SARS-CoV-2 Viral RNA Shedding for More Than 87 Days in an Individual With an Impaired CD8+ T Cell Response

Prolonged shedding of viral RNA occurs in some individuals following SARS-CoV-2 infection. We perform comprehensive immunologic evaluation of one individual with prolonged shedding. The case subject recovered from severe COVID-19 and tested positive for SARS-CoV-2 viral RNA repeatedly as many as 87...

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Bibliographic Details
Published in:Frontiers in immunology 2021-01, Vol.11, p.618402-618402
Main Authors: Turner, Jackson S, Day, Aaron, Alsoussi, Wafaa B, Liu, Zhuoming, O'Halloran, Jane A, Presti, Rachel M, Patterson, Bruce K, Whelan, Sean P J, Ellebedy, Ali H, Mudd, Philip A
Format: Article
Language:English
Subjects:
Aged, 80 and over
Antibodies, Neutralizing - immunology
Antibodies, Viral - immunology
CD4+ T cell
CD4-Positive T-Lymphocytes - immunology
CD4-Positive T-Lymphocytes - virology
CD8+ T cell
CD8-Positive T-Lymphocytes - immunology
CD8-Positive T-Lymphocytes - virology
cellular immunity
COVID-19
COVID-19 - immunology
COVID-19 - virology
Humans
Immunology
Male
Prospective Studies
RNA, Viral - immunology
SARS-CoV-2
SARS-CoV-2 - immunology
Viral Load - methods
Virus Shedding - immunology
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Summary:Prolonged shedding of viral RNA occurs in some individuals following SARS-CoV-2 infection. We perform comprehensive immunologic evaluation of one individual with prolonged shedding. The case subject recovered from severe COVID-19 and tested positive for SARS-CoV-2 viral RNA repeatedly as many as 87 days after the first positive test, 97 days after symptom onset. The subject did not have any associated rise in anti-Spike protein antibody titers or plasma neutralization activity, arguing against re-infection. This index subject exhibited a profoundly diminished circulating CD8+ T cell population and correspondingly low SARS-CoV-2-specific CD8+ T cell responses when compared with a cohort of other recovering COVID-19 subjects. CD4+ T cell responses and neutralizing antibody responses developed as expected in this individual. Our results demonstrate that detectable viral RNA shedding in the upper airway can occur more than 3 months following infection in some individuals with COVID-19 and suggest that impaired CD8+ T cells may play a role in prolonged viral RNA shedding.
ISSN:1664-3224
1664-3224
DOI:10.3389/fimmu.2020.618402