Immunocompromised Patients May Pose Unique COVID Mutation Risks

New threats have emerged in mutated variants of the COVID-19 virus, with some strains threatening to undermine every effort we’ve made to contain the previous waves. Researchers have been working to figure out why we’ve seen so many mutations in such a short span of time, and they may have pinpointed at least one source and it turns out that people with compromised immune systems could hold the key. 

How Viruses Mutate

Viruses mutate differently depending on whether they use DNA or RNA to replicate. Varieties like SARS-CoV-2, the virus that causes COVID-19, are RNA viruses, which mutate rapidly regardless of their hosts. These microbes produce an average of one or two mutations each time they split, which means no two generations are identical.

This constant evolution can work to the virus’ advantage, with some shifts allowing them to jump species or even become more infectious to their hosts. These mutations aren’t always a benefit to the virus; some changes create handicaps that eventually lead to a virus’s extinction.

In the case of COVID-19, many of these mutations have improved the virus’s ability to invade human cells so it can reproduce faster. Researchers are currently tracking multiple variants in the hope of discovering a common weakness.

The Set-Up for Mutation

The longer a virus survives, the more chances it has to mutate. Viruses that cause shorter infections have fewer chances to mutate into more dangerous strains. It makes sense, then, that longer infection times create greater opportunities for serious mutations. And that's where things get bad for those who are considered immunocompromised — and the rest of us.

The Immunocompromised and COVID-19

Reports of rare cases of extended infections in immunocompromised people have sparked a new study area in SARS-CoV-2 mutations. Evidence points to long-lasting infections increasing the chances of new variants.

The study of one patient in the UK allowed researchers to follow the process in real-time. The man had an autoimmune disease and took immunosuppressant drugs, which had left him susceptible to a 5-month-long COVID infection that ultimately ended his life.

The patient’s doctors saw a unique opportunity in the persistent infection, and they took regular samples of the virus to document the regular changes to its RNA. They found that not only was the virus running rampant in the man’s body, but it was also mutating at a rate of 10 and 20 times the expected rate. Studies in other regions have reported similar findings, highlighting the potential dangers of exposing immunocompromised people to this and other serious infections because the variants don't stay in the immunocompromised host.

COVID-19 has taken advantage of our every weakness, and now it could be using the most vulnerable among us as its most destructive weapon. Strategies to offer better and more stringent protection to the people who are most vulnerable could be our best defense in the fight against variants. In the meantime, it’s up to each of us to maintain current efforts (or redouble our own) to minimize the spread. 

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