A new report details the unprecedented case of a man in The Netherlands who was infected with COVID-19 for over a year and a half, marking the longest known COVID infection to date, lasting 613 days. The prolonged infection allowed the virus to mutate into a new variant within the man’s body.
The 72-year-old man had a complex medical history, having undergone a stem cell transplant to address blood cancer before being diagnosed with diffuse large B cell lymphoma. Due to his immunocompromised state from medication, he was at high risk for a severe case of COVID-19. Despite receiving multiple COVID vaccines before his infection, the man showed no signs of an antibody response.
After contracting COVID in February 2022, the man received monoclonal antibodies and steroids for treatment, which unfortunately proved ineffective as the infection persisted. Over the course of 600 days, he was hospitalized multiple times as early as 21 days after his initial treatment, signs of the virus mutating began to manifest.
Genetic sequencing revealed that the virus had acquired mutations associated with drug resistance, along with over 50 mutations discovered in nasal swabs collected between February 2022 and September 2023. These mutations, especially in the spike protein, indicated the virus was adapting to evade the human immune system.
Despite the patient’s extended battle with the virus, there was no evidence of the highly mutated strain infecting others in the community. Tragically, in October 2023, the patient succumbed to a relapse of his underlying illness. The case highlights the challenges of dealing with persistent infections, which can lead to the evolution of concerning variants like Omicron.
The medical team emphasized that while extreme cases like this are uncommon, prolonged infections in immunocompromised individuals are more prevalent. The upcoming ESCMID Global Conference 2024 will feature a presentation on this unique case, shedding light on the complexities of managing COVID-19 in immunocompromised patients.