Case Report
Re-infection with a different SARS-CoV-2 clade and prolonged viral shedding in a hematopoietic stem cell transplantation patient

https://doi.org/10.1016/j.ijid.2021.07.036Get rights and content
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Highlights

  • Immunocompromised patients may acquire different clades of SARS-CoV-2 infection.

  • Infection with different SARS-CoV-2 clades poses significant management challenges.

  • Prolonged secretion of SARS-CoV-2 occurs in immunocompromised patients.

  • The impact of rituximab and B cell-depleting agents requires definition.

  • The responses to COVID-19 vaccines need further study.

Abstract

Immunocompromised patients who have a severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection pose many clinical and public health challenges. We describe the case of a hematopoietic stem cell transplantation patient with lymphoma who had a protracted illness requiring three consecutive hospital admissions. Whole genome sequencing confirmed two different SARS-CoV-2 clades. Clinical management issues and the unanswered questions arising from this case are discussed.

KEYWORDS

SARS-CoV-2
Re-infection
Prolonged viral shedding
Immunocompromised
Hematological stem cell transplant
COVID-19

Cited by (0)

Abeer N. Alshukairi, Sherif A. El-Kafrawy, Alimuddin Zumla, and Esam I. Azhar contributed equally.