{"doi":"10.1101/2023.07.31.23293441","title":"SARS-CoV-2 Viral Clearance and Evolution Varies by Extent of Immunodeficiency","abstract":"Despite vaccination and antiviral therapies, immunocompromised individuals are at risk for prolonged SARS-CoV-2 infection, but the immune defects that predispose to persistent COVID-19 remain incompletely understood. In this study, we performed detailed viro-immunologic analyses of a prospective cohort of participants with COVID-19. The median time to nasal viral RNA and culture clearance in the severe hematologic malignancy/transplant group (S-HT) were 72 and 40 days, respectively, which were significantly longer than clearance rates in the severe autoimmune/B-cell deficient (S-A), non-severe, and non-immunocompromised groups (P<0.001). Participants who were severely immunocompromised had greater SARS-CoV-2 evolution and a higher risk of developing antiviral treatment resistance. Both S-HT and S-A participants had diminished SARS-CoV-2-specific humoral, while only the S-HT group had reduced T cell-mediated responses. This highlights the varied risk of persistent COVID-19 across immunosuppressive conditions and suggests that suppression of both B and T cell responses results in the highest contributing risk of persistent infection.","journal":"medRxiv","year":2023,"id":390418,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":11,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9559,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2023-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":218333,"name":"Manish C. Choudhary","orcid":"0000-0002-3192-7840","position":1,"is_corresponding":false},{"id":218316,"name":"James Regan","orcid":"0000-0003-0449-2295","position":2,"is_corresponding":false},{"id":108357,"name":"Julie Boucau","orcid":"0000-0001-6731-7238","position":3,"is_corresponding":false},{"id":463010,"name":"Anusha Nathan","orcid":"0000-0002-4418-1005","position":4,"is_corresponding":false},{"id":1162195,"name":"Tessa Speidel","orcid":"0009-0000-7590-4141","position":5,"is_corresponding":false},{"id":888770,"name":"May Y. Liew","orcid":null,"position":6,"is_corresponding":false},{"id":1024780,"name":"Gregory E. Edelstein","orcid":null,"position":7,"is_corresponding":false},{"id":866317,"name":"Yumeko Kawano","orcid":"0000-0003-2423-5982","position":8,"is_corresponding":false},{"id":659569,"name":"Rockib Uddin","orcid":"0000-0001-5953-1234","position":9,"is_corresponding":false},{"id":806067,"name":"Rinki Deo","orcid":null,"position":10,"is_corresponding":false},{"id":888772,"name":"Caitlin Marino","orcid":null,"position":11,"is_corresponding":false},{"id":539223,"name":"Matthew A. Getz","orcid":"0000-0002-4172-2187","position":12,"is_corresponding":false},{"id":1162731,"name":"Zahra Reynold","orcid":null,"position":13,"is_corresponding":false},{"id":1024071,"name":"Mamadou Barry","orcid":"0009-0005-1458-2528","position":14,"is_corresponding":false},{"id":259555,"name":"Rebecca F. Gilbert","orcid":"0000-0003-1761-4626","position":15,"is_corresponding":false},{"id":1024781,"name":"Dessie Tien","orcid":null,"position":16,"is_corresponding":false},{"id":1024782,"name":"Shruti Sagar","orcid":null,"position":17,"is_corresponding":false},{"id":660762,"name":"Tammy D. Vyas","orcid":null,"position":18,"is_corresponding":false},{"id":325436,"name":"James P. Flynn","orcid":"0000-0002-8663-5087","position":19,"is_corresponding":false},{"id":1024072,"name":"Sarah P. Hammond","orcid":"0000-0002-4271-7443","position":20,"is_corresponding":false},{"id":3888,"name":"Lewis A. Novack","orcid":"0000-0001-7508-1720","position":21,"is_corresponding":false},{"id":419515,"name":"Bina Choi","orcid":"0000-0003-1472-9639","position":22,"is_corresponding":false},{"id":640940,"name":"Manuela Cernadas","orcid":"0000-0002-5444-0074","position":23,"is_corresponding":false},{"id":236765,"name":"Zachary S. Wallace","orcid":"0000-0003-4708-7038","position":24,"is_corresponding":false},{"id":236764,"name":"Jeffrey A. Sparks","orcid":"0000-0002-5556-4618","position":25,"is_corresponding":false},{"id":284649,"name":"Jatin M. Vyas","orcid":"0000-0002-9985-9565","position":26,"is_corresponding":false},{"id":16991,"name":"Michael S. Seaman","orcid":"0000-0001-6444-3562","position":27,"is_corresponding":false},{"id":234874,"name":"Gaurav D. Gaiha","orcid":"0000-0001-6875-4472","position":28,"is_corresponding":false},{"id":69650,"name":"Mark J. Siedner","orcid":"0000-0003-3506-842X","position":29,"is_corresponding":false},{"id":646796,"name":"Amy K. Barczak","orcid":"0000-0003-3806-2381","position":30,"is_corresponding":false},{"id":226714,"name":"Jacob E. Lemieux","orcid":"0000-0002-2758-4005","position":31,"is_corresponding":false},{"id":108340,"name":"Jonathan Z. Li","orcid":"0000-0001-9914-9662","position":32,"is_corresponding":false},{"id":218325,"name":"Yijia Li","orcid":"0000-0001-5300-0571","position":0,"is_corresponding":true}],"reference_count":51,"raw_metadata":null,"created_at":"2026-07-19T01:18:37.743462Z","pmid":"37577493","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}