The curious case of the 471-day coronavirus infection
One patient couldn’t get rid of their coronavirus infection. The case gave scientists an unprecedented look at viral evolution.
As omicron subvariant BA.5 continues to drive the coronavirus’ spread in the United States, I’ve been thinking about what could come next. Omicron and its offshoots have been topping the variant charts since last winter. Before that, delta reigned.
Scientists have a few ideas for how new variants emerge. One involves people with persistent infections — people who test positive for the virus over a prolonged period of time. I’m going to tell you about the curious case of a person infected with SARS-CoV-2 for at least 471 days and what can happen when infections roil away uncontrolled.
That lengthy infection first came onto epidemiologist Nathan Grubaugh’s radar in the summer of 2021. His team had been analyzing coronavirus strains in patient samples from Yale New Haven Hospital when Grubaugh spotted something he had seen before. Known only as B.1.517, this version of the virus never got a name like delta or omicron, nor rampaged through communities quite like its infamous relatives.
Instead, after springing up somewhere in North America in early 2020, B.1.517 tooled around in a handful of regions around the world, even sparking an outbreak in Australia. But after April 2021, B.1.517 seemed to sputter, one of the who-knows-how-many viral lineages that flare up and then eventually fizzle.
B.1.517 might have been long forgotten, shouldered aside by the latest variant to stake a claim in local communities. “And yet we were still seeing it,” Grubaugh says. Even after B.1.517 had petered out across the country, his team noticed it cropping up in patient samples. The same lineage, every few weeks, like clockwork, for months.
One clue was the samples’ specimen ID. The code on the B.1.517 samples was always the same, Grubaugh’s team noticed. They had all come from a single patient.
That patient, a person in their 60s with a history of cancer, relapsed in November of 2020. That was right around when they first tested positive for SARS-CoV-2. After seeing B.1.517 show up again and again in their samples, Grubaugh worked with a clinician to get the patient’s permission to analyze their data.
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