Dutch Man Lived With COVID-19 for 613 Days Before Death

For most, COVID-19 symptoms last for a few weeks before passing. New research from the Netherlands finds a patient suffered from the respiratory virus for nearly two years before his death.

A Dutch man with a poor immune system lived with a high-mutated novel variant of COVID-19 for 613 days, according to the University of Amsterdam’s Centre for Experimental and Molecular Medicine (CEMM). The case is known as the longest bout of COVID-19.

Healthy patients diagnosed with COVID-19 typically recover from mild cases of the virus within a few weeks. However, immunocompromised individuals may develop a persistent infection with increased adverse effects that can evolve — such as the Omicron variant, which originated in a patient with a weakened immune system.

A European Society of Clinical Microbiology and Infectious Diseases release says the study led by Magda Vergouwe of the CEMM describes a male patient who was admitted to the Amsterdam University Medical Center in February 2022 due to COVID-19. He was infected with the Omicron SARS-CoV-2 variant BA.1.17.

The patient suffered from myelodysplastic and myeloproliferative overlap syndrome due to a stem cell transplant. In myelodysplastic diseases, immature blood cells in bone barrow do not mature and become healthy blood cells. Meanwhile, myeloproliferative diseases result in a total number of blood cells slow increasing.

“This case underscores the risk of persistent SARS-CoV-2 infections in immunocompromised individuals as unique SARS-CoV-2 viral variants may emerge due to extensive intra-host evolution,” study authors said. “We emphasise the importance of continuing genomic surveillance of SARS-CoV-2 evolution in immunocompromised individuals with persistent infections given the potential public health threat of possibly introducing viral escape variants into the community.”

The 72-year-old patient had previously received multiple COVID-19 vaccinations. He was treated with multiple antibody medications without any response and within 21 days, the man developed a mutation that resisted sotrovimab, one of the antibody medications. In the full genome sequencing of the virus that persisted for 613 days, researchers uncovered it had undergone 50 genetic code mutations.

The ESCMID Global release says study authors note there must be a balance between protecting the masses from new variants and providing care for these terminally ill patients. Also, scientists emphasize while there is an increased chance of novel variants in those with weakened immune systems, it is not the case for each patient.

The duration of SARS-CoV-2 infection in this described case is extreme, but prolonged infections in immunocompromised patients are much more common compared to the general community. Further work by our team includes describing a cohort of prolonged infections in immunocompromised patients from our hospital with infection durations varying between 1 month and 2 years.

Study authors

The complete research of this unique COVID-19 case will be presented at the ESCMID Global Congress in Barcelona which runs from April 27-30.

COVID-19 in the US today

The U.S. Centers for Disease Control and Prevention (CDC) updated its COVID-19 guidelines in March, no longer recommending isolation following a positive test. Those who are infected should wear a high-quality mask or respirator when around others, monitor symptoms, and contact a healthcare provider for possible treatments. The CDC reported 6,406 COVID-19 hospitalizations last week, a 13.8% drop.

However, COVID-19 can still be a threat to those with weak immune systems like the 72-year-old Dutch man. The CDC highlights those who are immunocompromised have lesser defenses against infections. Those six months and older who are moderately to severely immunocompromised are recommended to receive at least one dose of the updated 2023-24 COVID-19 vaccine.

The CDC says people with weakened immune symptoms may reach out to their healthcare provider for possible antiviral medications. Recovering from COVID-19 for immunocompromised patients may take longer than the normal few weeks

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