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Updated: Aug 31, 2025

Live Imaging and Quantification of Viral Infection in K18 hACE2 Transgenic Mice Using Reporter-Expressing Recombinant SARS-CoV-2
Published on: November 5, 2021
Recurrent SARS-CoV-2 mutations in immunodeficient patients.
S A J Wilkinson1, Alex Richter2, Anna Casey1
1Institute of Microbiology and Infection, School of Biosciences, University of Birmingham, Birmingham B15 2TT, UK.
Long-term SARS-CoV-2 infections in immunocompromised patients drive viral evolution. Key mutations emerge in the spike gene, impacting ACE2 affinity and immune escape, potentially generating new variants.
Area of Science:
- Virology
- Genomics
- Immunology
Background:
- Long-term SARS-CoV-2 infections in immunocompromised individuals are understudied.
- Existing case studies lack a cohesive dataset for genomic analysis.
Purpose of the Study:
- To analyze the genomics of SARS-CoV-2 in immunocompromised patients with persistent infections.
- To identify recurrent mutations and evolutionary patterns within this patient group.
Main Methods:
- Literature searches for published case studies.
- Analysis of sequences from the COVID-19 Genomics UK (COG-UK) dataset.
- Identification and characterization of mutations in viral genes, particularly the spike gene.
Main Results:
- The spike gene's receptor-binding domain and N-terminal domain are mutation hotspots.
- Recurrent mutations associated with variants of concern were frequently observed.
- The envelope gene mutation T30I was the second most frequent recurrent mutation.
Conclusions:
- Recurrent mutations in persistent infections are linked to ACE2 affinity, immune escape, and viral packaging.
- Selective pressures favor mutations for within-host transmission and persistence.
- Immunocompromised individuals are a significant source for novel variant emergence.
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