613 days: this was how long the positivity of a 72-year-old immunocompromised man who died of Covid lasted, the protagonist of a clinical case reported at the Congress of the European Society of Clinical Microbiology and Infectious Diseases (ESCMID) in Barcelona by Magda Vergouwe of the Amsterdam University Medical Center. This is the longest case ever reported. According to what the experts explained, the persistence of the infection has led to the onset of a new, highly genetically modified variant (with 50 mutations).
The story
The patient was admitted to the Amsterdam University Medical Center in February 2022. He was battling blood cancer, and was taking immunosuppressants for this reason. In particular, a drug that eliminated B lymphocytes (white blood cells), including those that normally produce antibodies directed against the Coronavirus. His immune system, in other words, was unable to eliminate the virus. The man received treatment with the anti-SARS-CoV-2 antibody sotrovimab, the anti-IL6 antibody sarilumab and deksamethasone. But unfortunately it wasn’t enough to avoid the worst.
The variations
The man ultimately died due to a relapse of his haematological condition. During the period of his positivity (almost two years), there were many symptomatic episodes that forced him to be hospitalized. He also had to remain in isolation for a long time while in hospital, and use personal protection intensively. The virus isolated from the man was found to be resistant to sotrovimab as early as 21 days after receiving the treatment infusion. Due to the prolonged injection, a new variant has also emerged. The virus genome map isolated from the patient revealed over 50 mutations, confirming that long-lasting infections pave the way for the evolution and development of new variants.
