Persistent Severe Acute Respiratory Syndrome Coronavirus 2 Infection in Immunocompromised Host Displaying Treatment Induced Viral Evolution

Ida Monrad; Signe Risgaard Sahlertz; Stine Sofie Frank Nielsen; Louise Ørnskov Pedersen; Mikkel Steen Petersen; Carl Mathias Kobel; Irene Harder Tarpgaard; Merete Storgaard; Klaus Leth Mortensen; Mariane H Schleimann; Martin Tolstrup; Line K Vibholm

doi:10.1093/ofid/ofab295

Persistent Severe Acute Respiratory Syndrome Coronavirus 2 Infection in Immunocompromised Host Displaying Treatment Induced Viral Evolution

Open Forum Infect Dis. 2021 Jun 4;8(7):ofab295. doi: 10.1093/ofid/ofab295. eCollection 2021 Jul.

Authors

Affiliations

¹ Department of Infectious Diseases, Aarhus University Hospital, Aarhus, Denmark.
² Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.
³ Department of Medicine, Regional Hospital West Jutland, Herning, Denmark.
⁴ Department of Clinical Immunology, Aarhus University Hospital, Aarhus, Denmark.
⁵ Department of Clinical Microbiology, Aarhus University Hospital, Aarhus, Denmark.

Abstract

We report a coronavirus disease 2019 case with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) persisting beyond 333 days in an immunocompromised patient with chronic lymphocytic leukemia, asymptomatically carrying infectious SARS-CoV-2 at day 197 postdiagnosis. In addition, viral sequencing indicates major changes in the spike protein over time, temporally associated with convalescent plasma treatment.

Keywords: CLL; SARS-CoV-2; persistent infection; viral evolution.