Drivers of adaptive evolution during chronic SARS-CoV-2 infections

• DOI: 10.1038/s41591-022-01882-4
• Publication Date: 2022-06-20T16:07:21Z
• Authors: Sheri Harari; Maayan Tahor; Natalie Rutsinsky; Suzy Meijer; Danielle Miller; Oryan Henig; Ora Halutz; Katia Levytskyi; Ronen Ben-Ami; Amos Adler; Yael Paran; Adi Stern
• Keywords: Chronic infection; Lineage (genetic); Transmissibility (structural dynamics)

Abstract In some immunocompromised patients with chronic severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, considerable adaptive evolution occurs. Some substitutions found in infections are lineage-defining mutations variants of concern (VOCs), which has led to the hypothesis that VOCs emerged from infections. this study, we searched for drivers VOC-like emergence by consolidating sequencing results a set 27 Most reflected VOC mutations; however, subset associated successful global transmission was absent We further tested ability associate antibody evasion patient-specific and virus-specific features viral rebound is strongly correlated evasion. evidence dynamic polymorphic populations most patients, suggesting compromised immune system selects particular niches patient’s body. suggest tradeoff exists between transmissibility extensive monitoring necessary understanding emergence.