Evidence map›Paper›PMID 41902301›Full record

ArticleViruses2026

Disentangling SARS-CoV-2 Sustained Viremia Cases: Evolution, Persistence and Reinfection.

Brunna M Alves, Filipe R R Moreira, Marianne M Garrido, Pedro S de Carvalho, Élida M de Oliveira, Caroline C de Sá, James Arthos, Claudia Cicala, João P B Viola, Livia R Goes and 3 more

Abstract read
In one paragraph

Article in Viruses, 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

13 authors.

Brunna M AlvesPrograma de Genética e Virologia Tumoral, Instituto Nacional de Câncer, Rio de Janeiro 20231-050, Brazil.ORCID 0000-0002-6230-3109
Filipe R R MoreiraDepartamento de Genética, Universidade Federal do Rio de Janeiro, Rio de Janeiro 21941-901, Brazil.
Marianne M GarridoComitê de Controle de Infecção Hospitalar, Instituto Nacional de Câncer, Rio de Janeiro 20230-130, Brazil.
Pedro S de CarvalhoPrograma de Genética e Virologia Tumoral, Instituto Nacional de Câncer, Rio de Janeiro 20231-050, Brazil.
Élida M de OliveiraPrograma de Genética e Virologia Tumoral, Instituto Nacional de Câncer, Rio de Janeiro 20231-050, Brazil.ORCID 0009-0005-1086-9652
Caroline C de SáPrograma de Genética e Virologia Tumoral, Instituto Nacional de Câncer, Rio de Janeiro 20231-050, Brazil.ORCID 0009-0007-9337-7956
James ArthosLaboratory of Immunoregulation, National Institute of Allergy and Infectious Diseases, Bethesda, MD 20892, USA.
Claudia CicalaLaboratory of Immunoregulation, National Institute of Allergy and Infectious Diseases, Bethesda, MD 20892, USA.
João P B ViolaPrograma de Imunologia e Biologia Tumoral, Instituto Nacional de Câncer, Rio de Janeiro 20231-050, Brazil.ORCID 0000-0002-0698-3146
Livia R GoesPrograma de Genética e Virologia Tumoral, Instituto Nacional de Câncer, Rio de Janeiro 20231-050, Brazil.ORCID 0000-0002-4909-4912
Juliana D SiqueiraPrograma de Genética e Virologia Tumoral, Instituto Nacional de Câncer, Rio de Janeiro 20231-050, Brazil.ORCID 0000-0002-4266-9795
Marcelo A SoaresPrograma de Genética e Virologia Tumoral, Instituto Nacional de Câncer, Rio de Janeiro 20231-050, Brazil.ORCID 0000-0002-9013-2570
Brazilian National Cancer Institute COVID-19 Task Force

Funding

Brazilian Ministry of Health IntramuralFundação de Amparo à Pesquisa do Estado do Rio de Janeiro E-26/211.126/2021NIH Common Fund Intramural
6 · The paper itself

Abstract

Based on the follow-up of patients who recovered from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, several reports of people who re-tested positive have been described. This may result from viral reactivation, true reinfection, superinfection, or an initial infection by more than one virus (multiple infection). These scenarios can only be correctly distinguished through viral quasispecies analysis. Herein, 26 cancer patients under extended follow-up for SARS-CoV-2 infection were submitted to multiple longitudinal analyses through nucleic acid isolation, PCR amplification and high-throughput sequencing. SARS-CoV-2 classification and the definition of cases as persistent or repeated infections were based on phylogenetic reconstruction. Supported by their viral complete genomes and intrahost quasispecies over time, the different scenarios were identified. Nine confirmed and 12 plausible persistence cases were identified. Virus evolution dynamics in the intrahost population from patients with persistent infection was shown for the first time. Regarding reinfection, three confirmed and two plausible cases were identified, including one case of multiple infection. Altogether, this is the first study that analyzes the plethora of SARS-CoV-2 within-host minor variants and describes reinfections, multiple infections and viral evolution across time in cancer patients, contributing to the understanding of SARS-CoV-2's within-host population dynamics in the natural history of COVID-19.

Indexed as

COVID-19Persistent InfectionReinfectionSARS-CoV-2ViremiaEvolution, MolecularGenome, ViralHigh-Throughput Nucleotide SequencingHumansNeoplasmsPhylogenyQuasispeciescancerCOVID-19intrahost dynamicspersistenceSARS-CoV-2

Identifiers

PMID41902301
PMCPMC13030517

What OpenQuestion holds

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Registered trials

None linked

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.