A formerly cancer survivor battled COVID-19 for a record 335 days, with the longest documented case of infection ever.
The 47-year-old woman was first hospitalized at the National Institutes of Health (NIH) campus in Bethesda, Maryland, in the spring of 2020. Less than a month after a year, he was still testing positive for the virus, Science News reported. The case was published as a preprint on MedRxiv, yet to be peer-reviewed.
After recovering from lymphoma three years ago, her treatment had left her with very few B cells (antibody-producing immune cells) and so she was more susceptible to a severe, long-term infection. Only in April of this year the patient’s symptoms began to subside and he was able to test negative for COVID-19. According to ZOE COVID Symptom Tracker, an app designed for people to self-report their symptoms, most people recover from symptoms after an average of 10 or 11 days. Only 5 to 10 percent of people continue to have symptoms that last longer for several weeks or months.
The infectious disease specialist who treated the patient (NIH), Dr. “I’ve never seen a patient with an ongoing infection for a year. That’s a really long time,” Veronique Nussenblatt told Science News.
Nussenblatt and colleagues initially believed that continued positive COVID-19 tests were the result of harmless viral fragments that remained in the body after the infection had cleared. However, when his previously very low viral load rose again this March, doctors decided to sequence his genome, hoping to answer some of their questions. Was this the same as a long-term infection that his body couldn’t clear? Or had he been reinfected with another strain of the virus?
The results showed that the coronavirus in the patient’s system was very similar to the one he was carrying ten months ago. This virus, one of the first variants of SARS-CoV-2, is no longer found in the community. Molecular virologist at the NIH and author of the study, Dr. “It was the same virus,” Elodie Ghedin told Science News.
The research also uncovered two genetic deletions that could explain how the virus evolved while fighting a patient’s weakened immune system. The first was the mutation of the spike protein the virus uses to enter cells. The second deletion, which was more interesting than the team said, was just outside the spike protein sequence and was much larger.
Such mutations allow the virus to evade our immune responses and continue to make us sick, giving rise to new variants. As described in the current study, chronic infections in immunocompromised individuals may help to perpetuate this by facilitating repeated rounds of viral replication, which is met by a partial immune response in which the virus continually evolves. For example, the alpha variant may have first appeared in an immunocompromised individual. Therefore, it is very important to prevent immunocompromised people from being infected, to limit the chance of the virus turning into a new variant and, of course, to protect their health.
Fortunately, this story has a happy ending, albeit belatedly. After multiple negative tests, Nussenblatt announced that the infection was finally over. . .
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