A Man Had Covid For 613 Straight Days—and Created a Whole New Mutation
Viruses are constantly mutating to develop strategies for improving transmission and avoiding immunization.
A new case study of a 72-year-old man from the Netherlands who had a sustained COVID-19 infection for nearly two years shows how immunocompromised people can give viruses the time they need to mutate into a new variant.
While the patient sadly died from an unrelated blood disorder, this variant wasn’t passed on to anyone else.
Alpha, Delta, Omicron—unless you’re a big fan of Hellenistic Greece, these words likely remind you of lockdowns, sickness, and an all-around scary time to be alive. When the world first woke up to the seriousness of the COVID-19 pandemic, the SARS-CoV-2 coronavirus was already hard at work mutating, quickly finding ways to avoid our immune response and transmit quickly among hosts. Of course, viruses don’t have emotions, so this rapid evolution wasn’t done with malice. It’s simply an all-too-effective viral survival strategy.
In order for viruses to develop into new variants, they require one thing above all: time. Every time a virus duplicates, it introduces room for error—time spent in a body means more time to mutate and to adapt. This is just one reason why SARS-CoV-2, as well as other viruses, are so deadly for the immunocompromised. A weakened immune system gives a virus more time to replicate and develop survival strategies of its own before moving on to its next host.
This is just a glimpse of the real story of a 72-year-old man living in the Netherlands, who suffered from a prolonged SARS-CoV-2 infection for 613 days—the longest of any COVID infection ever recorded. This is different from people who experience Long Covid, which is prolonged symptoms from a previous infection, but not a continuous infection as this particular patient experienced.
Because the virus remained for so long, a new variant was created inside the patient—though, luckily, this variant wasn’t passed on to anyone else. Sadly, the patient died of a blood disorder relapse while still infected. The data gathered from this case will be presented by scientists from the Center of Experimental and Molecular Medicine at the Amsterdam University Medical Center at the ESCMID Global Congress 2024 later this month in Barcelona, Spain.
“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,” the researchers said in a press statement. “We emphasize 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.”
Over the course of nearly two years, the patient underwent frequent hospitalizations and often required prolonged isolation periods to avoid spreading the virus. From February of 2022 to September of 2023, scientists conducted full genome sequencing on 27 viral specimens collected from the nasopharynx (the area located behind the nose). The genomic data revealed 50 nucleotide mutations compared to the currently circulating BA.1 variant, as well as several deletions for improved immune-escape.
In other words, the virus spent so long in the person’s body that it developed into a completely new variant.
“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,” the scientists concluded.
For many people, worlds like Alpha, Delta, and Omicron are in the rearview. But the Covid-19 pandemic isn’t going anywhere, and the virus will keep doing what it does best—mutating.
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