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Viral Haplotypes in COVID-19 Patients Associated With Prolonged Viral Shedding.
Wu, Yingping; Zheng, Shufa; Liu, Tian; Liu, Xueke; Tang, Huina; He, Yutong; Xu, Wei; Li, Lele; Yu, Wenxu; Xing, Ke; Xia, Xiaoping.
  • Wu Y; Fourth Affiliated Hospital, College of Medicine, Zhejiang University, Jinhua, China.
  • Zheng S; State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Centre for Infectious Diseases, Collaborative Innovation Centre for Diagnosis and Treatment of Infectious Diseases, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
  • Liu T; Fourth Affiliated Hospital, College of Medicine, Zhejiang University, Jinhua, China.
  • Liu X; Fourth Affiliated Hospital, College of Medicine, Zhejiang University, Jinhua, China.
  • Tang H; Fourth Affiliated Hospital, College of Medicine, Zhejiang University, Jinhua, China.
  • He Y; School of Life Sciences, Guangzhou University, Guangzhou, China.
  • Xu W; Fourth Affiliated Hospital, College of Medicine, Zhejiang University, Jinhua, China.
  • Li L; Fourth Affiliated Hospital, College of Medicine, Zhejiang University, Jinhua, China.
  • Yu W; Fourth Affiliated Hospital, College of Medicine, Zhejiang University, Jinhua, China.
  • Xing K; School of Life Sciences, Guangzhou University, Guangzhou, China.
  • Xia X; Fourth Affiliated Hospital, College of Medicine, Zhejiang University, Jinhua, China.
Front Cell Infect Microbiol ; 11: 715143, 2021.
Article in English | MEDLINE | ID: covidwho-1551489
ABSTRACT

Background:

Recently, more patients who recovered from the novel coronavirus disease 2019 (COVID-19) may later test positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) again using reverse transcription-polymerase chain reaction (RT-PCR) testing. Even though it is still controversial about the possible explanation for clinical cases of long-term viral shedding, it remains unclear whether the persistent viral shedding means re-infection or recurrence.

Methods:

Specimens were collected from three COVID-19-confirmed patients, and whole-genome sequencing was performed on these clinical specimens during their first hospital admission with a high viral load of SARS-CoV-2. Laboratory tests were examined and analyzed throughout the whole course of the disease. Phylogenetic analysis was carried out for SARS-CoV-2 haplotypes.

Results:

We found haplotypes of SARS-CoV-2 co-infection in two COVID-19 patients (YW01 and YW03) with a long period of hospitalization. However, only one haplotype was observed in the other patient with chronic lymphocytic leukemia (YW02), which was verified as one kind of viral haplotype. Patients YW01 and YW02 were admitted to the hospital after being infected with COVID-19 as members of a family cluster, but they had different haplotype characteristics in the early stage of infection; YW01 and YW03 were from different infection sources; however, similar haplotypes were found together.

Conclusion:

These findings show that haplotype diversity of SARS-CoV-2 may result in viral adaptation for persistent shedding in multiple recurrences of COVID-19 patients, who met the discharge requirement. However, the correlation between haplotype diversity of SARS-CoV-2 virus and immune status is not absolute. It showed important implications for the clinical management strategies for COVID-19 patients with long-term hospitalization or cases of recurrence.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 Type of study: Prognostic study / Randomized controlled trials Limits: Humans Language: English Journal: Front Cell Infect Microbiol Year: 2021 Document Type: Article Affiliation country: Fcimb.2021.715143

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Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 Type of study: Prognostic study / Randomized controlled trials Limits: Humans Language: English Journal: Front Cell Infect Microbiol Year: 2021 Document Type: Article Affiliation country: Fcimb.2021.715143