Longest ever case of Covid lasted 613 DAYS and turned into ultra-mutated variant: Immunocompromised Dutch 72-year-old battled lasting illness that eventually killed him

A Dutch pensioner had the longest Covid infection ever measured: 613 days.

While most people can expect to shake off the virus within days or weeks, the 72-year-old had a weakened immune system and ultimately died from his infection.

According to scientists, the virus mutated about 50 times, eventually producing an ultra-mutated variant.

They warned that such cases are perfect breeding grounds for the development of deadly new strains of the disease.

The patient was admitted to the Amsterdam University Medical Center in February 2022 with the omicron variant of Covid.

He had a history of blood cancer and had undergone treatment that depleted B cells, including those that normally produce Covid-induced antibodies.

Despite receiving several Covid vaccines, he had little antibody response to testing on hospital admission and did not respond to antibody treatments.

But researchers found that the virus developed a sotrovimab resistance mutation just 21 days after receiving the antibody.

They also noted that the development of anti-spike antibodies was minimal in the first month, indicating that the patient’s immune system was unable to clear the virus.

The prolonged infection led to the emergence of a new immune-evasive variant of the virus due to its extensive evolution within a host. He eventually died from a relapse of a blood disorder.

Presenting their findings at the ESCMID Global Congress in Barcelona next week, researchers said he had remained Covid positive for a total of 613 days, with high viral loads.

The mutated variant was not passed on to anyone else, they confirmed.

Dr. Magda Vergouwe, from the Center for Experimental and Molecular Medicine (CEMM) in Amsterdam, warned that the case underlined the importance of monitoring the infections of the most vulnerable patients, whose bodies could be used as hosts to develop drug-resistant mutations.

She said: ‘This case underlines the risk of persistent SARS-CoV-2 infections in immunocompromised individuals, as unique SARS-CoV-2 viral variants can arise as a result of extensive evolution within the host.

‘We emphasize the importance of continued genomic surveillance of SARS-CoV-2 evolution in immunocompromised individuals with persistent infections, given the potential threat to public health by potentially introducing viral escape variants into the community.’

She recognized that there had to be a balance between protecting the world from dangerous new variants and providing humane, supportive care to critically ill patients.

Before this case, British doctors believed they had documented the longest Covid infection ever, treating it for more than 16 months, or 505 days.

Doctors from King’s College London and Guy’s and St Thomas’ NHS Foundation Trust said detailed laboratory analysis of the unnamed patient revealed it was the same persistent infection, and not repeated attacks.

Dr. Vergouwe added that while there is an increased risk of new variants developing in immunocompromised patients, not every variant that develops will be a public concern.

The underlying mechanisms involved in the development of a variant of concern are much more complex, as they also depend on factors in the population surrounding the patient, including the prevalence of B and T cell-related immunity.

She added: ‘The duration of SARS-CoV-2 infection in this described case is extreme, but long-term infections in immunocompromised patients are much more common than in the general community.

‘Further work from our team includes describing a cohort of long-term infections in immunocompromised patients from our hospital, with infection durations ranging from one month to two years.

‘From the point of view of the general public, however, long-term infections remain rare as the immunocompromised population constitutes only a very small percentage of the total population.’