Patient's 'Persistent' COVID Infection Lasted 505 Days

A British patient with a severely weakened immune system had COVID-19 for almost a year and a half, scientists reported, underscoring the importance of protecting vulnerable people from the coronavirus. There’s no way to know for sure whether it was the longest-lasting COVID-19 infection because not everyone gets tested, especially on a regular basis like this case. But at 505 days, "it certainly seems to be the longest reported infection," said Dr. Luke Blagdon Snell, an infectious disease expert at the Guy’s & St. Thomas' NHS Foundation Trust. Snell's team plans to present several "persistent" COVID-19 cases at an infectious diseases meeting in Portugal this weekend, the AP reports.

Their study investigated which mutations arise—and whether variants evolve—in people with extremely long infections. It involved nine patients who tested positive for the virus for at least eight weeks. All had weakened immune systems from organ transplants, HIV, cancer, or treatment for other illnesses. None were identified for privacy reasons. Repeated tests showed their infections lingered for an average of 73 days. Two had the virus for more than a year. The person with the longest known infection tested positive in early 2020, was treated with the antiviral drug remdesiver, and died sometime in 2021. Researchers declined to name the cause of death and said the person had several other illnesses.

Persistent COVID-19 is rare and different from long COVID. "In long COVID, it’s generally assumed the virus has been cleared from your body but the symptoms persist," Snell said. "With persistent infection, it represents ongoing, active replication of the virus." Each time researchers tested patients, they analyzed the genetic code of the virus to make sure it was the same strain and that people didn't get COVID-19 more than once. Still, genetic sequencing showed that the virus changed over time, mutating as it adapted. Researchers hope more treatments will be developed to help people with persistent infections beat the virus. (This health care worker in Spain was infected twice within 20 days.)