PDF(Pubmed)
Abstract：
The evolution of SARS-CoV-2 within immunocompromised hosts who fail to clear the virus over many months has been proposed as a route to the development of Variants of Concern (VoCs). We present a case of an immunocompromised male patient with a prolonged SARS-CoV-2 infection. During hospitalisation, 7 weeks after first diagnosis, his condition worsened to require continuous ventilation support. Resolution of symptoms was observed after convalescent plasma therapy. Whole genome sequencing of the virus showed Pango lineage B.1.221. Between the first sample and the second from bronchoalveolar lavage fluid 7 weeks later, we identified eight mutations, including minor variants, which could be used to estimate the chronology of mutations. This suggests an elevated mutation rate, in-host accumulation of mutations and further evidence for sources of VoCs. Prolonged SARS-CoV-2 infections in immunocompromised hosts increase the likelihood of hospital stays and morbidity, and also pose an increased risk to global public health.
摘要：
已经提出了SARS-CoV-2在免疫受损宿主中的进化，这些宿主在数月内未能清除病毒，这是发展关注变体（VoCs）的途径。我们介绍了一例长期感染SARS-CoV-2的免疫功能低下的男性患者。住院期间,首次诊断后7周，他的病情恶化，需要持续的通气支持。在恢复期血浆治疗后观察到症状的缓解。该病毒的全基因组测序显示Pango谱系B.1.221。7周后，在第一个样本和第二个来自支气管肺泡灌洗液的样本之间，我们发现了8个突变,包括次要变体，可以用来估计突变的时间顺序。这表明突变率升高，突变的宿主内积累和VoCs来源的进一步证据。在免疫功能低下的宿主中延长SARS-CoV-2感染增加了住院时间和发病率的可能性。并对全球公共卫生构成更大的风险。
