The longer the coronavirus is investigated, the more it is confirmed: it does not look like anything. The latest discovery: it is possible that SARS-CoV-2 mutates inside the body of those who have already suffered the disease. Sometimes in those who have been ill, the symptoms really worsen again, it is believed that the cause may be the long-term persistence of the virus in the body. But sometimes a completely different strain is found in re-ill patients. It is possible that this is not a re-infection, but an accelerated evolution of the same virus.
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A patient living in the United States who suffered from an autoimmune disease experienced three more recurrences of infection after the initial infection with SARS-CoV-2. Experts first explained this by the long stay of the virus in the body, however, it turned out that in the course of accelerated evolution it acquired completely new properties.
The New England Journal of Medicine published an unusual clinical case that showed that the coronavirus can acquire mutations during its stay in the body of the same person. This case was described by doctors at Brigham and Weyman Hospital in Boston.
A 45-year-old man, before being infected with COVID-19, suffered from a serious autoimmune disease – antiphospholipid syndrome, the diagnosis was accompanied by hypercoagulability and provoked the formation of blood clots, the disease was further complicated by diffuse pulmonary hemorrhage.
Due to his underlying disease, the man received anticoagulants, glucocorticoids, and monoclonal antibodies on an ongoing basis.
He was admitted to the hospital with a high fever and a positive test for coronavirus, after five days of intensive care he was discharged to continue treatment at home.
A few weeks later he was hospitalized again, this time with abdominal pain and hypoxemia from diffuse pulmonary hemorrhage.
On the 72nd day, he again had a positive PCR test, which aroused doctors’ suspicions about re-infection with coronavirus or about the return of the infection (recurrence).
After 10 days, the test turned negative again and was sent home.
But on the 105th day, they were hospitalized with inflammation of the subcutaneous tissue. This time, due to severe hypoxemia, he required a high flow rate of oxygen. On the 128th day, the test showed a positive result for the third time.
On the 143rd day, judging by the analyzes, the virus continued to remain in the body, then the patient was injected with a cocktail of antibodies against the SARS-COV-2 S-protein. On the 150th day of his stay in the hospital, he was forced to be transferred to mechanical ventilation, on the 154th patient died of respiratory failure.
Post-mortem analysis showed a high viral load in the lungs and liver. And when comparing the SARS-COV-2 sequences found in the first and subsequent PCR tests, it turned out that the viruses are not identical – they are different strains.
Initially, it was assumed that the man was infected as many as three times, but further research showed that all samples of the coronavirus that differ in mutations have a common “ancestor”. The modified regions accounted for 13% and 2% of the total viral genome, 57% and 38% of mutations occurred in them, respectively.
For this reason, all three cases of re-infection should not be considered a new infection, but a recurrence. It is caused by the fact that the virus not only persisted for a long time in the patient’s body, but also evolved while inside the human body.
Is this a feature of a particular patient with an autoimmune disease or can it be transferred to any other person, because cases of re-infection with coronavirus are being detected more and more often? However, if it turns out that the accelerated evolution of the same COVID-19 is possible in the human body, then this creates the potential for persistent chronic infection.
Comments on the situation Jeanne Schmidt, pathologist at the University of Marburg: “Yes, the virus can circulate inside our body for a long time, and its mutations can theoretically lead to a change in its properties.
This can happen for a variety of reasons. For example, in a person with a malfunctioning immune system: due to the high viral load that he received. Or, being sick with a coronavirus infection, he simultaneously contracted some more ARVI and, due to external influences, COVID-19 evolved.
We still know too little about the nature of this disease to draw definitive conclusions.
Apparently, yes, with each new exacerbation there may be new, unusual symptoms.
The virus tries to adapt and stay in the human body for a long time, for this it “deceives” us in a variety of ways. “
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