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Covid-Pandemie und H5N1-Pandemie - das Ende der Menschheit und vieler anderer Tierarten => Covid-Pandemie und H5N1-Pandemie => Topic started by: Krik on April 21, 2024, 06:40:28 AM
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Per Email kam diese Meldung:
https://www.escmid.org/fileadmin/escmid/media/pdf/press_releases/2024/2024-q2/Press_Release_20240418_P3994UniqueCovidVariantV6.pdf
[*quote*]
Following longest known chronic SARS-CoV-2 infection of 613 days, experts
highlight the risk of development of novel potentially immune-evasive SARS-
CoV-2 variants due to persistent infections in immunocompromised patients
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Although rare, persistent SARS-CoV-2 infections in
immunocompromised patients could lead to increased number of
mutations in the virus genome.
Authors propose enhancing awareness of risks, close genomic
surveillance and early diagnostic tests for symptomatic contacts as part
of clinical management of these patients.
Embargo – 2301H UK time Thursday 18 April
*Please mention the ESCMID Global Congress (formerly ECCMID) Barcelona,
27-30 April) if using this material*
New research to be presented at next week’s ESCMID Global Congress (formerly
ECCMID) in Barcelona, Spain (27-30 April) highlights the risk of new immune-
evasive SARS-CoV-2 variants emerging in immunocompromised patients. The
report is by PhD candidate Magda Vergouwe, Centre for Experimental and Molecular
Medicine (CEMM), Amsterdam University Medical Center (Amsterdam UMC),
University of Amsterdam, Netherlands, and colleagues.
They describe the extended viral evolution in a SARS-CoV-2 infected patient for 613
days leading to a highly mutated novel variant. To the authors knowledge, it is the
longest SARS-CoV-2 infection duration to date, although several cases of hundreds
of days have been previously recorded.
Whereas healthy SARS-CoV-2 infected patients can clear the virus within a period of
days to weeks, an immunocompromised individual can develop a persistent infection
with prolonged viral replication and evolution. For instance, it is thought that the initial
emergence of the Omicron variant originated in an immunocompromised individual,
highlighting the importance of close genomic surveillance in this patient population.
In addition, the use of targeted immune pressure, including monoclonal antibody
therapies and/or novel antivirals, can further promote the emergence of viral escape
variants.
Vergouwe and colleagues describe in their report a 72-year-old
immunocompromised male patient who was admitted to Amsterdam University
Medical Center in February 2022 with a SARS-CoV-2 infection. Due to a history of
allogeneic stem cell transplantation as treatment of a myelodysplastic and
myeloproliferative overlap syndrome he was defined immunocompromised. This was
complicated by the development of a post-transplant lymphoma for which he
received rituximab that depletes all available B-cells, including those that normally
produce the SARS-CoV-2 directed antibodies.Previously, he had already received
multiple SARS-CoV-2 vaccinations without a
measurable SARS-CoV-2 IgG anitbody response at hospital admission. Routine
genomic surveillance showed infection with Omicron SARS-CoV-2 variant BA.1.17.
He received treatment with the anti-SARS-CoV-2 directed antibody sotrovimab, the
anti-IL6 antibody sarilumab and dexamethasone without clinical response.
Follow-up SARS-CoV-2 sequencing showed development of known sotrovimab-
resistance mutation S:E340K as early as 21 days after receiving the sotrovimab
infusion. SARS-CoV-2-specific T cell activity and anti-spike antibody development in
the first month were minimal, indicating that the patient’s immune system was not
capable of clearing the virus. The prolonged infection has led to the emergence of a
novel immune-evasive variant due to the extensive within-host evolution. In the end,
the patient died from a relapse of his haematological condition after remaining
SARS-CoV-2 positive with high viral loads for a total of 613 days. Fortunately, no
documented transmission had occurred with the highly mutated variant to secondary
cases in the community.
In more detail, the 613 days following initial SARS-CoV-2 detection were
characterised by multiple SARS-CoV-2-related and unrelated symptomatic episodes,
requiring hospital admissions. The persistent SARS-CoV-2 infection led to the
patient having prolonged isolation periods during hospital admission and enhanced
use of personal protective materials, greatly reducing his self-reported quality of life.
SARS-CoV-2 full genome sequencing was performed on 27 nasopharyngeal
specimens, collected from February 2022 until September 2023. It revealed over 50
nucleotide mutations compared to contemporary globally circulating BA.1-variants
with multiple amino acid substitutions, including ACE-2 receptor binding site
substitutions S:L452M/K and S:Y453F. Furthermore, several deletions in the N-
terminal domain of spike developed indicative of immune-escape.
The authors say: “This case underscores the risk of persistent SARS-CoV-2
infections in immunocompromised individuals as unique SARS-CoV-2 viral variants
may emerge due to extensive intra-host evolution. We emphasise the importance of
continuing genomic surveillance of SARS-CoV-2 evolution in immunocompromised
individuals with persistent infections given the potential public health threat of
possibly introducing viral escape variants into the community.”
While close surveillance is necessary the authors highlight that there must be a
balance between protecting the public from potential new variants and humane
supportive care at home of severely ill patients near the end of life. Possible
solutions can include an increased awareness of potential risks combined with
providing early accessible diagnostic testing of known (family) contacts as soon as
they develop relevant symptoms. This should be combined with genomic
surveillance in order to assess the public health threat together with public health
professionals. The authors highlight that although there may be an increased risk of
development of novel variants in immunocompromised patients, not every novel
variant in these patients will develop into a novel variant of concern (VOC) for the
community. The underlying mechanisms involved in the development of a VOC are
much more complex as they are also dependent of factors in the population
surrounding the patient, including the prevalence of B- and T-cell related immunity.
The authors conclude: “The duration of SARS-CoV-2 infection in this described case
is extreme, but prolonged infections in immunocompromised patients are much more
common compared to the general community. Further work by our team includes
describing a cohort of prolonged infections in immunocompromised patients from our
hospital with infection durations varying between 1 month and 2 years. However,
from the viewpoint of the general public, prolonged infections remain rare as the
immunocompromised population is only a very small percentage of the total
population.”
Magda Vergouwe, Centre for Experimental and Molecular Medicine (CEMM),
Amsterdam University Medical Center (Amsterdam UMC), University of
Amsterdam, Netherlands. Please contact via email
E) m.vergouwe@amsterdamumc.nl
AND PLEASE COPY Jack Daniel Cairns, Amsterdam UMC International
Science Communications Officer and Press Officer - Foreign Media.
T) +31 6 29 40 31 41 E) J.D.Cairns@AmsterdamUMC.nl
Alternative contact: Tony Kirby in the ESCMID Global Media Centre.
T) +44 7834 385827 E) tony@tonykirby.com
Notes to editors:
The authors declare no conflicts of interest.
This press release is based on poster P3994 at the ESCMID Global Congress
(formerly ECCMID). The material has been peer reviewed by the congress selection
committee. The research is currently in preparation for submission to a scientific
journal.
For full abstract click here
https://drive.google.com/file/d/1TmOYWK2CqyjgkxV8c5vp8RCsQPxqtQHo/view?usp=sharing
For full poster click here
https://drive.google.com/file/d/11pxDsxwtcqBgpvDGKSYA7LfWfYCVaA-R/view?usp=sharing
X – #ESCMIDGlobal #ECCMID2024 @ESCMID
[*/quote*]
Da haben die Journalistix mal wieder einen Riesenscheiß gebaut:
*Please mention the ESCMID Global Congress (formerly ECCMID) Barcelona,
27-30 April) if using this material*
Kein einziger Artikel, den ich finden konnte, hat die Quelle angegeben. Wieder total typisch für diese Analphabetenbande.
(http://www.allaxys.com/~aktenschrank/FRAUENPOWER/P3994COVIDVARIANT_pdf_PIC_1.png)
(http://www.allaxys.com/~aktenschrank/FRAUENPOWER/P3994COVIDVARIANT_pdf_PIC_2.png)
(http://www.allaxys.com/~aktenschrank/FRAUENPOWER/P3994COVIDVARIANTPOSTER_pdf_PIC.png)
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Das muß ich noch hinzufügen:
Das waren die einzigen, die die Ankündigung der Universität Amsterdam korrekt veröffentlicht haben. Die einzigen!
GROETJES !
https://www.vrt.be/nl/