover, researchers also noted two genetic deletions within the virus; one affected the spike protein and the other lay outside the spike sequence. Such mutations typically give rise to variants.
The study proved that chronic infections in immunocompromised individuals can help the virus mutate into new variants. Therefore, researchers call for timely intervention in immunocompromised people to prevent the emergence of variants.
Reference:
Nussenblatt, Veronique, et al. “Year-Long Covid-19 Infection Reveals within-Host Evolution of SARS-COV-2 in a Patient with B Cell Depletion.” 2021, doi:10.1101/2021.10.02.21264267.
