Immunocompromised Children and Young Adults May Have Prolonged Infection With COVID-19

A prolonged infection can allow a virus to mutate more often, potentially letting more transmissible variants to emerge.

A recent case study conducted by investigators from the Clinical Microbiology and Virology Laboratory at Children's Hospital Los Angeles has found that children and younger adults who are immunocompromised can potentially experience a prolonged period of infection with the SARS-CoV-2 virus.

Additionally, the long period of infection can allow the virus to mutate, increasing the incidence of variants.

Results from the case study were published in the journal EBioMedicine.

"It's significant that these patients continued to have active symptoms and active infections for such a long time," Jennifer Dien Bard, lead author on the study said. "The large number of pediatric and adult patients receiving cancer therapy and being actively screened for the virus leads us to conclude that this is a rare occurrence but one that could have public health implications."

For the study, investigators discuss 3 cases, 2 children and 1 young adult who have been diagnosed with acute lymphoblastic leukemia and tested positive for SARS-CoV-2 for months.

The cases are the first reported ones of prolonged infection with the virus in pediatric of young adult populations.

It is known that the SARS-CoV-2 virus mutates somewhere around 1 to 2 times per month. A longer period of infection could allow the virus to mutate more often, which is raising concerns about viral variants.

While most mutations have no effect on how the virus behaves or how the disease it causes impacts the individual with it, some can result in a very different virus, one that may be more transmissible or deadly.

Investigators have put forth the idea that the B.1.1.7 variant that originated in the United Kingdom could have come from someone who was immunocompromised.

"We have had many other immunocompromised patients who have not experienced these prolonged infections, but it's something to be aware of, and hospitals may want to consider changing infection control policies to address this particular special population," Bard said.