Evidence map›Paper›PMID 41767267›Full record

ArticleiScience2026

Extensive evolution and T cell escape by SARS-CoV-2 in a 2.5-year persistent infection of an immunocompromised host.

José Afonso Guerra-Assunção, Ruairi McErlean, Katie Townsend, Selin Cankat, Leonhard M Flaxl, Shengwei Jamie Tian, Thomas R Turner, Neema P Mayor, Judith Breuer, Leo Swadling and 1 more

Abstract read
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In one paragraph

Article in iScience, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

José Afonso Guerra-AssunçãoHerpeslabNL, department of Viroscience, Erasmus MC, Rotterdam, the Netherlands.
Ruairi McErleanDivision of Infection and Immunity, Institute of Immunity and Transplantation, University College London, London, UK.
Katie TownsendDivision of Infection and Immunity, Institute of Immunity and Transplantation, University College London, London, UK.
Selin CankatDivision of Infection and Immunity, Institute of Immunity and Transplantation, University College London, London, UK.
Leonhard M FlaxlDivision of Infection and Immunity, Institute of Immunity and Transplantation, University College London, London, UK.
Shengwei Jamie TianDivision of Infection and Immunity, Institute of Immunity and Transplantation, University College London, London, UK.
Thomas R TurnerAnthony Nolan Research Institute, Royal Free Hospital, London, UK.
Neema P MayorAnthony Nolan Research Institute, Royal Free Hospital, London, UK.
Judith BreuerInfection, Immunity and Inflammation, Institute of Child Health, University College London, London, UK.
Leo SwadlingDivision of Infection and Immunity, Institute of Immunity and Transplantation, University College London, London, UK.
David M LoweDivision of Infection and Immunity, Institute of Immunity and Transplantation, University College London, London, UK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Prolonged virus-host interaction and suboptimal immunity during persistent SARS-CoV-2 infection of immunocompromised patients enables viral adaptation. We investigated viral evolution and immune escape during a 2.5-year persistent infection in a patient with multiple myeloma and rheumatoid arthritis receiving anti-CD20 therapy. Virus isolated 899-days post-infection revealed an ancestral B.31 lineage with extensive evolution (56 non-synonymous mutations across 20 viral proteins). Many mutations were private or convergent with those seen in other persistent infections and later variants. SARS-CoV-2-specific antibodies were undetectable. Despite prolonged antigen exposure, T cell memory was functional high-in-magnitude and breadth, but with inhibitory receptor expression and dominant spike-specific CD8 response. 38/56 mutations occurred in T cell epitopes, reducing MHC binding or immunogenicity for 69% of CD8 epitopes affected. Importantly, functional assays confirmed T cell escape at 50% (1/2) and 86% (6/7) of CD8 and CD4 epitopes tested

Indexed as

immunityimmunologysequence analysisvirology

Identifiers

PMID41767267
PMCPMC12936837

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.