UK researchers cure man with persistent Covid for over a year

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British researchers say they used genetic sequencing to help cure a man infected with the coronavirus for more than 411 days.

The 59-year-old patient, who had a weakened immune system due to a kidney transplant and the use of immunosuppressive medication, initially tested positive in December 2020.

After further tests in February 2021 and January 2022 came back positive, the London team carried out a genetic analysis of the virus, which showed that the same strain was present at every stage, with only minor variations – this which means the patient was suffering from a chronic coronavirus infection, rather than multiple new infections.

Chronic coronavirus infection is distinct from long-term covid, in which people suffer persistent symptoms and long-term effects after being infected with the virus that causes covid-19.

“Nowadays everyone is infected with omicron, but when we looked at his virus, it was something that existed a long time ago – long before omicron, long before delta and even before alpha. So it was the ‘one of those old, early variants of the start of the pandemic,’ Luke Blagdon Snell, an infectious disease specialist and researcher on the case, told The Washington Post on Friday.

Because the patient had only mild or intermittent symptoms, he was not eligible for treatments used to prevent or treat severe covid.

Genetic sequencing results showed that the man had been infected with the B.1.177.18 variant of the coronavirus, which was present in Britain at the end of 2020. The team were therefore able to give the patient a combination antibody treatment which has been shown to be effective against this strain.

The case was among several highlighted by Snell and the team of researchers from Guy’s and St Thomas’ NHS Foundation Trust and the Department of Infectious Diseases at King’s College London in a preprint article. published in the peer-reviewed journal Clinical Infectious Diseases Thursday.

Although the newer variants now dominant in Britain do not respond to the antibodies used in this case, the results show the potential for individualized therapies in patients with chronic coronavirus infections. The genome sequencing process described in the article delivers results within 24 hours, allowing medical teams to respond quickly to patient needs.

In two other cases highlighted in the report, genetic sequencing showed that patients suspected of suffering from prolonged infection had in fact been reinfected with a new strain of the virus. Their doctors were therefore able to modify their treatment plans accordingly.

Genome sequencing has been used throughout the pandemic to identify new variants and substrains, such as omicron, which was first detected by scientists in southern Africa in November 2021.

Scientists have a powerful new tool to control the coronavirus: its own genetic code.

It is not known what the prevalence of chronic coronavirus infections is. The longest known case to date involves a patient who tested positive for 505 days before dying and was treated by the same teams.

“But there is certainly a difference between a normal community infection that resolves within two weeks,” as happens in most cases, and the small proportion of immunocompromised patients who are at risk of having a chronic infection that lasts longer than six weeks, Snell said.

Among persistent infections, he said, there are two groups: those, like the man who was cured, who are relatively asymptomatic, and others who face more serious consequences.

Any long-term infection will affect the body, but even asymptomatic cases can be dangerous: “We know that some people, even after several months, if they have this persistent infection, may deteriorate later.”

And while cases of chronic infection are rare, high levels of infection mean vulnerable patients are more likely to become infected and potentially develop chronic infections, he added.

The goal of future research in this area is to collect enough data on persistent infections to identify new treatment options – an issue that has become all the more important given the growing resistance of new variants to treatments. antivirals, Snell said.

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