Due to immunodeficiency, a 72-year-old patient was positive for Covid-19 for 613 days. This is the longest infection duration recorded to date.
- A 72-year-old patient was positive for Covid-19 for 613 days.
- This prolonged infection is linked to an immune deficiency, resulting from a blood disease.
- Scientists are concerned about mutations in the virus caused by these long infections.
He was contaminated for more than a year and a half. In the Netherlands, a 72-year-old man was infected with SARS-CoV-2 for 613 days. His case is the subject of a scientific study, which will be presented in Barcelona, during the Congress of the European Society of Clinical Microbiology and Infectious Diseases (ESCMID), between April 27 and 30. This persistent infection is linked to an immune deficiency in the patient, resulting from a blood disease. For scientists, this case raises fears of the appearance of new variants, capable of evading the immune system.
Covid-19: a prolonged infection linked to an immune deficiency
“While healthy SARS-CoV-2 infected patients can clear the virus within days or even weeks, an immunocompromised person may develop a persistent infection with prolonged viral replication and progression, explain the authors. For example, the initial emergence of the Omicron variant is believed to have originated in an immunocompromised individual.” In this recent case, the 72-year-old man was admitted to hospital in February 2022 following infection with SARS-CoV-2. Due to a blood disease, for which he received stem cell transplants, the patient was considered immunocompromised. “This was complicated by the development of post-transplant lymphoma for which he received rituximab which depletes all available B cells, including those that normally produce antibodies against SARS-CoV-2.”, specify the authors. Prior to this admission, the man had received several vaccine injections, but his immune system had not responded.
Covid-19 and immune deficiency: 613 days of contamination and several hospitalizations
From the first detection of the virus in his body, until his death, 613 days passed. Several cases of infections lasting several hundred days have been observed by scientists, but this case constitutes the longest period of infection observed. “The 613 days following initial detection of SARS-CoV-2 were characterized by multiple SARS-CoV-2-related and unrelated symptomatic episodes, requiring hospitalizations., indicate the scientists. His immune system was not able to eliminate the virus, despite various treatments.
Prolonged Covid-19 infection: an increase in virus mutations
Above all, the virus has evolved in his body. The 27 PCR tests carried out showed more than 50 mutations, compared to the initial variant. “Prolonged infection led to the emergence of a new immune-evasive variant due to extensive evolution within the hostthey develop. Ultimately, the patient died due to a relapse in his hematological status after remaining SARS-CoV-2 positive with a high viral load for a total of 613 days. Fortunately, there has been no documented transmission of the highly mutated variant to secondary cases in the community..”
For scientists, it is essential to monitor persistent infections in immunocompromised people to reduce the risk of viral mutations appearing. “The duration of SARS-CoV-2 infection in this described case is extreme, but prolonged infections in immunocompromised patients are much more common than in the general community, they warn. (…) However, from the point of view of the general public, prolonged infections remain rare, because the immunocompromised population represents only a very small percentage of the total population.”