Is it true that you can be sick with coronavirus infection for a year?

Over more than a year and a half of the pandemic, we have become accustomed to the fact that coronavirus infection is an acute disease that does not become chronic. However, recently publications began to appear that some patients, based on PCR results, continue to isolate the virus for many months. We decided to check whether this is possible and what doctors and scientists say about this.

Publications about a Russian patient who suffered from coronavirus for 11 months appeared in such media as Lenta.ru, "Gazeta.ru», "Vesti.ru», "Russian newspaper». A similar case in the UK was reported by the newspaper The Guardian, and also a tabloid The Mirror.

Covid infection, as a respiratory disease, has long been considered an ailment that has only acute form. Since the first wave of the pandemic, patients who do not require hospitalization have been prescribed observe home self-isolation for 14 days; patients receive the same order after discharge from the hospital. In some cases of outpatient, that is, without hospitalization, observation of the patient, the smear before the end of self-isolation was positive, and the isolation regime could be extended for another week. However, in none of these cases was there talk of a chronic coronavirus infection, accompanied by stable viral shedding for months.

At the same time, in September 2020, the International Classification of Diseases was added to the section for designating new diagnoses of unknown etiology or for use in emergency situations was added code U09.9, indicating a health disorder associated with a previous coronavirus infection. Behind this code in Russian established the name of post-Covid syndrome (PCS), or simply post-Covid, as well as its English language Name — long-covid (literal translation options: “long”, “long”, “protracted” covid). However, this diagnosis is made only if the virus is no longer detected in the body by PCR testing. Publications about Long Covid now becomes more and more, some scientists even are afraidthat this syndrome will cause temporary or permanent disability for some of those who have recovered from the disease. Moreover, in addition to the lungs, coronavirus infection can disrupt work nervous system, gastrointestinal tract, urogenital, cardiovascular systems, etc.

However, in publications about an 11-month period (from April 2020 to March 2021, further information on PCR results of patients is not publicly available) coronavirus Russian women and almost 10 months (290 days) British it is emphasized that their PCR tests during this time regularly (or most of the time) gave positive results. The Russian case became interested in the First St. Petersburg Medical University. Pavlova. In addition to this patient, doctors also discovered 27 other cases of prolonged viral shedding. These patients have coronavirus infection was discovered a slightly shorter period - from several months to six months, but still too long for an acute respiratory infection. By words infectious disease doctor at the University. Pavlov and the Chairman of the Council of Young Scientists of the Influenza Research Institute Oksana Stanevich, the share of such patients is about 0.7% of all cases hospitalized in them. Both Russian and foreign doctors initially suspected that their cured patients were re-infected with the coronavirus after being discharged from the hospital, but genetic sequencing of the samples showedthat this is the same virus. 

Scientists, based on observation materials of a Russian patient, have already published preprint - a preliminary version of an article that has not yet been published in a peer-reviewed scientific publication. The interesting thing about it is that the virus in the patient, who had not traveled abroad and had no contact with those returning from abroad, at some point mutated into a variant related to the one discovered at minks in Denmark. Moreover, the rate of mutation of the virus in the patient’s body was significantly higherthan the average overall mutation rate of the coronavirus. At the same time, a comforting fact was discovered: the ability of the mutated virus to evade antibodies is not increased, which means that vaccines against such a virus would still protect with fairly high efficiency.

Similar cases have been described in other publications and reports, patients isolated the virus 52 days, 69 days, 70 days, 74 days. However, if you look closely at the accompanying diagnoses of these people, you will notice a pattern. All of them had oncohematological and oncological diseases. Thus, the Russian patient had non-Hodgkin’s lymphoma, the British patient completed chemotherapy against leukemia in 2019, and other described long-term virus carriers also took immunosuppressive drugs after transplantation or as part of antitumor therapy. To date supposedthat the reason for their long virus-secreting activity may be the reduced ability of the immune system to respond to various infectious agents due to special treatment.

Thus, long-term (more than a month) coronavirus infection does exist; quite a few such patients have been described in the scientific literature. The record holder can be considered a British person, if we take into account the strictly continuous duration of virus shedding, or a Russian woman, if we take into account those periods when the virus was not released, but then appeared in the body again. Moreover, in all the described cases, the researchers note that, in addition to coronavirus infection, the patients had concomitant conditions accompanied by immunosuppression.

Is it true

What do our verdicts mean?

Read on the topic:

1. Very long covid. Four versions of the origin of post-coronavirus syndrome (PCS) and its most dangerous consequences
2. Is it true that those who have recovered from COVID-19 have an irreversible decline in their intelligence level?