AI Article Synopsis

  • Immunocompromised individuals tend to experience longer SARS-CoV-2 infections, increasing the chances for new mutations, especially in the spike protein, which is important for vaccines.
  • A study in Paris analyzed samples from 444 immunocompromised patients and 234 healthcare workers, finding greater genetic diversity of the virus in the immunocompromised group.
  • The research indicated that mutations in the viruses from immunocompromised patients contributed to the evolution of new variants, suggesting potential concerns for immune response and severity of future infections.

Article Abstract

Background: A severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection lasts longer in immunocompromised hosts than in immunocompetent patients. Prolonged infection is associated with a higher probability of selection for novel SARS-CoV-2 mutations, particularly in the spike protein, a critical target for vaccines and therapeutics.

Methods: From December 2020 to September 2022, respiratory samples from 444 immunocompromised patients and 234 health care workers positive for SARS-CoV-2, diagnosed at 2 hospitals in Paris, France, were analyzed using whole-genome sequencing using Nanopore technology. Custom scripts were developed to assess the SARS-CoV-2 genetic diversity between the 2 groups and within the host.

Results: Most infections were SARS-CoV-2 Delta or Omicron lineages. Viral genetic diversity was significantly higher in infections of immunocompromised patients than those of controls. Minor mutations were identified in viruses sequenced from immunocompromised individuals, which became signature mutations for newer SARS-CoV-2 variants as the epidemic progressed. Two patients were coinfected with Delta and Omicron variants. The follow-up of immunocompromised patients revealed that the SARS-CoV-2 genome evolution differed in the upper and lower respiratory tracts.

Conclusions: This study found that SARS-CoV-2 infection in immunocompromised patients is associated with higher genetic diversity, which could lead to the emergence of new SARS-CoV-2 variants with possible immune evasion or different virulence characteristics.

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Source
http://dx.doi.org/10.1093/infdis/jiad499DOI Listing

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