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SARS-CoV-2 Viral Clearance and Evolution Varies by Extent of Immunodeficiency.
Li, Yijia; Choudhary, Manish C; Regan, James; Boucau, Julie; Nathan, Anusha; Speidel, Tessa; Liew, May Yee; Edelstein, Gregory E; Kawano, Yumeko; Uddin, Rockib; Deo, Rinki; Marino, Caitlin; Getz, Matthew A; Reynold, Zahra; Barry, Mamadou; Gilbert, Rebecca F; Tien, Dessie; Sagar, Shruti; Vyas, Tammy D; Flynn, James P; Hammond, Sarah P; Novack, Lewis A; Choi, Bina; Cernadas, Manuela; Wallace, Zachary S; Sparks, Jeffrey A; Vyas, Jatin M; Seaman, Michael S; Gaiha, Gaurav D; Siedner, Mark J; Barczak, Amy K; Lemieux, Jacob E; Li, Jonathan Z.
Afiliação
  • Li Y; Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
  • Choudhary MC; Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
  • Regan J; University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
  • Boucau J; Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
  • Nathan A; Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
  • Speidel T; Ragon Institute of MGH, MIT and Harvard, Cambridge, MA, USA.
  • Liew MY; Ragon Institute of MGH, MIT and Harvard, Cambridge, MA, USA.
  • Edelstein GE; Program in Health Sciences and Technology, Harvard Medical School and Massachusetts Institute of Technology, Boston, MA 02115, USA.
  • Kawano Y; Center for Virology and Vaccine Research, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
  • Uddin R; Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
  • Deo R; Broad Institute of MIT and Harvard, Cambridge, MA, USA.
  • Marino C; Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
  • Getz MA; Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
  • Reynold Z; Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
  • Barry M; Broad Institute of MIT and Harvard, Cambridge, MA, USA.
  • Gilbert RF; Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
  • Tien D; Ragon Institute of MGH, MIT and Harvard, Cambridge, MA, USA.
  • Sagar S; Ragon Institute of MGH, MIT and Harvard, Cambridge, MA, USA.
  • Vyas TD; Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
  • Flynn JP; Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
  • Hammond SP; Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
  • Novack LA; Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
  • Choi B; Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
  • Cernadas M; Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
  • Wallace ZS; Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
  • Sparks JA; Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
  • Vyas JM; Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
  • Seaman MS; Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
  • Gaiha GD; Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
  • Siedner MJ; Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
  • Barczak AK; Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
  • Lemieux JE; Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
  • Li JZ; Ragon Institute of MGH, MIT and Harvard, Cambridge, MA, USA.
medRxiv ; 2023 Aug 07.
Article em En | MEDLINE | ID: mdl-37577493
Despite vaccination and antiviral therapies, immunocompromised individuals are at risk for prolonged SARS-CoV-2 infection, but the immune defects that predispose to persistent COVID-19 remain incompletely understood. In this study, we performed detailed viro-immunologic analyses of a prospective cohort of participants with COVID-19. The median time to nasal viral RNA and culture clearance in the severe hematologic malignancy/transplant group (S-HT) were 72 and 40 days, respectively, which were significantly longer than clearance rates in the severe autoimmune/B-cell deficient (S-A), non-severe, and non-immunocompromised groups (P<0.001). Participants who were severely immunocompromised had greater SARS-CoV-2 evolution and a higher risk of developing antiviral treatment resistance. Both S-HT and S-A participants had diminished SARS-CoV-2-specific humoral, while only the S-HT group had reduced T cell-mediated responses. This highlights the varied risk of persistent COVID-19 across immunosuppressive conditions and suggests that suppression of both B and T cell responses results in the highest contributing risk of persistent infection.
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Texto completo: 1 Base de dados: MEDLINE Idioma: En Ano de publicação: 2023 Tipo de documento: Article País de afiliação: Estados Unidos
Texto completo
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XML
PubMed Links
Buscar no Google

Texto completo: 1 Base de dados: MEDLINE Idioma: En Ano de publicação: 2023 Tipo de documento: Article País de afiliação: Estados Unidos