Within-Host Evolution of SARS-CoV-2 in a B-Cell Depleted Patient With Successful Treatment

J Korean Med Sci. 2023 Jun 5;38(22):e175. doi: 10.3346/jkms.2023.38.e175.

Abstract

Prolonged viral shedding of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in an immunocompromised host is a challenge as the treatment and infection control for chronic coronavirus disease 2019 infection is not well established and there is a potential risk of new variants emerging. A 48-year-old woman who underwent chemotherapy, including rituximab and steroid, had reactivation of SARS-CoV-2 68 days after the virus was first detected. She successfully recovered after receiving convalescent plasma and intravenous immunoglobulin. Genomic analysis demonstrated that viruses collected from the nasopharyngeal specimens at day 0 and day 68 had 18 different nucleotide mutations, implying within-host evolution after in-depth epidemiologic investigation.

Keywords: Coronavirus Disease 2019; Immunodeficiency; SARS-CoV-2; Within-Host Evolution.

Publication types

  • Case Reports

MeSH terms

  • COVID-19 Serotherapy
  • COVID-19*
  • Female
  • Humans
  • Immunocompromised Host
  • Middle Aged
  • Rituximab / therapeutic use
  • SARS-CoV-2*
  • Steroids

Substances

  • Rituximab
  • Steroids