Viro-immunological evaluation in an immunocompromised patient with long-lasting SARS-CoV-2 infection

Detection of viable SARS-CoV-2 in deep respiratory specimens despite negative nasopharyngeal SARS-CoV-2 RT-PCR: Occult COVID-19 as an unsuspected cause of pulmonary infiltrates in immunocompromised patients

“…Seroconversion rates of 17.5-40% have been reported in the literature [10] , [11] . Similarly, other cases of occult COVID-19 reported in the literature occurred in individuals who received anti-CD20 treatment and were unable to produce neutralising antibodies to SARS-CoV-2 [5] , [12] . Both our cases made a full recovery after administration of antivirals and monoclonal antibodies directed against COVID-19; this was in keeping with emerging data suggesting good clinical outcomes in B-cell-depleted patients treated with anti-spike monoclonal antibodies [13] .…”

Persistent detection and sequencing of SARS‐CoV‐2 in the bloodstream of an immunocompromised patient

“…Confirming the evidence by Andersson et al about the lack of association between virions detected in the bloodstream and viral infectiousness, 8 the prolonged persistence of SARS‐CoV‐2 RNA at high levels in the bloodstream of our patient might be the consequence of massive viral dissemination from the pulmonary district; this hypothesis is confirmed by the absence of intra‐host viral evolution as revelated in other immunosuppressed long COVID‐19 cases (phylogenetic tree in Supporting Information: Figure S 1 ), as well as the absence of viral growth despite the low Ct values. 9 , 10 Further studies, especially in immunocompromised patients with persistence of SARS‐CoV‐2, should be conducted to investigate the viral viability in different anatomical districts and the possible emergence of specific mutations related to viral compartmentalization.…”