It’s noteworthy to share with you very interesting COVID-19 case undergoing immunosuppressive agents. this report highlighted SARS-CoV-2 persistence regardless the given treatment, and viral genetic evolution in the course of the infection
Persistence and Evolution of SARS-CoV-2 in an Immunocompromised Host | NEJM
December 3, 2020 N Engl J Med 2020; 383:2291-2293 DOI: 10.1056/NEJMc2031364
Dear Dr. Ijaz Durrani
. Thank you,I just want to highlight two points regarding the intersting paper you shared:
1) generally antibodies in response to coronaviruses do not last for longtime, and it has been observed a decrease in antibodies titers after 120 days or more in several studies.
2) cross-reactivity was observed with SARS-CoV-1.
Regards
Due to the decreased immune status of the body, these viruses tend to lodge in for a longer duration and may cause reinfection in several cases.
Our national guidelines ask for the covid-19 negative reports before discharge in severe cases. the only exception to this is immunocompromised cases as they tend to remain symptomatic and covid positive by PCR for longer periods. This carries the risk of spread to others and poor prognosis in such patients.
Further details can be found down here
COVID-19 and immunosuppression: a review of current clinical experiences and implications for ophthalmology patients taking immunosuppressive drugs
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7316101/
These observation are consistent with the possible development of some form of latency/senescence of Sars Cov-2 as a I allude to in my article Procunier William. The Perfect Storm and A Global Call to Reason: An Evolutionary Perspective on The Existential Threat of Covid-19 to Humanity. Clin Rev Cases. 2020; 2(1): 1-4.
(19) William Procunier (researchgate.net)
Dear Dr. William Stanley Procunier
I profoundly appreciate your comment and attached publication. I believe a lot of effort has been made to gather all these info and publish this paper
Regards
Prolonged infection -Article Persistent COVID-19 in an Immunocompromised Patient Temporar...
A lot of detailed can be checked and provided by google scholar, I thought.
Message from Astrobiology: first global foci are linked geographically.
We have answer why.
There is the current practice locally not to test someone who is positive for the next 90 days
Vaccines are currently the only way to limit the infection. But there are too many negative opinions against vaccines. Even people without primary education express opinions (negative), people who do not understand anything but are "against". False "facts" are written. This prevents all of humanity from solving this serious problem.
Unfortunately, COVID-19 cases have started rising in my country and I agree hesitancy to the vaccine is widespread even though it is majorly unfounded fears and misinformation.
I also fear if this persistence of viral infection in immunocompromised can potentially lead to increased spread; thus they must be isolated till we have a microbiologically proven negative report.
Please see below links
Prolonged SARS‐CoV‐2 shedding and mild course of COVID‐19 in a patient after recent heart transplantation
Article Prolonged SARS‐CoV‐2 shedding and mild course of COVID‐19 in...
SARS‐CoV‐2 persistence and non‐protective immunity in infected haematological patients
Article SARS‐CoV‐2 persistence and non‐protective immunity in infect...
Persistent SARS-CoV-2 infection and increasing viral variants in children and young adults with impaired humoral immunity
Preprint Persistent SARS-CoV-2 infection and increasing viral variant...
Regards
Please have a look at this interesting article in JAMA:
Article Vaccinated but Not Protected—Living Immunocompromised During...
Persistence of SARS-CoV-2 in an advanced HIV-AIDS case for more than 6 months
Please also have a look at this preprint article:
Persistent SARS-CoV-2 infection and intra-host evolution in association with advanced HIV infection
Preprint Persistent SARS-CoV-2 infection and intra-host evolution in ...
Immunosuppressed patients with organ transplantation may need 3 or even more doses of COVID-19 vaccine
In a study published in NEJM (1), transplant recipients who had 2 doses of COVID-19 m-RNA vaccine had negligible antibodies, and third dose resulted in protective antibodies in 44% of them (still much less than >90% antibody rate in immunocompetent persons).
This means that immunosuppressed patient may need even more than three doses of COVID-19 vaccine to afford same degree of protection for SARS-CoV-2 infection as compared with immunocompetent persons.
https://www.nejm.org/doi/full/10.1056/NEJMc2108861?query=featured_coronavirus