Persistence and Evolution of SARS-CoV-2 in an Immunocompromised Host
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SARS-CoV-2 in an Immunocompromised Host This letter describes an immunocompromised patient who had persistent infection with SARS-CoV-2 over a period of months, despite several courses of remdesivi...
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The authors say that immune evasion can arise in chronically infected immunocompromised patients under treatment with immune plasma or monoclonal antibodies.
“The possible theories about the origin of novel variants are the evolution of circulating intermediate mutants in the chronically infected immunocompromised patients supporting high viral replication while on treatment with immune plasma or monoclonal antibodies [88, 89].”
From Waves and variants of SARS-CoV-2: understanding the causes and effect of the COVID-19 catastrophe (2022) · cites this paper as [88]
The main text reports persistent infection, high viral loads, and accelerated viral evolution in one immunocompromised patient, who later received a SARS-CoV-2 antibody cocktail. It does not report immune-plasma treatment or establish immune evasion, the origin of novel variants, or that antibody treatment drove the observed evolution. The indexed copy gives no page number. (LLM, conf=0.86)
Experimental — accuracy not yet measuredThe recent emergence of B.1.1.7, B.1.351 and P.1 marks the beginning of SARS-CoV-2 antigenic drift.
“The recent emergence of B.1.1.7,B.1.351and P.1 marks the beginning of SARS-CoV-2 antigenic drift.”
From Antibody resistance of SARS-CoV-2 variants B.1.351 and B.1.1.7 (2021) · cites this paper as [46]
In the PHIRST-C community cohort study in two South African locations, infection prior to the second wave provided 84% protection against reinfection during the second (Beta) wave.
“which found that infection prior to the second wave provided 84% protection against reinfection during the second (Beta) wave ( 18 )”
From Increased risk of SARS-CoV-2 reinfection associated with emergence of Omicron in South Africa (2021) · cites this paper as [18]
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- Authors
- Choi, B., Choudhary, M. C., Regan, J., Sparks, J. A., Padera, R. F., Qiu, X., Solomon, I. H., Kuo, H.-H., Boucau, J., Bowman, K., Adhikari, U. D., Winkler, M. L., Mueller, A. A., Hsu, T. Y.-T., Desjardins, M., Baden, L. R., Chan, B. T., Walker, B. D., Lichterfeld, M., Brigl, M., Kwon, D. S., Kanjilal, S., Richardson, E. T., Jonsson, A. H., Alter, G., Barczak, A. K., Hanage, W. P., Yu, X. G., Gaiha, G. D., Seaman, M. S., Cernadas, M., & Li, J. Z.
- Affiliations
- Brigham and Women's Hospital (US)
- Harvard University (US)
- Ragon Institute of MGH, MIT and Harvard (US)
- Beth Israel Deaconess Medical Center (US)
- Corresponding author
- Cernadas, Manuela
- ORCID
- Choi, Bina
- Choudhary, Manish C.
- Regan, James
- Sparks, Jeffrey A.
- Padera, Robert F.
- Qiu, Xueting
- Solomon, Isaac H.
- Kuo, Hsiao-Hsuan
- Boucau, Julie
- Bowman, Kathryn
- Adhikari, U. Das
- Winkler, Marisa L.
- Mueller, Alisa A.
- Hsu, Tiffany Y.-T.
- Desjardins, Michaël
- Baden, Lindsey R.
- Chan, Brian T.
- Walker, Bruce D.
- Lichterfeld, Mathias
- Kwon, Douglas S.
- Kanjilal, Sanjat
- Richardson, Eugene T.
- Jonsson, A. Helena
- Alter, Galit
- Barczak, Amy K.
- Hanage, William P.
- Yu, Xu G.
- Gaiha, Gaurav D.
- Seaman, Michael S.
- Cernadas, Manuela
- Li, Jonathan Z.
- Venue
- New England Journal of Medicine
- Publisher
- Massachusetts Medical Society
- Published
- 2020-12-03
- Volume
- 383
- Issue
- 23
- Pages
- 2291-2293
- ISSN
- 0028-4793 (ISSN-L)
- 1533-4406
- PMC
- PMC7673303
- OpenAlex
- W3102798166
- Cited by
- 1,246
- References
- 5
- Citations by year
- 2026: 45 · 2025: 89 · 2024: 122 · 2023: 208 · 2022: 382 · 2021: 391 · 2020: 8
- FWCI
- 32.43
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- New England Journal of Medicine (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Massachusetts Consortium for Pathogen Readiness
- Evergrande Fund
- Mark, Lisa, and Enid Schwartz
- Harvard University Center for AIDS Research (NIAID 5P30AI060354)
- Brigham and Women’s Hospital
- National Center for Advancing Translational Sciences (1UL1TR001102)
- Topics
- Health Sciences › Medicine › Infectious Diseases › COVID-19 Clinical Research Studies
- Health Sciences › Medicine › Infectious Diseases › SARS-CoV-2 and COVID-19 Research
- Health Sciences › Medicine › Neurology › Long-Term Effects of COVID-19
- Keywords
- SARS-CoV-2, persistent infection, immunocompromised patients, remdesivir, COVID-19 pandemic, viral persistence, treatment failure
- MeSH terms
- COVID-19, SARS-CoV-2, Humans, Male, Middle Aged, Antiphospholipid Syndrome, Immunocompromised Host, Fatal Outcome, Viral Load
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