SARS-CoV-2 Genome Variations in Viral Shedding of an Immunocompromised Patient with Non-Hodgkin's Lymphoma
Por:
Villaseñor-Echavarri R., Gomez-Romero, Laura, Martin-Onraet, Alexandra, Herrera, Luis A., Escobar-Arrazola, Marco A., Ramirez-Vega, Oscar A., Barrientos-Flores, Corazon, Mendoza-Vargas, Alfredo, Hidalgo-Miranda, Alfredo, Vilar-Compte, Diana, Cedro-Tanda, Alberto
Publicada:
1 feb 2023
Resumen:
Background. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)
causing coronavirus disease 2019 (COVID-19) is the most transmissible
ss-coronavirus in history, affecting all population groups.
Immunocompromised patients, particularly cancer patients, have been
highlighted as a reservoir to promote accumulation of viral mutations
throughout persistent infection. Case presentation. We aimed to describe
the clinical course and SARS-CoV-2 mutation profile for 102 days in an
immunocompromised patient with non-Hodgkin's lymphoma and COVID-19. We
used RT-qPCR to quantify SARS-CoV-2 viral load over time and whole-virus
genome sequencing to identify viral lineage and mutation profile. The
patient presented with a persistent infection through 102 days while
being treated with cytotoxic chemotherapy for non-Hodgkin's lymphoma and
received targeted therapy for COVID-19 with remdesivir and hyperimmune
plasma. All sequenced samples belonged to the BA.1.1 lineage. We
detected nine amino acid substitutions in five viral genes
(Nucleocapsid, ORF1a, ORF1b, ORF13a, and ORF9b), grouped in two
clusters: the first cluster with amino acid substitutions only detected
on days 39 and 87 of sample collection, and the second cluster with
amino acid substitutions only detected on day 95 of sample collection.
The Spike gene remained unchanged in all samples. Viral load was dynamic
but consistent with the disease flares. Conclusions. This report shows
that the multiple mutations that occur in an immunocompromised patient
with persistent COVID-19 could provide information regarding viral
evolution and emergence of new SARS-CoV-2 variants.
Filiaciones:
Villaseñor-Echavarri R.:
Department of Infectious Diseases, Instituto Nacional de CancerologíaMexico City 14080, Mexico
School of Medicine, Universidad PanamericanaMexico City 03920, Mexico
Gomez-Romero, Laura:
Instituto Nacional de Medicina GenómicaMexico City 14610, Mexico
Martin-Onraet, Alexandra:
School of Medicine, Universidad PanamericanaMexico City 03920, Mexico
Herrera, Luis A.:
Instituto Nacional de Medicina GenómicaMexico City 14610, Mexico
Unidad de Investigación Biomédica en Cáncer, Instituto Nacional de Cancerología-Instituto de Investigaciones Biomédicas, UNAMMexico City 14080, Mexico
Escobar-Arrazola, Marco A.:
Instituto Nacional de Medicina GenómicaMexico City 14610, Mexico
Unidad de Investigación Biomédica en Cáncer, Instituto Nacional de Cancerología-Instituto de Investigaciones Biomédicas, UNAMMexico City 14080, Mexico
Ramirez-Vega, Oscar A.:
Instituto Nacional de Medicina GenómicaMexico City 14610, Mexico
Unidad de Investigación Biomédica en Cáncer, Instituto Nacional de Cancerología-Instituto de Investigaciones Biomédicas, UNAMMexico City 14080, Mexico
Barrientos-Flores, Corazon:
Department of Infectious Diseases, Instituto Nacional de CancerologíaMexico City 14080, Mexico
Mendoza-Vargas, Alfredo:
Instituto Nacional de Medicina GenómicaMexico City 14610, Mexico
Hidalgo-Miranda, Alfredo:
Instituto Nacional de Medicina GenómicaMexico City 14610, Mexico
Vilar-Compte, Diana:
Department of Infectious Diseases, Instituto Nacional de CancerologíaMexico City 14080, Mexico
Cedro-Tanda, Alberto:
Instituto Nacional de Medicina GenómicaMexico City 14610, Mexico
Green Accepted, gold, All Open Access; Gold
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