tetano
Editor, Senior Moderator
Sci Transl Med
. 2024 Jan 24;16(731):eadk1599.
doi: 10.1126/scitranslmed.adk1599. Epub 2024 Jan 24. SARS-CoV-2 viral clearance and evolution varies by type and severity of immunodeficiency
Yijia Li[SUP] 1 2 3 [/SUP], Manish C Choudhary[SUP] 1 [/SUP], James Regan[SUP] 1 4 [/SUP], Julie Boucau[SUP] 5 [/SUP], Anusha Nathan[SUP] 5 6 [/SUP], Tessa Speidel[SUP] 7 [/SUP], May Yee Liew[SUP] 2 8 [/SUP], Gregory E Edelstein[SUP] 1 [/SUP], Yumeko Kawano[SUP] 1 [/SUP], Rockib Uddin[SUP] 2 8 [/SUP], Rinki Deo[SUP] 1 [/SUP], Caitlin Marino[SUP] 5 [/SUP], Matthew A Getz[SUP] 5 [/SUP], Zahra Reynolds[SUP] 2 [/SUP], Mamadou Barry[SUP] 2 [/SUP], Rebecca F Gilbert[SUP] 2 [/SUP], Dessie Tien[SUP] 2 [/SUP], Shruti Sagar[SUP] 2 [/SUP], Tammy D Vyas[SUP] 2 [/SUP], James P Flynn[SUP] 1 [/SUP], Sarah P Hammond[SUP] 2 [/SUP], Lewis A Novack[SUP] 1 [/SUP], Bina Choi[SUP] 1 [/SUP], Manuela Cernadas[SUP] 1 [/SUP], Zachary S Wallace[SUP] 2 [/SUP], Jeffrey A Sparks[SUP] 1 [/SUP], Jatin M Vyas[SUP] 2 5 [/SUP], Michael S Seaman[SUP] 7 [/SUP], Gaurav D Gaiha[SUP] 2 5 [/SUP], Mark J Siedner[SUP] 2 [/SUP], Amy K Barczak[SUP] 2 5 [/SUP], Jacob E Lemieux[SUP] 2 8 [/SUP], Jonathan Z Li[SUP] 1 [/SUP]
Affiliations
Despite vaccination and antiviral therapies, immunocompromised individuals are at risk for prolonged severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, but the immune defects that predispose an individual to persistent coronavirus disease 2019 (COVID-19) remain incompletely understood. In this study, we performed detailed viro-immunologic analyses of a prospective cohort of participants with COVID-19. The median times to nasal viral RNA and culture clearance in individuals with severe immunosuppression due to hematologic malignancy or transplant (S-HT) were 72 and 40 days, respectively, both of which were significantly longer than clearance rates in individuals with severe immunosuppression due to autoimmunity or B cell deficiency (S-A), individuals with nonsevere immunodeficiency, and nonimmunocompromised groups (P < 0.01). Participants who were severely immunocompromised had greater SARS-CoV-2 evolution and a higher risk of developing resistance against therapeutic monoclonal antibodies. Both S-HT and S-A participants had diminished SARS-CoV-2-specific humoral responses, whereas only the S-HT group had reduced T cell-mediated responses. This highlights the varied risk of persistent COVID-19 across distinct immunosuppressive conditions and suggests that suppression of both B and T cell responses results in the highest contributing risk of persistent infection.
. 2024 Jan 24;16(731):eadk1599.
doi: 10.1126/scitranslmed.adk1599. Epub 2024 Jan 24. SARS-CoV-2 viral clearance and evolution varies by type and severity of immunodeficiency
Yijia Li[SUP] 1 2 3 [/SUP], Manish C Choudhary[SUP] 1 [/SUP], James Regan[SUP] 1 4 [/SUP], Julie Boucau[SUP] 5 [/SUP], Anusha Nathan[SUP] 5 6 [/SUP], Tessa Speidel[SUP] 7 [/SUP], May Yee Liew[SUP] 2 8 [/SUP], Gregory E Edelstein[SUP] 1 [/SUP], Yumeko Kawano[SUP] 1 [/SUP], Rockib Uddin[SUP] 2 8 [/SUP], Rinki Deo[SUP] 1 [/SUP], Caitlin Marino[SUP] 5 [/SUP], Matthew A Getz[SUP] 5 [/SUP], Zahra Reynolds[SUP] 2 [/SUP], Mamadou Barry[SUP] 2 [/SUP], Rebecca F Gilbert[SUP] 2 [/SUP], Dessie Tien[SUP] 2 [/SUP], Shruti Sagar[SUP] 2 [/SUP], Tammy D Vyas[SUP] 2 [/SUP], James P Flynn[SUP] 1 [/SUP], Sarah P Hammond[SUP] 2 [/SUP], Lewis A Novack[SUP] 1 [/SUP], Bina Choi[SUP] 1 [/SUP], Manuela Cernadas[SUP] 1 [/SUP], Zachary S Wallace[SUP] 2 [/SUP], Jeffrey A Sparks[SUP] 1 [/SUP], Jatin M Vyas[SUP] 2 5 [/SUP], Michael S Seaman[SUP] 7 [/SUP], Gaurav D Gaiha[SUP] 2 5 [/SUP], Mark J Siedner[SUP] 2 [/SUP], Amy K Barczak[SUP] 2 5 [/SUP], Jacob E Lemieux[SUP] 2 8 [/SUP], Jonathan Z Li[SUP] 1 [/SUP]
Affiliations
- PMID: 38266109
- DOI: 10.1126/scitranslmed.adk1599
Despite vaccination and antiviral therapies, immunocompromised individuals are at risk for prolonged severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, but the immune defects that predispose an individual to persistent coronavirus disease 2019 (COVID-19) remain incompletely understood. In this study, we performed detailed viro-immunologic analyses of a prospective cohort of participants with COVID-19. The median times to nasal viral RNA and culture clearance in individuals with severe immunosuppression due to hematologic malignancy or transplant (S-HT) were 72 and 40 days, respectively, both of which were significantly longer than clearance rates in individuals with severe immunosuppression due to autoimmunity or B cell deficiency (S-A), individuals with nonsevere immunodeficiency, and nonimmunocompromised groups (P < 0.01). Participants who were severely immunocompromised had greater SARS-CoV-2 evolution and a higher risk of developing resistance against therapeutic monoclonal antibodies. Both S-HT and S-A participants had diminished SARS-CoV-2-specific humoral responses, whereas only the S-HT group had reduced T cell-mediated responses. This highlights the varied risk of persistent COVID-19 across distinct immunosuppressive conditions and suggests that suppression of both B and T cell responses results in the highest contributing risk of persistent infection.