SARS-CoV-2 Evolution and Spike-Specific CD4+ T-Cell Response in Persistent COVID-19 with Severe HIV Immune Suppression.

Abstract

Intra-host evolution of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been reported in cases with persistent coronavirus disease 2019 (COVID-19). In this study, we describe a severely immunosuppressed individual with HIV-1/SARS-CoV-2 coinfection with a long-term course of SARS-CoV-2 infection. A 28-year-old man was diagnosed with HIV-1 infection (CD4+ count: 3 cells/µL nd 563000 HIV-1 RNA copies/mL) and simultaneous Pneumocystis jirovecii pneumonia, disseminated Mycobacterium avium complex infection and SARS-CoV-2 infection. SARS-CoV-2 real-time reverse transcription polymerase chain reaction positivity from nasopharyngeal samples was prolonged for 15 weeks. SARS-CoV-2 was identified as variant Alpha (PANGO lineage B.1.1.7) with mutation S:E484K. Spike-specific T-cell response was similar to HIV-negative controls although enriched in IL-2, and showed disproportionately increased immunological exhaustion marker levels. Despite persistent SARS-CoV-2 infection, adaptive intra-host SARS-CoV-2 evolution, was not identified. Spike-specific T-cell response protected against a severe COVID-19 outcome and the increased immunological exhaustion marker levels might have favoured SARS-CoV-2 persistence.

• Authors: Hortensia Álvarez, Ezequiel Ruiz-Mateos, Pedro Miguel Juiz-González, Joana Vitallé, Irene Viéitez, María Del Carmen Vázquez-Friol, Isabel Torres-Beceiro, Alberto Pérez-Gómez, Pilar Gallego-García, Nuria Estévez-Gómez, Loretta De Chiara, Eva Poveda, David Posada, Josep M Llibre
• Journal: Microorganisms (Microorganisms) Vol. 10 Issue 1 (Jan 11 2022) ISSN: 2076-2607 [Print] Switzerland
• PMID: 35056592 (Publication Type: Case Reports)