在奥米克朗时期免疫受损的患者中SARS-CoV-2的分泌和演变:一个多中心的前性分析
Zoe Raglow1, Diya Surie2, James D Chappell3
1Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA.
The Lancet. Microbe
|January 29, 2024
概括
长期感染SARS-CoV-2的免疫功能低下个体可能会发展出新的变种. 患有B细胞功能障碍,移植或艾滋病的患者面临更高的风险,需要针对性监测和治疗抗病毒耐药性.
科学领域:
- 病毒学 病毒学
- 免疫学 免疫学 免疫学
- 传染性疾病 传染性疾病
背景情况:
- 长时间的SARS-CoV-2感染在免疫受损的个体中可能会导致高度突变的变种的出现.
- 缺乏对长期感染风险最高的免疫抑制类型的系统调查.
研究的目的:
- 评估免疫功能低下患者长期感染SARS-CoV-2的危险因素.
- 为了调查相关的宿主内病毒进化.
主要方法:
- 这是一项多中心的前性分析,涉及美国五个医疗中心150名免疫受损患者.
- 定期进行RT-PCR测试,病毒培养和阳性样本的全基因组测序.
- 考克斯比例危险模型用于识别与感染持续时间相关的因素.
主要成果:
- 在25%的参与者中观察到长期的SARS-CoV-2感染 (持续时间>21天).
- 与自身免疫性疾病患者相比,B细胞功能障碍,固体器官移植/HSCT和艾滋病患者的感染持续时间明显更长.
- 在感染超过56天的个体中,发现了De novo尖端突变,特别是在受体结合域中.
结论:
- 长期的,具有复制能力的Omicron SARS-CoV-2感染并不常见,但可能导致明显的宿主内尖端突变.
- 高风险人群需要针对重复测试,治疗和潜在的抗病毒耐药性进行有针对性的监测.
- 了解风险因素对于管理长期感染和预防变种出现至关重要.
相关概念视频
Viral Mutations
32.3K
A mutation is a change in the sequence of bases of DNA or RNA in a genome. Some mutations occur during replication of the genome due to errors made by the polymerase enzymes that replicate DNA or RNA. Unlike DNA polymerase, RNA polymerase is prone to errors because it is not capable of “proofreading” its work. Viruses with RNA-based genomes, like HIV, therefore accrue mutations faster than viruses with DNA-based genomes. Because mutation and recombination provide the raw material...
32.3K
Viral Recombination
23.4K
Cells are sometimes infected by more than one virus at once. When two viruses disassemble to expose their genomes for replication in the same cell, similar regions of their genomes can pair together and exchange sequences in a process called recombination. Alternatively, viruses with segmented genomes can swap segments in a process called reassortment.
23.4K
Single Nucleotide Polymorphisms-SNPs
15.1K
A single nucleotide polymorphism or SNP is a single nucleotide variation at a specific genomic position in a large population. It is the most prevalent type of sequence variation found in the human genome. Point mutations that occur in more than 1% of the population qualify as SNPs. These are present once every 1000 nucleotides on an average in the human genome. Replacement of a purine with another purine (A/G) or a pyrimidine with another pyrimidine (C/T) is known as a transition. In contrast,...
15.1K
Rous Sarcoma Virus (RSV) and Cancer
5.1K
Rous Sarcoma virus or RSV was discovered by F. Peyton Rous in the year 1911 as a filterable transmissible agent that could cause tumors in chickens. He won a Nobel Prize for this discovery in 1966. His experiments clearly demonstrated that some cancers could be caused by infectious agents and led to the discovery of many more cancer-causing viruses in animals as well as humans.
RSV is a retrovirus that contains two copies of a plus-strand RNA genome. Its genome consists of four main open...
RSV is a retrovirus that contains two copies of a plus-strand RNA genome. Its genome consists of four main open...
5.1K
Infection
7.9K
When a pathogen enters the body and reproduces, it can cause an infection, damage body cells, and cause illness symptoms that eventually lead to disease. Therefore, its prevention requires breaking the chain of infection.
The chain begins with pathogens: bacteria, viruses, fungi, prions, or parasites such as protozoa helminths. These can be present on the skin as transient or resident flora, or they can be acquired from the environment. Identifying and treating the type of infection and...
The chain begins with pathogens: bacteria, viruses, fungi, prions, or parasites such as protozoa helminths. These can be present on the skin as transient or resident flora, or they can be acquired from the environment. Identifying and treating the type of infection and...
7.9K
Transmission-based Precautions II: Airborne and Protective Environment
1.3K
Transmission-based precautions are for patients infected or suspected to be infected (or colonized) with organisms posing a significant risk to others. The transmission precautions include airborne and protective environment precautions.
Airborne precautions:
Use airborne precautions when treating patients known or suspected to have diseases that spread through the air—for example, tuberculosis or measles. These organisms are present in smaller droplets expelled by an infected person and...
Airborne precautions:
Use airborne precautions when treating patients known or suspected to have diseases that spread through the air—for example, tuberculosis or measles. These organisms are present in smaller droplets expelled by an infected person and...
1.3K


