A truly extraordinary tale of a single patient with a 471 day ongoing Covid-19 infection involving three genetically distinct SARS-CoV-2 genotypes.
“Here we investigate intrahost evolution and genetic diversity of lineage B.1.517 during a SARS-CoV-2 chronic infection lasting for 471 days (and still ongoing) with consistently recovered infectious virus and high viral loads.
During the infection, we found an accelerated virus evolutionary rate translating to 35 nucleotide substitutions per year, approximately two-fold higher than the global SARS-CoV-2 evolutionary rate.
We measured SARS-CoV-2 viral load using RT-PCR and performed whole-genome sequencing on 30 samples. We tested a subset of twelve for infectious virus and found the individual was infectious with high virus copies for almost the entire duration of their infection.
This intrahost evolution led to the emergence and persistence of at least three genetically distinct genotypes suggesting the establishment of spatially structured viral populations continually reseeding different genotypes into the nasopharynx.”
