The primacy belongs to another man, who remained positive for Covid for 505 days. But the story of this 59-year-old, told through the pages of the magazine Clinical Infectious Diseases, also testifies to how positivity to SARS-CoV-2 infection can be persistent. And, above all, it invites us to keep our attention towards the emergence of new variants. Why to put it with Luke Blagdon Snellan infectious disease specialist at Guy’s and St Thomas’ Nhs Foundation Trust in London, “some of these are developing resistance to monoclonal antibody treatments.”
Covid, record patient infected for 505 days
by Irma D’Aria
Positive at Covid for 14 months
The involuntary protagonist of this story is a London man, who positivized himself in December 2020 with the sub-variant B.1.177.18. by SARS-CoV-2. Symptoms of the infection, which he contracted before the vaccines arrived, vanished within a few weeks. But the virus continued to lodge in his body for 411 days: until January of this year. A discovery made after the man, who in the meantime had received the three doses of prophylaxis, had undergone a swab in view of a scheduled examination. The positive outcome of the test intrigued the specialists, who at the same time were also managing what is currently the longest positivity case in the world. RNA sequencing of the virus revealed a mutation involving 14 regions of the genetic code. Sign, according to the researchers: including the Italian infectious disease specialist Gaia Nebbia, of a series of mutations that SARS-CoV-2 had undergone to adapt to living in this man’s body. A person in good health today, but still on immunosuppressive therapy after having undergone a kidney transplant.
Negativization thanks to monoclonal antibodies
Having disposed of almost all the after-effects of the infection made it suitable for any pharmacological treatment: both preventive and therapeutic, reserved for acute patients in the early stages of the infection. Having studied the evolution of the genome of the virus, the London white coats, however, decided to subject the patient to a combined therapy based on monoclonal antibodies – casirivimab / imdevimab: the same drug that was administered to the former president of the United States, Donald Trump – which allowed man to reach negativization over the next two months. The same path, albeit with different drugs, reserved for a 45-year-old woman with HIV infection and who remained positive for six months: despite a similar treatment. Also in this case, the study of the viral genome has allowed UK health professionals to identify the mutations developed in the meantime by Sars-CoV-2 and evaluate the most effective eradication therapy: in this case Paxlovid.
Covid, after a thousand days the word end to the pandemic is not yet written
by Fabio Di Todaro
High guard to protect the immunosuppressed
A sign that the continuous emergence of new variants has undermined the effectiveness of some treatments with monoclonal antibodies. For this reason, according to the researchers, it is appropriate not to let your guard down. The spread of the infections, by now everyone knows, amplifies the risk of further evolution of SARS-CoV-2. Infection prevention therefore continues to be a priority. But no less important is the research on the therapy front, since “there are no specific monoclonal antibodies effective against the Omicron sub-variants currently prevalent in Europe”, is what the authors put in black and white. An additional concern, especially for immunosuppressed people who, in the event of infection, can still develop a severe form of Covid today.