A 47-year-old cancer survivor carried the SARS-CoV-2 virus for a staggering 335 days—the longest documented COVID-19 infection to date, according to a new NIH study.
The patient first sought care at the National Institutes of Health (NIH) in Maryland during spring 2020, battling cough and shortness of breath. What began as a short hospital stay stretched through summer, fall, and winter, puzzling infectious disease specialist Dr. Véronique Nussenblatt.
Repeated positive tests and ongoing symptoms—at times requiring home oxygen—confirmed the infection lasted 335 days. Viral levels dipped to barely detectable for months post-initial infection, then surged in March 2021. Genomic analysis of multiple samples verified it was the same virus strain throughout, ruling out reinfection.
This wasn't long COVID (lingering symptoms after clearance); the patient remained actively infected.
Her weakened immune system likely enabled the virus's persistence. Three years prior, CAR T-cell therapy had successfully treated her lymphoma but depleted most B cells responsible for antibody production.
Genetic sequencing revealed two deletions in the viral genome, including one in genes for the spike protein used to enter human cells—mutations seen in other chronic cases.
Such immunocompromised infections offer a “window into how the virus explores genetic space,” says lead author Elodie Ghedin, NIH molecular virologist, in Science magazine. “Analyzing these samples reveals viral evolution patterns.”
Fortunately, the patient cleared the virus, testing negative since April 2021. The findings appear in a medRxiv preprint.
