This is not the case with "long COVID." His immune system never eliminated the virus. A 41-year-old man in the United States, with advanced HIV, has maintained an active COVID-19 infection for over 750 days, setting what researchers believe is a global record.
Unlike "long COVID," where symptoms persist even after the virus has cleared, this patient never cleared the virus. His body, severely immunocompromised with only 35 T cells per μL, allowed the virus to remain active and evolve within him.
He was hospitalized five times between 2020 and 2022 due to persistent breathing problems, and early in his infection he did not have access to antiretroviral therapy, giving the virus room to mutate over time.
Genetic analysis revealed that the virus within it had mutated at a rate similar to global trends, even acquiring changes in the spike protein that resembled those of the Omicron variant. Although the mutated version was not very contagious in this case, scientists warn that long-term infections in vulnerable individuals could serve as a breeding ground for new variants of the virus.
This case highlights the public health importance of treating chronic infections, supporting vaccination, and monitoring viral evolution in immunocompromised populations to prevent the emergence of new potentially dangerous strains./The Lancet
