Halfmann Peter J, Minor Nicholas R, Haddock Iii Luis A, Maddox Robert, Moreno Gage K, Braun Katarina M, Baker David A, Riemersa Kasen K, Prasad Ankur, Alman Kirsten J, Lambert Matthew C, Florek Kelsey, Bateman Allen, Westergaard Ryan, Safdar Nasia, Andes David R, Kawaoka Yoshihiro, Fida Madiha, Yao Joseph D, Friedrich Thomas C, O'Connor David H
Department of Pathobiological Sciences, University of Wisconsin-Madison, 2015 Linden Dr, Madison, WI 53706, USA.
Department of Pathology and Laboratory Medicine, 3170 UW Medical Foundation Centennial Building (MFCB), 1685 Highland Avenue, Madison, WI 53705, USA.
Virus Evol. 2022 Nov 5;9(2):veac104. doi: 10.1093/ve/veac104. eCollection 2023.
Prolonged infections in immunocompromised individuals may be a source for novel Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) variants, particularly when both the immune system and antiviral therapy fail to clear the infection and enable within-host evolution. Here we describe a 486-day case of SARS-CoV-2 infection in an immunocompromised individual. Following monotherapy with the monoclonal antibody Bamlanivimab, the individual's virus acquired resistance, likely via the earliest known occurrence of Spike amino acid variant E484T. Recently, E484T has arisen again as a derivative of E484A in the Omicron Variant of Concern, supporting the hypothesis that prolonged infections can give rise to novel variants long before they become prevalent in the human population.
免疫功能低下个体的长期感染可能是新型严重急性呼吸综合征冠状病毒2（SARS-CoV-2）变体的来源，特别是当免疫系统和抗病毒治疗均无法清除感染并导致病毒在宿主体内进化时。在此，我们描述了一名免疫功能低下个体感染SARS-CoV-2长达486天的病例。在接受单克隆抗体巴尼韦单抗单药治疗后，该个体的病毒产生了耐药性，可能是通过最早已知的刺突氨基酸变体E484T的出现。最近，E484T作为关注的奥密克戎变体中E484A的衍生物再次出现，支持了这样一种假设，即长期感染早在新型变体在人群中流行之前就可能产生新的变体。
