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The study looked at a cohort of 27 patients with chronic SARS-CoV-2 infection. The researchers examined the accumulation of viral mutations for each patient and summarized their medical backgrounds, with emphasis on immunosuppressive and COVID-19 treatments. 

The study identified both links and discrepancies between SARS-CoV-2 evolution in chronic infection and variant of concerns, and our findings highlight the importance of constantly monitoring chronic SARS-CoV-2 infection in immunosuppressed patients. Indeed, a negative PCR result might not indicate clearance of the virus, and a viral rebound might suggest that a more ‘fit’ virus has emerged and that constant monitoring of the patient is required. Furthermore, genomic analysis of chronic infection is one key route to understanding how VOCs emerge. As immunosuppressed patients are at high risk for COVID-19 complications and might serve as a background for the virus to thrive and evolve, these people should be protected from SARS-CoV-2 infection.