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Prolonged SARS-CoV-2 Risk Varies Across Immunosuppressive Conditions

Severely immunocompromised individuals had greater SARS-CoV-2 evolution, higher risk for developing resistance against therapeutic mAbs

By Elana Gotkine HealthDay Reporter

WEDNESDAY, Jan. 31, 2024 (HealthDay News) — The risk for prolonged severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) varies across immunosuppressive conditions, according to a study published in the Jan. 24 issue of Science Translational Medicine.

Yijia Li, M.D., from Harvard Medical School in Boston, and colleagues performed a detailed viro-immunologic analysis of a prospective cohort of patients with COVID-19 to examine the immune defects that predispose an individual to persistent COVID-19.

The researchers found that in individuals with severe immunosuppression due to hematologic malignancy or transplant (S-HT), the median times to nasal viral RNA and culture clearance were 72 and 40 days, respectively, which were significantly longer than clearance rates for patients with severe immunosuppression due to autoimmunity or B cell deficiency (S-A), those with nonsevere immunodeficiency, and those who were not immunocompromised. Greater SARS-CoV-2 evolution and a higher risk for developing resistance against therapeutic monoclonal antibodies were seen in severely immunocompromised individuals. Diminished SARS-CoV-2-specific humoral responses were seen for S-HT and S-A patients, while reduced T-cell mediated responses were only seen in the S-HT group.

“Our results highlight the finding that the risk of chronic SARS-CoV-2 infection is not uniform across immunosuppressive conditions and provide clarity on which immunosuppression conditions predispose individuals to delayed SARS-CoV-2 RNA and culture clearance as well as viral evolution,” the authors write.

Several authors disclosed ties to the pharmaceutical and medical technology industries.

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