Department of Pathology and Immunology, Washington University School of Medicine, Saint Louis, MO, United States.
Department of Emergency Medicine, Washington University School of Medicine, Saint Louis, MO, United States.
Front Immunol. 2021 Jan 8;11:618402. doi: 10.3389/fimmu.2020.618402. eCollection 2020.
Prolonged shedding of viral RNA occurs in some individuals following SARS-CoV-2 infection. We perform comprehensive immunologic evaluation of one individual with prolonged shedding. The case subject recovered from severe COVID-19 and tested positive for SARS-CoV-2 viral RNA repeatedly as many as 87 days after the first positive test, 97 days after symptom onset. The subject did not have any associated rise in anti-Spike protein antibody titers or plasma neutralization activity, arguing against re-infection. This index subject exhibited a profoundly diminished circulating CD8+ T cell population and correspondingly low SARS-CoV-2-specific CD8+ T cell responses when compared with a cohort of other recovering COVID-19 subjects. CD4+ T cell responses and neutralizing antibody responses developed as expected in this individual. Our results demonstrate that detectable viral RNA shedding in the upper airway can occur more than 3 months following infection in some individuals with COVID-19 and suggest that impaired CD8+ T cells may play a role in prolonged viral RNA shedding.
在某些个体中，SARS-CoV-2 感染后会持续排出病毒 RNA。我们对一名持续排出病毒 RNA 的个体进行了全面的免疫评估。该病例患者从严重的 COVID-19 中康复，在首次检测呈阳性后多达 87 天、症状出现后 97 天连续多次检测 SARS-CoV-2 病毒 RNA 呈阳性。该患者的抗刺突蛋白抗体滴度或血浆中和活性没有任何相关升高，排除了再感染的可能性。与其他康复的 COVID-19 患者队列相比，该指标患者表现出循环 CD8+T 细胞群体显著减少，相应的 SARS-CoV-2 特异性 CD8+T 细胞反应也较低。该个体中出现了预期的 CD4+T 细胞反应和中和抗体反应。我们的研究结果表明，一些 COVID-19 患者在感染后 3 个多月的时间里，上呼吸道中可检测到病毒 RNA 持续排出，并提示受损的 CD8+T 细胞可能在持续病毒 RNA 排出中发挥作用。
