State-of-the-Art Virology in Norway

A special issue of Viruses (ISSN 1999-4915). This special issue belongs to the section "General Virology".

Deadline for manuscript submissions: closed (20 January 2023) | Viewed by 19675

Special Issue Editors


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Guest Editor
1. Department of Microbiology and Infection Control, University hospital of North Norway, N-9038 Tromsø, Norway
2. Department of Clinical Medicine, UiT The Arctic University of Norway, N-9037 Tromsø, Norway
Interests: viruses causing disease in immunocompromised humans, especially BK- and JC polyomavirus, hepatitis E-virus, and SARS-CoV-2; virus replication; virus-cell interactions; pathogenesis; immunity; cancer; antiviral treatment; diagnostics

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Guest Editor
1. Department of Forestry and Wildlife Management, Faculty of Applied Ecology, Agricultural Sciences and Biotechnology, Inland Norway University of Applied Sciences, N-2480 Koppang, Norway
2. Arctic and Marine Biology, UiT The Arctic University of Norway, N-9037 Tromsø, Norway
Interests: zoonoses and one health; infection biology and viral infections in wildlife and semi-domesticated reindeer

Special Issue Information

Dear Colleagues,

Norway is positioned in a remote and sparsely inhabited corner of the world with less than 5.4 million human inhabitants spread over 385 207 km² of forest, tundra, coastal landscapes, and mountains. We enjoy conditions that are generally conducive to good health for humans; domesticated- and wild-, land- and marine animals; and plants. In addition to traditional livestock and meat production, farmed fish have become the most important production species with about 1.5 million tons salmon and rainbow trout produced annually. Norway, as the only country in Europe, has about 25,000 wild reindeer living in the southern mountain areas. In addition, there are about 220,000 semi-domesticated reindeer, most of them associated with the Saami reindeer herding in the northern part of the country. Viruses, the most abundant and biologically diverse entities on our planet, infect every living organism. While the majority of viruses probably do not harm their host, some cause acute or chronic diseases that may have serious health-related and economic consequences. Virology research in Norway has mainly focused on viruses that cause disease, but viruses can also be beneficial. Oncolytic viruses can be used for tumor therapy, and bacteriophages can be used to protect farmed fish and humans from bacterial infections. Both strategies have become important fields of research. Importantly, access to next-generation sequencing methods has given us the possibility to identify new viruses and follow viral evolution.

Norway is part of the “global village”, and the ongoing SARS-CoV-2 pandemic of the last two years has spurred a flurry of Norwegian SARS-CoV-2 publications. These papers mainly present epidemiological data from Norway and only rarely include experimental work with SARS-CoV-2. The SARS-COV-2 pandemic has increased the interest in virology both among researchers and the general public. With our travelling habits and the movements and seasonal migrations of birds, mammals, fish, and insects, we are constantly exposed to new hosts, vectors, and potential pathogens, and high-quality virus research is more important than ever.

The goal of this Special Issue is to engage virology researchers in Norway working on viruses infecting humans, animals, fish, arthropods, plants, or bacteriophages to display their state-of-the-art virology research as original research articles or short communications, but reviews are also welcome. We hope to be able to cover many different aspects including, but not limited to, the below-mentioned topics. If more than 10 papers are accepted, this can be published as a reprinted Special Issue book.

Prof. Dr. Christine Hanssen Rinaldo
Prof. Dr. Morten Tryland
Guest Editors

Manuscript Submission Information

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Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Viruses is an international peer-reviewed open access monthly journal published by MDPI.

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Keywords

  • epidemiology
  • pathogenesis
  • diagnostics
  • immunity
  • (immuno)pathology
  • molecular aspects
  • omics and metabolomics aspects
  • virus evolution
  • virus-host interactions
  • prophylaxis and prevention
  • antiviral treatment
  • next generation sequencing
  • zoonotic viruses
  • emerging viruses
  • indigenous viruses

Published Papers (11 papers)

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Editorial

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5 pages, 207 KiB  
Editorial
State-of-the-Art Virology Research in Norway
by Christine Hanssen Rinaldo and Morten Tryland
Viruses 2023, 15(12), 2383; https://doi.org/10.3390/v15122383 - 5 Dec 2023
Viewed by 938
Abstract
Norway is situated in a remote and sparsely inhabited part of the world with about 5 [...] Full article
(This article belongs to the Special Issue State-of-the-Art Virology in Norway)

Research

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13 pages, 2607 KiB  
Article
Bovine Enteroids as an In Vitro Model for Infection with Bovine Coronavirus
by Ruchika Shakya, Alejandro Jiménez-Meléndez, Lucy J. Robertson and Mette Myrmel
Viruses 2023, 15(3), 635; https://doi.org/10.3390/v15030635 - 27 Feb 2023
Cited by 5 | Viewed by 1879
Abstract
Bovine coronavirus (BCoV) is one of the major viral pathogens of cattle, responsible for economic losses and causing a substantial impact on animal welfare. Several in vitro 2D models have been used to investigate BCoV infection and its pathogenesis. However, 3D enteroids are [...] Read more.
Bovine coronavirus (BCoV) is one of the major viral pathogens of cattle, responsible for economic losses and causing a substantial impact on animal welfare. Several in vitro 2D models have been used to investigate BCoV infection and its pathogenesis. However, 3D enteroids are likely to be a better model with which to investigate host–pathogen interactions. This study established bovine enteroids as an in vitro replication system for BCoV, and we compared the expression of selected genes during the BCoV infection of the enteroids with the expression previously described in HCT-8 cells. The enteroids were successfully established from bovine ileum and permissive to BCoV, as shown by a seven-fold increase in viral RNA after 72 h. Immunostaining of differentiation markers showed a mixed population of differentiated cells. Gene expression ratios at 72 h showed that pro-inflammatory responses such as IL-8 and IL-1A remained unchanged in response to BCoV infection. Expression of other immune genes, including CXCL-3, MMP13, and TNF-α, was significantly downregulated. This study shows that the bovine enteroids had a differentiated cell population and were permissive to BCoV. Further studies are necessary for a comparative analysis to determine whether enteroids are suitable in vitro models to study host responses during BCoV infection. Full article
(This article belongs to the Special Issue State-of-the-Art Virology in Norway)
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14 pages, 2033 KiB  
Article
Dynamics of SARS-CoV-2 Spike-IgG throughout Three COVID-19 Vaccination Regimens: A 21-Month Longitudinal Study of 82 Norwegian Healthcare Workers
by Marita Helen Augustinussen, Garth D. Tylden and Christine Hanssen Rinaldo
Viruses 2023, 15(3), 619; https://doi.org/10.3390/v15030619 - 23 Feb 2023
Cited by 1 | Viewed by 1532
Abstract
To facilitate interpretation of clinical SARS-CoV-2 anti-spike IgG analyses post-vaccination, 82 healthcare workers were followed through three vaccination-regimens: two regimens were comprised of two doses of BNT162b2 three or six weeks apart, followed by a dose of mRNA-vaccine, and in the other regimen, [...] Read more.
To facilitate interpretation of clinical SARS-CoV-2 anti-spike IgG analyses post-vaccination, 82 healthcare workers were followed through three vaccination-regimens: two regimens were comprised of two doses of BNT162b2 three or six weeks apart, followed by a dose of mRNA-vaccine, and in the other regimen, the first dose was replaced by ChAdOx1 nCov-19. After each dose, anti-spike IgG was compared between regimens. As many participants became infected, anti-spike IgG persistence was compared between infected and uninfected participants. Thirteen to twenty-one days after the first dose, seroconversion, and the median anti-spike IgG level in the ChAdOx1 group was significantly lower than in the BNT162b2 groups (23 versus 68 and 73 AU/mL). The second dose caused a significant increase in anti-spike IgG, but the median level was lower in the BNT162b2-short-interval group (280 AU/mL), compared to the BNT162b2-long-interval (1075 AU/mL) and ChAdOx1 (1160 AU/mL) group. After the third dose, all groups showed increases to similar anti-spike IgG levels (2075–2390 AU/mL). Over the next half year, anti-spike IgG levels declined significantly in all groups, but appeared to persist longer after post-vaccination infection. This is the first three-dose study with one dose of ChAdOx1. Despite initial differences, all vaccine regimens gave similarly high antibody levels and persistence after the third dose. Full article
(This article belongs to the Special Issue State-of-the-Art Virology in Norway)
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15 pages, 1434 KiB  
Article
A Screening for Virus Infections among Wild Eurasian Tundra Reindeer (Rangifer tarandus tarandus) in Iceland, 2017–2019
by Morten Tryland, Javier Sánchez Romano, Ingebjørg Helena Nymo, Torill Mørk, Rán Þórarinsdóttir, Eva Marie Breines, Hong Li, Cristina Wetzel Cunha and Skarphéðinn G. Thórisson
Viruses 2023, 15(2), 317; https://doi.org/10.3390/v15020317 - 23 Jan 2023
Viewed by 1953
Abstract
A winter population of around 4000–5000 wild Eurasian tundra reindeer (Rangifer t. tarandus) in the eastern part of Iceland represents descendants from 35 semi-domesticated reindeer imported to Iceland from Finnmark county, Norway, in 1787. While previous studies have indicated that they [...] Read more.
A winter population of around 4000–5000 wild Eurasian tundra reindeer (Rangifer t. tarandus) in the eastern part of Iceland represents descendants from 35 semi-domesticated reindeer imported to Iceland from Finnmark county, Norway, in 1787. While previous studies have indicated that they host fewer parasite species as compared to reindeer in Fennoscandia, little information exists on their exposure to reindeer viral pathogens. The aim of this study was to investigate blood from hunted reindeer for antibodies against alphaherpesvirus and gammaherpesviruses (malignant catarrhal fever viruses, MCFV), pestivirus, bluetongue virus, and Schmallenberg virus, and to investigate nasal and oral mucosal membrane swab samples for the presence of parapoxvirus-specific DNA. Blood samples collected during the hunting seasons in 2017 (n = 40), 2018 (n = 103), and 2019 (n = 138) were tested for viral antibodies using enzyme-linked immunosorbent assays (ELISA). Screening for parapoxvirus DNA was conducted on swab samples from 181 reindeer by polymerase chain reaction (PCR), targeting the B2L and GIF genes. Antibodies against pestivirus were detected in two animals from 2017, and antibodies against MCFV were detected in two reindeer from 2018. No antibodies were detected against the other viruses tested. Parapoxvirus-specific DNA was detected in nasal swab samples from two animals sampled in 2019. This study suggests that the investigated viral infections are either not present or present at a low prevalence only, probably not representing a major health threat to this reindeer population. The lack of exposure to alphaherpesvirus, an enzootic pathogen in most investigated Rangifer populations, was unexpected. Full article
(This article belongs to the Special Issue State-of-the-Art Virology in Norway)
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11 pages, 1609 KiB  
Article
Viral Haemorrhagic Septicemia Virus (VHSV) Isolated from Atlantic Herring, Clupea harengus, Causes Mortality in Bath Challenge on Juvenile Herring
by Øivind Bergh, Torsten Snogdal Boutrup, Renate Johansen, Helle Frank Skall, Nina Sandlund and Niels Jørgen Olesen
Viruses 2023, 15(1), 152; https://doi.org/10.3390/v15010152 - 4 Jan 2023
Cited by 1 | Viewed by 1740
Abstract
Viral hemorrhagic septicaemia virus (VHSV) has been demonstrated to cause high mortalities in a wide range of teleosts, farmed as well as wild. In Europe, VHSV of genotypes Ib, Id, II, and III have been detected in wild fish, including Atlantic herring Clupea [...] Read more.
Viral hemorrhagic septicaemia virus (VHSV) has been demonstrated to cause high mortalities in a wide range of teleosts, farmed as well as wild. In Europe, VHSV of genotypes Ib, Id, II, and III have been detected in wild fish, including Atlantic herring Clupea harengus, but disease outbreaks have not been observed in Atlantic herring and the effects on wild stocks are not well documented. Here, we have tested two VHSV isolates from herring (genotypes Ib and III, from the western coasts of Norway and Denmark, respectively) in a challenge experiment with herring (mean weight 2.59 g, SD 0.71 g) caught on the west coast of Denmark. The Norwegian genotype Ib isolate (NO-F-CH/2009) showed an accumulated mortality of 47% compared to 6% mortality with the Danish genotype III isolate 4p168 and zero in the unchallenged control group. In both groups, we found positive rt-RT-PCR and positive immunohistochemistry of VHSV from days 6 and 8 onward. With both isolates, the organs mainly affected were the heart and kidney. The results demonstrate the susceptibility of Atlantic herring to VHSV, and both genotypes gave pathological findings in several organs. Genotype III showed a low mortality rate, and the importance of this genotype for herring is therefore not determined. Genotype Ib showed both high prevalence and mortality, and this genotype is therefore likely to have a negative effect on wild Atlantic herring stocks. Further examinations to determine how VHSV can affect wild Atlantic herring stocks are needed. Full article
(This article belongs to the Special Issue State-of-the-Art Virology in Norway)
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11 pages, 2269 KiB  
Article
Molecular Epidemiology of the Norwegian SARS-CoV-2 Delta Lineage AY.63
by Line Victoria Moen, Hilde Synnøve Vollan, Jon Bråte, Olav Hungnes and Karoline Bragstad
Viruses 2022, 14(12), 2734; https://doi.org/10.3390/v14122734 - 7 Dec 2022
Cited by 1 | Viewed by 1391
Abstract
Extensive genomic surveillance has given great insights into the evolution of the SARS-CoV-2 virus and emerging variants. During the summer months of 2021, Norway was dominated by the Pango lineage AY.63 which is a sub-lineage of the highly transmissible Delta variant. Strikingly, AY.63 [...] Read more.
Extensive genomic surveillance has given great insights into the evolution of the SARS-CoV-2 virus and emerging variants. During the summer months of 2021, Norway was dominated by the Pango lineage AY.63 which is a sub-lineage of the highly transmissible Delta variant. Strikingly, AY.63 did not spread in other countries to any significant extent. AY.63 carried a key mutation, A222V, in the spike protein, as well as the deletion of three residues in nsp1. Although these mutations are close to functionally important areas, we did not find any evidence that they induced higher fitness compared to other Delta lineages. This variant was introduced to Norway at a time when there were low levels of SARS-CoV-2 and contact-reducing measures were relaxed, which probably explains why the lineage rose so quickly. Furthermore, we found that the lack of imports of AY.63 from other countries probably led to the eventual demise of the lineage in Norway. Full article
(This article belongs to the Special Issue State-of-the-Art Virology in Norway)
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8 pages, 743 KiB  
Article
SARS CoV-2 Infection among Health Care Workers from Different Health Care Facilities in Western Norway: A Prospective, Cross-Sectional Study
by Bård Reiakvam Kittang, Bjørn Blomberg, Marianne Sævik, Jan Stefan Olofsson, Bergen COVID-19 Research Group, Nina Langeland and Rebecca Jane Cox
Viruses 2022, 14(12), 2652; https://doi.org/10.3390/v14122652 - 28 Nov 2022
Viewed by 1545
Abstract
Background: Comparative data on COVID-19 among health care workers (HCWs) in different health care settings are scarce. This study investigated the rates of previous COVID-19 among HCWs in nursing homes, hospitals and a municipal emergency room (ER). Methods: We prospectively included 747 HCWs: [...] Read more.
Background: Comparative data on COVID-19 among health care workers (HCWs) in different health care settings are scarce. This study investigated the rates of previous COVID-19 among HCWs in nursing homes, hospitals and a municipal emergency room (ER). Methods: We prospectively included 747 HCWs: 313 from nursing homes, 394 from hospitals and 40 from the ER. The diagnosis of COVID-19 was based on serological evidence of SARS-CoV-2 antibody positivity and self-reported RT-PCR positivity prior to inclusion. Information regarding age, sex and exposure to SARS-CoV-2 infection was collected. Results: A total of 4% (11/313) of nursing home HCWs and 6% (28/434) of HCWs in hospitals/the ER tested positive by serology and/or RT-PCR (p = 0.095). Fewer HCWs in nursing homes had occupational exposure to SARS-CoV-2 compared to those in hospitals/the ER (16% vs. 48%, p < 0, 001), but nursing homes had a higher proportion of HCWs with occupational exposure using partial/no PPE (56% vs. 19%, p < 0.001). Nevertheless, no significant differences in the risk for COVID-19 were found in relation to the rate of occupational exposure (p = 0.755) or use of inadequate PPE (p = 0.631). Conclusions: Despite a small sample size, the risk for COVID-19 among HCWs did not appear to be related to the type of health care facility, rates of occupational exposure or use of PPE. Full article
(This article belongs to the Special Issue State-of-the-Art Virology in Norway)
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11 pages, 2029 KiB  
Article
Stability and Feasibility of Dried Blood Spots for Hepatitis E Virus Serology in a Rural Setting
by Joakim Øverbø, Asma Aziz, K. Zaman, Cathinka Halle Julin, Firdausi Qadri, Kathrine Stene-Johansen, Rajib Biswas, Shaumik Islam, Taufiqur Rahman Bhuiyan, Warda Haque, Synne Sandbu, Jennifer L Dembinski and Susanne Dudman
Viruses 2022, 14(11), 2525; https://doi.org/10.3390/v14112525 - 15 Nov 2022
Cited by 2 | Viewed by 1935
Abstract
Hepatitis E virus (HEV) is the most common cause of acute viral hepatitis worldwide. In many low-income countries it causes large outbreaks and disproportionally affects pregnant women and their offspring. Surveillance studies to find effective preventive interventions are needed but are hampered by [...] Read more.
Hepatitis E virus (HEV) is the most common cause of acute viral hepatitis worldwide. In many low-income countries it causes large outbreaks and disproportionally affects pregnant women and their offspring. Surveillance studies to find effective preventive interventions are needed but are hampered by the lack of funding and infrastructure. Dried blood spots (DBS) offer an easier and more robust way to collect, transport, and store blood samples compared to plasma/serum samples, and could ease some of the barriers for such studies. In this study we optimize an HEV IgG ELISA for DBS samples and validate it on 300 paired DBS and plasma samples collected in rural areas of Bangladesh from participants in a HEV vaccine study. We demonstrate that HEV IgG in blood stored as DBS is stable for two months at up to 40 °C, and for five freeze-thaw cycles. The specificity was 97% and the overall sensitivity of the DBS assay was 81%. The sensitivity was higher in samples from vaccinated participants (100%) compared to previously infected participants (59%), reflecting a positive correlation between IgG titer and sensitivity. We found a strong correlation between DBS and plasma samples with an r2 of 0.90, but with a higher degree of difference between individual paired samples. Our study shows that DBS offers a stable alternative to plasma/serum for HEV IgG measurements and can facilitate serological studies, particularly in resource limited areas. Full article
(This article belongs to the Special Issue State-of-the-Art Virology in Norway)
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11 pages, 407 KiB  
Article
The Performances of Three Commercially Available Assays for the Detection of SARS-CoV-2 Antibodies at Different Time Points Following SARS-CoV-2 Infection
by Heidi Syre, Marius Eduardo Brå Obreque, Ingvild Dalen, Åse Garløv Riis, Åse Berg, Iren Høyland Löhr, Jon Sundal, Lars Kåre Kleppe, May Sissel Vadla, Ole Bernt Lenning, Jan Stefan Olofsson, Kristin Greve-Isdahl Mohn, Camilla Tøndel, Bjørn Blomberg, Mai Chi Trieu, Nina Langeland and Rebecca Jane Cox
Viruses 2022, 14(10), 2196; https://doi.org/10.3390/v14102196 - 5 Oct 2022
Cited by 1 | Viewed by 1444
Abstract
The aim of this study was to evaluate the performances of three commercially available antibody assays for the detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibodies at different time points following SARS-CoV-2 infection. Sera from 536 cases, including 207 SARS-CoV-2 PCR [...] Read more.
The aim of this study was to evaluate the performances of three commercially available antibody assays for the detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibodies at different time points following SARS-CoV-2 infection. Sera from 536 cases, including 207 SARS-CoV-2 PCR positive, were tested for SARS-CoV-2 antibodies with the Wantai receptor binding domain (RBD) total antibody assay, Liaison S1/S2 IgG assay and Alinity i nucleocapsid IgG assay and compared to a two-step reference ELISA (SARS-CoV-2 RBD IgG and SARS-CoV-2 spike IgG). Diagnostic sensitivity, specificity, predictive values and Cohen’s kappa were calculated for the commercial assays. The assay’s sensitivities varied greatly, from 68.7% to 95.3%, but the specificities remained high (96.9–99.1%). The three tests showed good performances in sera sampled 31 to 60 days after PCR positivity compared to the reference ELISA. The total antibody test performed better than the IgG tests the first 30 days and the nucleocapsid IgG test showed reduced sensitivity two months or more after PCR positivity. Hence, the test performances at different time points should be taken into consideration in clinical practice and epidemiological studies. Spike or RBD IgG tests are preferable in sera sampled more than two months following SARS-CoV-2 infection. Full article
(This article belongs to the Special Issue State-of-the-Art Virology in Norway)
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Other

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6 pages, 701 KiB  
Brief Report
Omicron Variant Generates a Higher and More Sustained Viral Load in Nasopharynx and Saliva Than the Delta Variant of SARS-CoV-2
by Beathe K. Granerud, Thor Ueland, Andreas Lind, Arne Søraas, Børre Fevang, Anne Katrine Steffensen, Huda Al-Baldawi, Fridtjof Lund-Johansen, Pål Aukrust, Bente Halvorsen, Tuva B. Dahl, Susanne Dudman, Fredrik Müller and Jan Cato Holter
Viruses 2022, 14(11), 2420; https://doi.org/10.3390/v14112420 - 31 Oct 2022
Cited by 5 | Viewed by 1850
Abstract
The Omicron variant of SARS-CoV-2 spreads more easily than earlier variants, possibly as a result of a higher viral load in the upper respiratory tract and oral cavity. Hence, we investigated whether the Omicron variant generates a higher viral load than that of [...] Read more.
The Omicron variant of SARS-CoV-2 spreads more easily than earlier variants, possibly as a result of a higher viral load in the upper respiratory tract and oral cavity. Hence, we investigated whether the Omicron variant generates a higher viral load than that of the Delta variant in saliva and nasopharynx. Both specimens were collected from 52 Omicron and 17 Delta cases at two time points one week apart and analyzed by qRT-PCR. Viral load was measured as 10 log RNA genome copies per 1000 human cells according to the WHO reference standard. We found that Omicron cases carried a higher viral load and had more sustained viral shedding compared to the Delta cases, especially in the nasopharynx. Full article
(This article belongs to the Special Issue State-of-the-Art Virology in Norway)
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10 pages, 930 KiB  
Case Report
Persistent Fever and Positive PCR 90 Days Post-SARS-CoV-2 Infection in a Rituximab-Treated Patient: A Case of Late Antiviral Treatment
by Nina Urke Ertesvåg, Sunniva Todnem Sakkestad, Fan Zhou, Ingrid Hoff, Trygve Kristiansen, Trygve Müller Jonassen, Elisabeth Follesø, Karl Albert Brokstad, Ruben Dyrhovden and Kristin G.-I. Mohn
Viruses 2022, 14(8), 1757; https://doi.org/10.3390/v14081757 - 11 Aug 2022
Cited by 9 | Viewed by 2160
Abstract
Background: Persistent fever after SARS-CoV-2 infection in rituximab-treated patients has been reported. Due to reduced sensitivity in conventional sampling methods and unspecific symptoms in these patients, distinguishing between low-grade viral replication or hyperinflammation is challenging. Antiviral treatment is recommended as prophylactic or early [...] Read more.
Background: Persistent fever after SARS-CoV-2 infection in rituximab-treated patients has been reported. Due to reduced sensitivity in conventional sampling methods and unspecific symptoms in these patients, distinguishing between low-grade viral replication or hyperinflammation is challenging. Antiviral treatment is recommended as prophylactic or early treatment in the at-risk population; however, no defined treatment approaches for protracted SARS-CoV-2 infection exist. Results: We present a case of 96 days of persistent fever and SARS-CoV-2 infection in a patient receiving B cell depletion therapy for multiple sclerosis. Migratory lung infiltrates and positive PCR tests from serum (day-58 post infection) and lower airways (day-90 post infection) confirmed continuous viral replication. The dominant symptoms were continuous high fever, dyspnea and mild to moderate hypoxemia, which never developed into severe respiratory failure. The patient was hospitalized three times, with transient improvement after late antiviral treatment and full recovery 6 months post-rituximab infusion. Conclusions: A strategy for securing samples from lower airways and serum should be a prioritization to strengthen diagnostic certainty in immunocompromised patients. B-cell-deprived patients could benefit from late treatment with SARS-CoV-2-specific monoclonal antibodies and antivirals. Importantly, increased intervals between immunosuppressive therapy should be considered where feasible. Full article
(This article belongs to the Special Issue State-of-the-Art Virology in Norway)
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