Dynamic Evolution of SARS-CoV-2 in a Patient on Chemotherapy

Weihua Huang; Changhong Yin; Kimberly P Briley; William A B Dalzell; John T Fallon

doi:10.3390/v15081759

Dynamic Evolution of SARS-CoV-2 in a Patient on Chemotherapy

Viruses. 2023 Aug 18;15(8):1759. doi: 10.3390/v15081759.

Authors

Weihua Huang¹, Changhong Yin¹, Kimberly P Briley¹, William A B Dalzell², John T Fallon¹

Affiliations

¹ Department of Pathology and Laboratory Medicine, Brody School of Medicine, East Carolina University, Greenville, NC 27834, USA.
² Department of Pediatrics, Brody School of Medicine, East Carolina University, Greenville, NC 27834, USA.

Abstract

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has evolved significantly during the pandemic and resulted in daunting numbers of genomic sequences. Tracking SARS-CoV-2 evolution during persistent cases could provide insight into the origins and dynamics of new variants. We report here a case of B-cell acute lymphocytic leukemia on chemotherapy with infection of SARS-CoV-2 for more than two months. Genomic surveillance of his serial SARS-CoV-2-positive specimens revealed two unprecedented large deletions, Δ15-26 and Δ138-145, in the viral spike protein N-terminal domain (NTD) and demonstrated their dynamic shifts in generating these new variants. Located at antigenic supersites, these large deletions are anticipated to dramatically change the spike protein NTD in three-dimensional protein structure prediction, which may lead to immune escape but reduce their viral transmissibility. In summary, we present here a new viral evolutionary trajectory in a patient on chemotherapy.

Keywords: COVID-19; SARS-CoV-2; chemotherapy; deletion; evolution.

Publication types

Case Reports
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, P.H.S.

MeSH terms

COVID-19*
Genomics
Humans
Leukemia, Lymphocytic, Chronic, B-Cell*
SARS-CoV-2 / genetics
Spike Glycoprotein, Coronavirus / genetics

Substances

Spike Glycoprotein, Coronavirus
spike protein, SARS-CoV-2

Grants and funding

This research was partially supported by the Coronavirus Variant Sequencing (CORVASEQ) project of the North Carolina Department of Health and Human Services (NCDHHS), funded by the CDC Epidemiology and Laboratory Capacity for Prevention and Control of Emerging Infectious Diseases (ELC) grant.