British researchers have been treating a man with persistent Covid for more than a year
After further tests in February 2021 and January 2022 came back positive, the team in London carried out a genetic analysis of the virus, which showed that the same strain was present at each stage, with only minor variations – meaning the patient was suffering from chronic infection with the coronavirus, not multiple new infections.
Chronic coronavirus infection is different from long-term covid, in which people suffer from persistent symptoms and long-term effects after being infected with the virus that causes covid-19.
“Everyone is infected with omicron today, but when we looked at his virus, it was something that existed a long time ago – long before omicron, long before delta, and even before alpha. So it was one of those older, early variants from the beginning of the pandemic,” Luke Blagdon Snell, an infectious disease specialist and researcher on the case, told The Washington Post on Friday.
Because the patient only experienced mild or intermittent symptoms, he was not eligible for treatments used to prevent or treat severe covid.
Genetic sequencing results showed that the man was infected with the B.1.177.18 variant of the coronavirus, which was present in Britain at the end of 2020. The team was therefore able to give the patient a combination antibody treatment that proved effective against that strain.
The case was among several that Snell and a team of researchers from Guy’s and St Thomas’ NHS Foundation Trust and the Department of Infectious Diseases at King’s College London highlighted in the preprint article. published in the peer-reviewed journal Clinical Infectious Diseases on Thursday.
Although the newer variants that now dominate in Britain do not respond to the antibodies used in this case, the findings show the potential for individualized therapies in patients with chronic coronavirus infections. The genome sequencing process described in the paper provides results within 24 hours, allowing medical teams to respond quickly to patient needs.
In two other cases highlighted in the report, genetic sequencing showed that patients suspected of having prolonged infection were in fact reinfected with a newer strain of the virus. Their doctors were therefore able to change their treatment plans accordingly.
Genome sequencing has been used throughout the pandemic to identify new variants and sub-strains, such as omicron, which was first discovered by scientists in southern Africa in November 2021.
It is unclear how widespread chronic coronavirus infections are. The longest known case so far was in a patient who was positive for 505 days before death and treated by the same teams.
“But there’s definitely a difference between a normal infection in the community that clears up within two weeks,” as happens in most cases, and a small fraction of immunocompromised patients who are at risk of a chronic infection that lasts more than six weeks, Snell said. .
Among persistent infections, he said, there are two groups: those, like the cured man, who are relatively asymptomatic, and others who face more serious outcomes.
Any long-term infection will affect the body, but even asymptomatic cases can prove dangerous: “We know that some people, even after a few months, if they have this persistent infection, they can get worse later.”
And although cases of chronic infection are rare, high levels of infection mean that vulnerable patients are more likely to be infected and potentially develop chronic infections, he added.
The goal of future research in this area is to collect enough data on persistent infections to identify new treatment options — an issue that has become increasingly important given the increasing resistance of new variants to antiviral treatments, Snell said.
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