Prolonged COVID-19 Infection Fuels Variant Concerns
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Washington – A recently documented case in the United States underscores the potential global risk posed by exceptionally long-lasting COVID-19 infections. A patient with advanced, untreated HIV experienced active SARS-CoV-2 infection for over 750 days, raising concerns that such prolonged illnesses could provide opportunities for the virus to evolve into more dangerous variants.
Over Two Years of Continuous Infection
Published in The Lancet, the case details a man with a severely compromised immune system who battled a continuous COVID-19 infection from March 2021 to July 2022. Unlike typical “Long COVID” scenarios involving lingering symptoms after infection clears, this patient remained actively infected throughout the period, requiring five hospitalizations due to persistent respiratory issues. Repeated testing consistently confirmed the presence of the virus.
Genetic analysis of the virus samples taken from the patient revealed a rate of mutation comparable to that observed in widespread community transmission. Notably, some of the mutations identified were similar to those later found in the Omicron variant. ”Long-term infections give the virus time to find ways to more effectively attack cells,” explained William Hanage, a Harvard University epidemiologist and co-author of the study.
Scientists emphasize that these prolonged infections can contribute to the emergence of new, more transmissible variants. “Effective treatment of such infections is thus decisive not only for the patient, but also for public health,” Hanage added.
Severely Compromised Immune System
The patient’s prolonged infection was linked to advanced,untreated HIV,resulting in a critically low T-lymphocyte count of 35 cells per microliter of blood – significantly lower than the typical range of 500 to 1500. This weakened immune system allowed the virus to persist for an unusually extended period. While current evidence suggests this specific infection wasn’t easily transmissible, researchers caution that this may not always be the case.A team lead by Joseline Velasquez-Reyes from Boston University warns, ”Long-term infections can also bring variants that will spread easier.”
A Public Health Imperative
Experts stress the importance of protecting vulnerable individuals and preventing the emergence of new viral mutations.They highlight the continued relevance of vaccination, respirator use in crowded or poorly ventilated spaces, and prompt diagnosis and treatment. These measures, they say, can minimize the likelihood of similar extreme cases and limit the opportunities for the virus to further evolve.
