A 72-year-old patient in the Netherlands suffered from the novel coronavirus infection for 613 days – marking the longest SARS-CoV-2 infection duration to date – before he died from an underlying blood disorder.
The man had failed to mount a strong immune response to multiple Covid shots before catching the Omicron variant in February 2022, reports TIME.
Detailed analysis of specimens collected from more than two dozen nose and throat swabs found the coronavirus developed resistance to sotrovimab, a Covid antibody treatment, within a few weeks, said scientists at the University of Amsterdam’s Centre for Experimental and Molecular Medicine.
It later acquired more than 50 mutations, including some that suggested an enhanced ability to evade immune defences.
The patient had also undergone stem cell transplantation for his blood disorder, and in the end he died from a relapse of his pre-existing condition while remaining SARS-CoV-2 positive with high loads of the virus.
The 20-month-long SARS-CoV-2 infection is the longest known, according to the researchers, who are presenting the case at a medical meeting in Barcelona next month.
While his mutant virus wasn’t known to have infected other people, it highlights how prolonged infections enable the pandemic virus to accumulate genetic changes, potentially spawning new variants of concern.
“This case underscores the risk of persistent SARS-CoV-2 infections in immunocompromised individuals,” the authors said. “We emphasise the importance of continuing genomic surveillance of SARS-CoV-2 evolution in immunocompromised individuals with persistent infections.
“The duration of SARS-CoV-2 infection in this case is extreme, but prolonged infections in immunocompromised patients are far more common compared with the general community.”
Scientists studying genomic data collected from wastewater samples have reported evidence of individuals in the community shedding heavily mutated coronaviruses for more than four years. Such persistent infections may also be causing patients to experience long Covid symptoms, research suggests.
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One in eight adults likely to develop long COVID symptoms – Dutch study