A patient from the United Kingdom with a severely weakened immune system has had COVID-19 for almost a year and a half, scientists said, stressing the importance of protecting vulnerable people from the coronavirus.
There is no way to know for sure whether this is the longest-lasting COVID-19 infection, because not everyone is tested, especially regularly as in this case.
But at 505 days, “it certainly seems to be the longest reported infection,” said Dr. Luke Blagden Snell, an infectious disease expert at the Guy’s & St. Louis Foundation. Thomas’ NHS Foundation Trust.
Snell’s team plans to present several “sustainable” cases of COVID-19 at a meeting on infectious diseases in Portugal this weekend.
Their study examines which mutations occur – and whether variants develop – in people with super long infections. It involved nine patients who tested positive for the virus for at least eight weeks. All had weakened immune systems from organ transplants, HIV, cancer or other diseases. No one was identified for privacy reasons.
Repeat tests showed that their infections lasted an average of 73 days. Two had the virus for more than a year. Earlier, researchers said the longest known case, which was confirmed by PCR, lasted 335 days.
Persistent COVID-19 is rare and different from long-term COVID.
“Prolonged COVID usually assumes that the virus has been cleared from your body, but symptoms persist,” Snell said. “In persistent infection, this is a continuous, active replication of the virus.”
Each time the researchers tested patients, they analyzed the genetic code of the virus to make sure it was the same strain and that people did not get COVID-19 more than once. However, genetic sequencing has shown that the virus changes over time, mutating as it adapts.
The mutations are similar to those that later appear in widespread variants, Snell said, although none of the patients have spawned new mutants that have become anxiety variants. There is also no evidence that they have spread the virus to others.
The man with the longest known infection tested positive in early 2020, was treated with the antiviral drug Remdesiver and died sometime in 2021. Researchers declined to say the cause of death and said the person had several other illnesses.
Five patients survived. Two cleared the infection without treatment, two cleared it after treatment and one still has COVID-19. At the last follow-up earlier this year, the patient’s infection lasted 412 days.
Researchers hope that more treatments will be developed to help people with persistent infections defeat the virus.
“We have to keep in mind that there are some people who are more susceptible to these problems, such as persistent infection and serious illness,” Snell said.
Although persistent infections are rare, experts said there are many people with compromised immune systems who remain at risk of severe COVID-19 and who are trying to stay safe after governments lifted restrictions and masks began to be removed. And it’s not always easy to know who they are, said Dr. Wesley Long, a Houston Methodist pathologist in Texas who was not part of the study.
“Masking in crowds is a careful thing and a way we can protect others,” he said.
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