Another group, writing in New England Journal of Medicine Earlier this month, he gave a detailed description of the route of the virus in a 45-year-old man with an autoimmune disorder on whom he was receiving immunization. In this case they found that the individual had an “accelerated” evolution of the virus, and many of the mutations were in the spike protein. Most people with immunosuppression clear up SARS-CoV-2 infections without major complications, they wrote, but “this case illustrates the potential for chronic disease and accelerated viral evolution. -bound to a protective state. ”
The same has been observed in other situations where the immune system is blocked. HIV attacks immune function, which allows it to develop at an alarmingly high level, making it even harder for the body to keep producing antibodies that bind and neutralize the virus. Similarly, HIV infections allow other viruses in the individual to survive longer and morph. Herpes simplex virus can develop resistance to rare drugs in AIDS patients, for example.
However, we need to better understand exactly which patients with vaccines are most vulnerable to long-term SARS-CoV-2 infection. The “immunocompromised” category captures such a wide range of different conditions, and may not all present the same risk for persistent Covid-19. Brian Wasik, a physiologist at Cornell University, points out that the term could include people born with rare disorders that reduce their ability to fight pathogens, as well as those taking immunosuppressants to allow transmission or elimination of autoimmune disease.
Evidence for the links between immune individuals and chronic SARS-CoV-2 diseases, and between chronic diseases and viral evolution, is strong enough to be considered in discussions about vaccine priority. On Sunday, a panel from the U.S. Centers for Disease Control and Prevention recommended that immunocompromised individuals should be placed in “Stage 1c” – the third wave – of vaccine distribution. That means they get the injection at the same time as those with cancer, coronary heart disease, or obesity, among other conditions. That decision was intended to address the specific risks posed by Covid-19 to people with immune system issues, but pointed out that vaccination of these individuals could help prevent the development of mutations. new SARS-CoV-2 that would make this pandemic even worse than it already is. For this reason, even though there are only a few directly relevant case reports, public health officials should consult virologists on whether it would be wise for people with vaccinations to move into the Stage 1b group earlier.
At the very least, we need to better investigate potential changes to SARS-CoV-2. The U.S. government should do more to organize viral sequencing efforts. The CDC has a program nicknamed Spheres that has tried to capture series data during the pandemic, but it falls short: Where the UK has about 10 per cent of Covid cases -19 of them classified, the U.S. has only regulated 0.3 percent. “It’s a little different,” says Adam Lauring of the University of Michigan School of Medicine, who says his team has uploaded about 2 percent of variable variable data in the U.S. “There are large areas of the country where there are not many people who spend a lot of time and effort” on this task. A better study of viral evolution may help to clarify the question of where exactly – in which people are sick – these changes are more likely to accumulate.
As we monitor for SARS-CoV-2 mutations, we must acknowledge that more work is needed to understand their epidemiological and clinical significance. At the same time, the virus is still rampant, giving it more chances to get around even as it spreads from person to person. However, attention should be paid to the chronic diseases in some people with immunodeficiency, and the potential associated with viral evolution.
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