Case Study: Prolonged Infectious SARS-CoV-2 Shedding from an Asymptomatic Immunocompromised Individual with Cancer | Zendy

Victoria A. Avanzato | Zendy; M. Jeremiah Matson | Zendy; Stephanie N. Seifert | Zendy; Rhys Pryce | Zendy; Brandi N. Williamson | Zendy; Sarah L. Anzick | Zendy; Kent Barbian | Zendy; Seth Judson | Zendy; Elizabeth R. Fischer | Zendy; Craig Martens | Zendy; Thomas A. Bowden | Zendy; Emmie de Wit | Zendy; Francis X. Riedo | Zendy; Vincent J. Munster | Zendy

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Case Study: Prolonged Infectious SARS-CoV-2 Shedding from an Asymptomatic Immunocompromised Individual with Cancer

Author(s) -

Victoria A. Avanzato,

M. Jeremiah Matson,

Stephanie N. Seifert,

Rhys Pryce,

Brandi N. Williamson,

Sarah L. Anzick,

Kent Barbian,

Seth Judson,

Elizabeth R. Fischer,

Craig Martens,

Thomas A. Bowden,

Emmie de Wit,

Francis X. Riedo,

Vincent J. Munster

Publication year - 2020

Publication title -

cell

Language(s) - English

Resource type - Journals

SCImago Journal Rank - 26.304

H-Index - 776

eISSN - 1097-4172

pISSN - 0092-8674

DOI - 10.1016/j.cell.2020.10.049

Subject(s) - biology , viral shedding , virology , subgenomic mrna , asymptomatic , coronavirus , vero cell , virus , immunology , coronaviridae , viral replication , respiratory tract infections , respiratory tract , respiratory system , rna , covid-19 , gene , medicine , infectious disease (medical specialty) , pathology , genetics , disease , anatomy

Long-term severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) shedding was observed from the upper respiratory tract of a female immunocompromised individual with chronic lymphocytic leukemia and acquired hypogammaglobulinemia. Shedding of infectious SARS-CoV-2 was observed up to 70 days, and of genomic and subgenomic RNA up to 105 days, after initial diagnosis. The infection was not cleared after the first treatment with convalescent plasma, suggesting a limited effect on SARS-CoV-2 in the upper respiratory tract of this individual. Several weeks after a second convalescent plasma transfusion, SARS-CoV-2 RNA was no longer detected. We observed marked within-host genomic evolution of SARS-CoV-2 with continuous turnover of dominant viral variants. However, replication kinetics in Vero E6 cells and primary human alveolar epithelial tissues were not affected. Our data indicate that certain immunocompromised individuals may shed infectious virus longer than previously recognized. Detection of subgenomic RNA is recommended in persistently SARS-CoV-2-positive individuals as a proxy for shedding of infectious virus.

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