Prolonged severe acute respiratory syndrome coronavirus 2 infection and intrahost viral evolution in a severely immunocompromised patient with human immunodeficiency virus infection: A whole-genome sequencing study

Key Points

• Distinct viral strains emerged due to prolonged infection in an immunocompromised host, highlighting rapid genetic changes.
• Key evidence shows fixation of spike substitutions, indicating a selective sweep during the infection process.
• Whole-genome sequencing unveiled significant viral evolution in the context of advanced HIV infection and deep immunosuppression.
• These findings support the need for targeted monitoring strategies in severely immunocompromised individuals, addressing risks associated with persistent infections.