Longest Covid infection recorded at 613 days

An elderly man spent almost two years infected with Covid, scientists revealed as they warned of possible dangerous mutations.

The unnamed 72-year-old, from Amsterdam, was immunocompromised due to previous stem cell transplants. He had the virus for 613 days before he died, during which time the virus mutated around 50 times.

It is the longest Covid infection duration to date, according to the scientists, although several cases of hundreds of days have been previously recorded.

Although healthy Covid infected patients can clear the virus within a period of days to weeks, an immunocompromised person can develop a persistent infection while the virus replicates and evolves. For instance, it is thought that the initial emergence of the Omicron variant originated in an immunocompromised person, highlighting the importance of closely monitoring such patients.

In a report to be presented at the European Society of Clinical Microbiology and Infectious Diseases’ global conference in Barcelona next week, researchers said the pensioner was admitted to the Amsterdam University Medical Centre in February 2022 with a Covid infection, believed to be of the Omicron variant.

His immunocompromised status was further complicated by the development of a post-transplant lymphoma, for which he received a targeted cancer medication that depletes all available B-cells – including those that normally produce the Covid antibodies.

The man had received multiple Covid vaccinations without any measurable antibody response upon being admitted to hospital. After 21 days, the virus developed an antibody-resisting mutation before doctors discovered his immune system was incapable of clearing the virus.

The prolonged infection led to the emergence of a novel, immune-evasive variant of the virus owing to its extensive evolution within a host. The elderly man eventually died from a relapse of a condition in his blood, having spent prolonged periods in isolation.

The researchers said he had remained Covid positive, with high viral loads, for a total of 613 days, but that the mutated variant that had developed was not transmitted to anyone else.

Dr Magda Vergouwe, a PhD candidate at the Centre for Experimental and Molecular Medicine in Amsterdam and lead author of the study, warned that the case underscored the importance of tracking the infections of the most vulnerable patients, whose bodies could be used as hosts to develop resistant mutations of the Covid virus.

However, Dr Vergouwe and her team also acknowledged there had to be a balance between protecting the world from dangerous new variants and providing humane, supportive end-of-life care to severely ill patients.