For most people, a COVID-19 infection clears up within weeks. But scientists have now documented a case where the virus stayed inside one man’s body for over 750 days, more than two years. This rare case was linked to an individual living with advanced HIV, whose immune system was too weak to fight back.
When the body cannot clear the virus
The patient, who was not receiving antiretroviral therapy, carried the SARS-CoV-2 virus from mid-2020 until mid-2022. Researchers collected eight clinical samples during this period and sequenced them to track how the virus behaved inside his body. His immune system, severely compromised, became an unusual environment where the virus could survive and evolve continuously.
How the virus changed inside one person
The analysis revealed something extraordinary. Over two years, the virus accumulated 68 consensus and 67 subconsensus mutations. Some of these mutations occurred in the spike protein, the same region that helped Omicron become so infectious worldwide. In fact, 10 mutations matched positions later found in the Omicron lineage, and nine of them were present before Omicron was even officially identified in late 2021.
A personal infection, not a global threat
The virus stayed largely confined to this one patient. Researchers found no evidence of onward transmission in the community. Some mutations were rare in public databases, suggesting the virus may have adapted so specifically to the patient’s body that it lost the ability to spread easily to others. In other words, the infection became a private battleground between one immune system and one evolving virus.
What this means for the future
The study suggests that persistent infections in immunocompromised people may play a role in shaping viral evolution, offering insights into how new variants like Omicron could emerge. It also underscores the importance of access to timely HIV treatment, vaccines, and close monitoring of such long-term infections. Beyond science, it is a reminder that gaps in healthcare can have ripple effects that extend far beyond individual patients.This case is not just a scientific record; it is a human story about vulnerability, strength, and the urgent need to strengthen health systems. A virus that lasted more than 750 days inside one body tells us as much about medicine as it does about society’s responsibility to protect its most fragile members.Disclaimer: This article is based on findings published in The Lancet (2024). It is intended for informational purposes only and should not be considered medical advice. For personal health concerns, always seek guidance from a qualified medical professional.
