SARS-CoV-2 evolution and spike-specific CD4+ T-Cell response in persistent COVID-19 with severe HIV immune suppression
Álvarez, Hortensia; Ruiz Mateos, Ezequiel; Juiz González, Pedro Miguel; Vitallé, Joana; Viéitez, Irene; Vázquez Friol, María del Carmen; Torres Beceiro, Isabel; Pérez Gómez, Alberto; Gallego Garcia, Maria Del Pilar
; Estevez Gomez, Nuria
; De Chiara Prada, Loretta
; Poveda, Eva; Posada González, David
; Llibre, Josep M.




DATE:
2022-01-11
UNIVERSAL IDENTIFIER: http://hdl.handle.net/11093/3115
EDITED VERSION: https://www.mdpi.com/2076-2607/10/1/143
DOCUMENT TYPE: article
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.