Case Study: Prolonged Infectious SARS-CoV-2 Shedding from an Asymptomatic Immunocompromised Individual with Cancer.

Abstract:

:Long-term severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) shedding was observed from the upper respiratory tract of a female immunocompromised individual with chronic lymphocytic leukemia and acquired hypogammaglobulinemia. Shedding of infectious SARS-CoV-2 was observed up to 70 days, and of genomic and subgenomic RNA up to 105 days, after initial diagnosis. The infection was not cleared after the first treatment with convalescent plasma, suggesting a limited effect on SARS-CoV-2 in the upper respiratory tract of this individual. Several weeks after a second convalescent plasma transfusion, SARS-CoV-2 RNA was no longer detected. We observed marked within-host genomic evolution of SARS-CoV-2 with continuous turnover of dominant viral variants. However, replication kinetics in Vero E6 cells and primary human alveolar epithelial tissues were not affected. Our data indicate that certain immunocompromised individuals may shed infectious virus longer than previously recognized. Detection of subgenomic RNA is recommended in persistently SARS-CoV-2-positive individuals as a proxy for shedding of infectious virus.

journal_name

Cell

journal_title

Cell

authors

Avanzato VA,Matson MJ,Seifert SN,Pryce R,Williamson BN,Anzick SL,Barbian K,Judson SD,Fischer ER,Martens C,Bowden TA,de Wit E,Riedo FX,Munster VJ

doi

10.1016/j.cell.2020.10.049

subject

Has Abstract

pub_date

2020-12-23 00:00:00

pages

1901-1912.e9

issue

7

eissn

0092-8674

issn

1097-4172

pii

S0092-8674(20)31456-2

journal_volume

183

pub_type

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