Evolution of SARS-CoV-2 Viral Mutations in Individuals with Prolonged Infections.

Objective: The world has been faced with the repeat rise of SARS-CoV-2 variants since late 2020, including Alpha, Beta, Gamma, Delta, and the latest simultaneous emergence of far-flung spawn of Omicron sub-lineages in different parts of the globe. This has brought us the challenge of determining what factor(s) have been the selective force behind these immune evasive and therapy resistant mutations. It is very possible that such variants evolved in limited host individuals with prolonged infections, or from a localized community of patients.