Chronic COVID-19 infection in an immunosuppressed patient shows changes in lineage over time: a case report

Abstract Background The COVID-19 pandemic, caused by the Severe Acute Respiratory Syndrome Coronavirus 2 virus, emerged in late 2019 and spready globally. Many effects of infection with this pathogen are still unknown, with both chronic and repeated COVID-19 infection producing novel pathologies. Ca...

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Main Authors: Sheridan J. C. Baker, Landry E. Nfonsam, Daniela Leto, Candy Rutherford, Marek Smieja, Andrew G. McArthur
Format: Article
Language:English
Published: BMC 2024-01-01
Series:Virology Journal
Subjects:
Online Access:https://doi.org/10.1186/s12985-023-02278-7
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author Sheridan J. C. Baker
Landry E. Nfonsam
Daniela Leto
Candy Rutherford
Marek Smieja
Andrew G. McArthur
author_facet Sheridan J. C. Baker
Landry E. Nfonsam
Daniela Leto
Candy Rutherford
Marek Smieja
Andrew G. McArthur
author_sort Sheridan J. C. Baker
collection DOAJ
description Abstract Background The COVID-19 pandemic, caused by the Severe Acute Respiratory Syndrome Coronavirus 2 virus, emerged in late 2019 and spready globally. Many effects of infection with this pathogen are still unknown, with both chronic and repeated COVID-19 infection producing novel pathologies. Case presentation An immunocompromised patient presented with chronic COVID-19 infection. The patient had history of Hodgkin’s lymphoma, treated with chemotherapy and stem cell transplant. During the course of their treatment, eleven respiratory samples from the patient were analyzed by whole-genome sequencing followed by lineage identification. Whole-genome sequencing of the virus present in the patient over time revealed that the patient at various timepoints harboured three different lineages of the virus. The patient was initially infected with the B.1.1.176 lineage before coinfection with BA.1. When the patient was coinfected with both B.1.1.176 and BA.1, the viral populations were found in approximately equal proportions within the patient based on sequencing read abundance. Upon further sampling, the lineage present within the patient during the final two timepoints was found to be BA.2.9. The patient eventually developed respiratory failure and died. Conclusions This case study shows an example of the changes that can happen within an immunocompromised patient who is infected with COVID-19 multiple times. Furthermore, this case demonstrates how simultaneous coinfection with two lineages of COVID-19 can lead to unclear lineage assignment by standard methods, which are resolved by further investigation. When analyzing chronic COVID-19 infection and reinfection cases, care must be taken to properly identify the lineages of the virus present.
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spelling doaj.art-1f5774b9781b41abbe8f3e57f324febd2024-01-07T12:11:10ZengBMCVirology Journal1743-422X2024-01-0121111110.1186/s12985-023-02278-7Chronic COVID-19 infection in an immunosuppressed patient shows changes in lineage over time: a case reportSheridan J. C. Baker0Landry E. Nfonsam1Daniela Leto2Candy Rutherford3Marek Smieja4Andrew G. McArthur5David Braley Centre for Antibiotic Discovery, McMaster UniversityDepartment of Pathology and Molecular Medicine, McMaster UniversityDepartment of Pathology and Molecular Medicine, McMaster UniversityHamilton Regional Laboratory Medicine Program, St Joseph’s HealthcareMichael G. DeGroote Institute for Infectious Disease Research, McMaster UniversityDavid Braley Centre for Antibiotic Discovery, McMaster UniversityAbstract Background The COVID-19 pandemic, caused by the Severe Acute Respiratory Syndrome Coronavirus 2 virus, emerged in late 2019 and spready globally. Many effects of infection with this pathogen are still unknown, with both chronic and repeated COVID-19 infection producing novel pathologies. Case presentation An immunocompromised patient presented with chronic COVID-19 infection. The patient had history of Hodgkin’s lymphoma, treated with chemotherapy and stem cell transplant. During the course of their treatment, eleven respiratory samples from the patient were analyzed by whole-genome sequencing followed by lineage identification. Whole-genome sequencing of the virus present in the patient over time revealed that the patient at various timepoints harboured three different lineages of the virus. The patient was initially infected with the B.1.1.176 lineage before coinfection with BA.1. When the patient was coinfected with both B.1.1.176 and BA.1, the viral populations were found in approximately equal proportions within the patient based on sequencing read abundance. Upon further sampling, the lineage present within the patient during the final two timepoints was found to be BA.2.9. The patient eventually developed respiratory failure and died. Conclusions This case study shows an example of the changes that can happen within an immunocompromised patient who is infected with COVID-19 multiple times. Furthermore, this case demonstrates how simultaneous coinfection with two lineages of COVID-19 can lead to unclear lineage assignment by standard methods, which are resolved by further investigation. When analyzing chronic COVID-19 infection and reinfection cases, care must be taken to properly identify the lineages of the virus present.https://doi.org/10.1186/s12985-023-02278-7COVID-19Hodgkin’s lymphomaCancerImmunocompromisedCOVID-19 reinfectionChronic COVID-19
spellingShingle Sheridan J. C. Baker
Landry E. Nfonsam
Daniela Leto
Candy Rutherford
Marek Smieja
Andrew G. McArthur
Chronic COVID-19 infection in an immunosuppressed patient shows changes in lineage over time: a case report
Virology Journal
COVID-19
Hodgkin’s lymphoma
Cancer
Immunocompromised
COVID-19 reinfection
Chronic COVID-19
title Chronic COVID-19 infection in an immunosuppressed patient shows changes in lineage over time: a case report
title_full Chronic COVID-19 infection in an immunosuppressed patient shows changes in lineage over time: a case report
title_fullStr Chronic COVID-19 infection in an immunosuppressed patient shows changes in lineage over time: a case report
title_full_unstemmed Chronic COVID-19 infection in an immunosuppressed patient shows changes in lineage over time: a case report
title_short Chronic COVID-19 infection in an immunosuppressed patient shows changes in lineage over time: a case report
title_sort chronic covid 19 infection in an immunosuppressed patient shows changes in lineage over time a case report
topic COVID-19
Hodgkin’s lymphoma
Cancer
Immunocompromised
COVID-19 reinfection
Chronic COVID-19
url https://doi.org/10.1186/s12985-023-02278-7
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