Garcia-Vidal Carolina, Iglesias-Caballero María, Puerta-Alcalde Pedro, Mas Vicente, Cuesta-Chasco Genoveva, Garcia-Pouton Nicole, Varona Sarai, Pozo Francisco, Vázquez-Morón Sonia, Marcos Maria Angeles, Soriano Alex, Casas Inmaculada
Department of Infectious Diseases, Hospital Clinic of Barcelona-IDIBAPS, University of Barcelona, Barcelona, Spain.
Respiratory Virus and Influenza Unit, National Center of Microbiology, National Influenza Center, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain.
Front Microbiol. 2022 Mar 3;13:826883. doi: 10.3389/fmicb.2022.826883. eCollection 2022.
We documented a hematologic patient with prolonged SARS-CoV-2 viral replication in whom emergence of viral mutations was documented after the consecutive use of antivirals and convalescent plasma. The virus detected in the last of 12 clinical samples (day 237) had accumulated 22 changes in amino acids and 29 in nucleotides. Some of these changes, such as the E484Q, were mutations of concern as defined by WHO. This finding represents an enormous epidemiological threat and poses a major clinical challenge. Combined antiviral strategies, as well as specific strategies related to the diagnostic approach of prolonged infections for this specific population, may be needed.
我们记录了一名血液学患者，其感染的严重急性呼吸综合征冠状病毒2（SARS-CoV-2）病毒复制持续时间较长，在连续使用抗病毒药物和康复期血浆后出现了病毒突变。在12份临床样本中的最后一份（第237天）检测到的病毒，其氨基酸发生了22处变化，核苷酸发生了29处变化。其中一些变化，如E484Q，是世界卫生组织定义的值得关注的突变。这一发现构成了巨大的流行病学威胁，并带来了重大的临床挑战。可能需要联合抗病毒策略，以及针对这一特定人群长期感染诊断方法的具体策略。
