Increased viral variants in children and young adults with impaired humoral immunity and persistent SARS-CoV-2 infection: A consecutive case series.
EBioMedicine
; 67: 103355, 2021 May.
Article
in English
| MEDLINE | ID: covidwho-1385438
ABSTRACT
BACKGROUND:
There is increasing concern that persistent infection of SARS-CoV-2 within immunocompromised hosts could serve as a reservoir for mutation accumulation and subsequent emergence of novel strains with the potential to evade immune responses.METHODS:
We describe three patients with acute lymphoblastic leukemia who were persistently positive for SARS-CoV-2 by real-time polymerase chain reaction. Viral viability from longitudinally-collected specimens was assessed. Whole-genome sequencing and serological studies were performed to measure viral evolution and evidence of immune escape.FINDINGS:
We found compelling evidence of ongoing replication and infectivity for up to 162 days from initial positive by subgenomic RNA, single-stranded RNA, and viral culture analysis. Our results reveal a broad spectrum of infectivity, host immune responses, and accumulation of mutations, some with the potential for immune escape.INTERPRETATION:
Our results highlight the potential need to reassess infection control precautions in the management and care of immunocompromised patients. Routine surveillance of mutations and evaluation of their potential impact on viral transmission and immune escape should be considered.Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Precursor Cell Lymphoblastic Leukemia-Lymphoma
/
Immune Evasion
/
SARS-CoV-2
/
COVID-19
/
Mutation
Type of study:
Experimental Studies
/
Observational study
Topics:
Variants
Limits:
Adult
/
Child, preschool
/
Female
/
Humans
/
Male
/
Young adult
Language:
English
Journal:
EBioMedicine
Year:
2021
Document Type:
Article
Affiliation country:
J.EBIOM.2021.103355
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