Patients with COVID-19 who have compromised immune systems from other diseases such as cancer or HIV may serve as hosts for new variants, a number of case reports suggest, The Washington Post reported March 11.
The theory is one supported by the fact that some of the now widely known variants, including the B.1.1.7, first identified in the U.K., and B.1.351, first detected in South Africa, were seen in some hospitalized patients months before their official discovery.
One of the case reports cited by the Post details the experience of a 2-year-old cancer patient with COVID-19 who initially seemed to recover, but then continued feeling sick off and on for 196 days. Throughout that time period, the toddler was hospitalized six times and tested positive for COVID-19 each time.
The patient's medical team at the Children's Hospital Los Angeles found it wasn't reinfection. Instead, the virus had been mutating throughout the months-long period.
"The evidence points to these immunocompromised patients as an accelerated cauldron of evolution," David Pollack, PhD, genomics professor at the University of Colorado at Boulder, told the Post.
Similar cases have been reported globally, and while there isn't a given answer, some researchers suspect treatments such as convalescent plasma and monoclonal antibodies may be a contributing factor. In some case reports involving cancer patients, researchers found an increase in the number and type of mutations after such therapies were given, suggesting the virus was evolving to escape the treatments.
The challenge physicians now face: how to best treat COVID-19 patients who are immunocompromised. That's because there's not much information as to how the combination of COVID-19 therapies and cancer treatments could affect viral mutation.
"I will tell you, to be completely honest, we don't know the best thing to do," Ghady Haidar, MD, infectious diseases physician at the University of Pittsburgh, told the Post.
To read the full Washington Post article, click here.