British patient had COVID-19 continuously for 505 days

The patient, who was taking part in a study with eight other patients, died in a hospital back in 2021, but only now has the case been presented at the European Congress of Clinical Microbiology and Infectious Diseases in Lisbon, Portugal. It is not known whether the unnamed patient also died of COVID-19, since according to the doctors he had other diseases in addition to an immune deficiency, but the observations brought important insights into mutations of the virus.

A patient in the UK had been sick with COVID-19 for 505 days before dying – the longest duration of illness on record to date.

Facts

Persistent COVID-19: Rare and Different from Long COVID

While Long COVID is becoming more common, permanent COVID-19 is rare. In long COVID, the SARS-CoV-2 virus is only in the body for a while, but the symptoms remain permanent, while in prolonged COVID-19 disease, the virus stays active in the body, replicating – and also mutating.

Each time the researchers examined patients in the study, they analyzed the genetic code of the virus to make sure it was the same strain and that the patients hadn’t been infected with COVID-19 more than once. However, genetic sequencing showed that the virus in the British patient changed over time, mutating as it adapted.

The mutations were similar to those that later appeared in common variants, Dr. Luke Blagdon Snell, an infectious disease expert at Guy’s & St Thomas‘ NHS Foundation Trust, although none of the patients produced new mutants that became variants of concern. There is also no evidence that they passed the virus on to others.

The study

The study presented at the congress, which has not yet been published, examined which mutations occur in people with particularly long infections and whether variants develop. The study involved nine patients who had tested positive for the virus for at least eight weeks. All had weakened immune systems due to organ transplants, HIV, cancer, or treatment for other diseases.

Repeated testing found their infections lasted an average of 73 days. Two had the virus for more than a year. The longest known case to date, confirmed with a PCR test, lasted 335 days, the researchers said.

Five of the nine patients were still alive at the end of the study, which ran from 2020 to 2021. Two of them cleared the infection without treatment, two after treatment and one still has COVID-19. At the last follow-up in early 2022, the infection in this patient had lasted 412 days.

Immunocompromised individuals remain at risk

It must not be forgotten that the pandemic is far from over with the lifting of most corona measures. In particular, immunocompromised people, whether due to illness or necessary medication, are at risk of getting Long COVID or the persistent COVID-19, which is still rare.

And therein lies the danger: If persistent COVID-19 occurs more frequently, the possibility of mutations developing and spreading more frequently in such sufferers also increases – and this possibility increases as more people go back to shopping without protective masks and at festivals , concerts and parties.

Dr. David Strain from the University of Exeter Medical School: “Although omicron did not appear in these individuals, this shows a very clear pathway by which vaccine-resistant variants can arise. While we were fortunate with BA.2 that the mutation is linked to a less severe disease, there is no guarantee the next iteration will be the same.“

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Originaltext

Bereits 2021 verstarb der Patient, der mit acht anderen Patienten an einer Studie teilnahm, in einem Krankenhaus, doch jetzt erst wurde der Fall auf dem Europäischen Kongress für klinische Mikrobiologie und Infektionskrankheiten in Lissabon, Portugal, vorgestellt.