ArticleNature communications2021
Within-host evolution of SARS-CoV-2 in an immunosuppressed COVID-19 patient as a source of immune escape variants.
Article in Nature communications, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 129 papers, 4 of them syntheses that pooled it.
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Who cites it
129 citing papers in PubMed, 4 syntheses or guidelines pooled it, 203 citations in OpenAlex.
- A Systematic Review of Prolonged SARS-CoV-2 Shedding in Immunocompromised Persons.Influenza and other respiratory viruses · 2025Pooled it
- Viral cultures, cycle threshold values and viral load estimation for assessing SARS-CoV-2 infectiousness in haematopoietic stem cell and solid organ transplant patients: a systematic review.The Journal of hospital infection · 2023Pooled it
- Duration of SARS-CoV-2 shedding and infectivity in the working age population: a systematic review and meta-analysis.La Medicina del lavoro · 2022Pooled it
- Analysis of Immune Escape Variants from Antibody-Based Therapeutics against COVID-19: A Systematic Review.International journal of molecular sciences · 2021Pooled it
- Targeting SARS-CoV-2 Structural and Accessory Proteins: Emerging Opportunities for Small-Molecule Coronavirus Antivirals.Pharmaceutics · 2026Review
- Low frequency variants can predetermine antiviral drug resistance development in herpes simplex virus type 1.PLoS pathogens · 2026Article
- Extensive evolution and T cell escape by SARS-CoV-2 in a 2.5-year persistent infection of an immunocompromised host.iScience · 2026Article
- Review
- Immune-focused RBD nanoparticles induce cross-reactive, RBS-directed responses capable of variant-resistant SARS-CoV-2 neutralization.PLoS pathogens · 2026Article
- Impact of prolonged infection on SARS-CoV-2 evolution.Microbiology spectrum · 2026Article
- Immune Suppression, Preexisting Immunity, and Mutation Tendency Shaped SARS-CoV-2 Evolution in Persistent Infection.Microorganisms · 2025Article
- Genomic and epidemiologic characteristics of SARS-CoV-2 persistent infections in California, January 2021 - July 2023.PLoS pathogens · 2025Article
- Intra-Host Evolution of SARS-CoV-2 During Persistent Infection of Pediatric COVID-19 Patients.Viruses · 2025Article
- SARS-CoV-2 infection dynamics in a MHCI-mismatched lung transplant recipient.Nature communications · 2025Article
- COVID-19 Vaccine Boosters in People With Multiple Sclerosis: Improved SARS-CoV-2 Cross-Variant Antibody Response and Prediction of Protection.Neurology(R) neuroimmunology & neuroinflammation · 2025Observational
- Characterisation of a persistent SARS-CoV-2 infection lasting more than 750 days in a person living with HIV: a genomic analysis.The Lancet. Microbe · 2025Article
- Signatures of omicron-like adaptation in early SARS-CoV-2 variants and chronic infection.Cell reports · 2025Article
- Rapid Emergence and Evolution of SARS-CoV-2 Intrahost Variants among COVID-19 Patients with Prolonged Infections, Singapore.Emerging infectious diseases · 2025Article
- Long-term serial passaging of SARS-CoV-2 reveals signatures of convergent evolution.Journal of virology · 2025Article
- Mycophenolic acid treatment drives the emergence of novel SARS-CoV-2 variants.Proceedings of the National Academy of Sciences of the United States of America · 2025Article
69 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
23 authors at 2 institutions in 2 countries.
Funding
Abstract
The origin of SARS-CoV-2 variants of concern remains unclear. Here, we test whether intra-host virus evolution during persistent infections could be a contributing factor by characterizing the long-term SARS-CoV-2 infection dynamics in an immunosuppressed kidney transplant recipient. Applying RT-qPCR and next-generation sequencing (NGS) of sequential respiratory specimens, we identify several mutations in the viral genome late in infection. We demonstrate that a late viral isolate exhibiting genome mutations similar to those found in variants of concern first identified in UK, South Africa, and Brazil, can escape neutralization by COVID-19 antisera. Moreover, infection of susceptible mice with this patient's escape variant elicits protective immunity against re-infection with either the parental virus and the escape variant, as well as high neutralization titers against the alpha and beta SARS-CoV-2 variants, B.1.1.7 and B.1.351, demonstrating a considerable immune control against such variants of concern. Upon lowering immunosuppressive treatment, the patient generated spike-specific neutralizing antibodies and resolved the infection. Our results suggest that immunocompromised patients could be a source for the emergence of potentially harmful SARS-CoV-2 variants.
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