Department of Pathobiological Sciences, University of Wisconsin-Madison, Madison, WI, USA.
Department of Epidemiology of Microbial Diseases, School of Public Health, Yale University, New Haven, CT, USA.
Lancet Infect Dis. 2024 Jul;24(7):e453-e462. doi: 10.1016/S1473-3099(23)00815-0. Epub 2024 Feb 7.
SARS-CoV-2 causes persistent infections in a subset of individuals, which is a major clinical and public health problem that should be prioritised for further investigation for several reasons. First, persistent SARS-CoV-2 infection often goes unrecognised, and therefore might affect a substantial number of people, particularly immunocompromised individuals. Second, the formation of tissue reservoirs (including in non-respiratory tissues) might underlie the pathophysiology of the persistent SARS-CoV-2 infection and require new strategies for diagnosis and treatment. Finally, persistent SARS-CoV-2 replication, particularly in the setting of suboptimal immune responses, is a possible source of new, divergent virus variants that escape pre-existing immunity on the individual and population levels. Defining optimal diagnostic and treatment strategies for patients with persistent virus replication and monitoring viral evolution are therefore urgent medical and public health priorities.
SARS-CoV-2 在一部分个体中引起持续性感染，这是一个主要的临床和公共卫生问题，应该优先进一步调查，原因有几个。首先，持续性 SARS-CoV-2 感染常常未被识别，因此可能会影响相当数量的人，特别是免疫功能低下的个体。其次，组织储库（包括非呼吸道组织）的形成可能是持续性 SARS-CoV-2 感染的病理生理学基础，需要新的诊断和治疗策略。最后，持续性 SARS-CoV-2 复制，特别是在免疫反应不佳的情况下，可能是新的、不同的病毒变异株逃避个体和人群水平上现有免疫的来源。因此，确定持续性病毒复制患者的最佳诊断和治疗策略并监测病毒进化是紧迫的医学和公共卫生重点。
