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During hospitalisation, 7\u2009weeks after first diagnosis, his condition worsened to require continuous ventilation support. Resolution of symptoms was observed after convalescent plasma therapy. Whole genome sequencing of the virus showed Pango lineage B.1.221. Between the first sample and the second from bronchoalveolar lavage fluid 7\u2009weeks later, we identified eight mutations, including minor variants, which could be used to estimate the chronology of mutations. This suggests an elevated mutation rate, in-host accumulation of mutations and further evidence for sources of VoCs. Prolonged SARS-CoV-2 infections in immunocompromised hosts increase the likelihood of hospital stays and morbidity, and also pose an increased risk to global public health.<\/jats:p>","DOI":"10.1136\/bcr-2023-255255","type":"journal-article","created":{"date-parts":[[2023,12,9]],"date-time":"2023-12-09T18:10:36Z","timestamp":1702145436000},"page":"e255255","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":4,"title":["SARS-CoV-2 in an immunocompromised host: convalescent plasma therapy and viral evolution elucidated by whole genome sequencing"],"prefix":"10.1136","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6082-5114","authenticated-orcid":false,"given":"Helena","family":"Seth-Smith","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silvan","family":"Vesenbeckh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adrian","family":"Egli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sebastian","family":"Ott","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2023,12,9]]},"reference":[{"key":"2023123021454067000_16.12.e255255.1","doi-asserted-by":"crossref","first-page":"1403","DOI":"10.1038\/s41564-020-0770-5","article-title":"A dynamic nomenclature proposal for SARS-Cov-2 lineages to assist genomic epidemiology","volume":"5","author":"Rambaut","year":"2020","journal-title":"Nat Microbiol"},{"key":"2023123021454067000_16.12.e255255.2","doi-asserted-by":"crossref","first-page":"383","DOI":"10.1016\/j.ajic.2021.10.039","article-title":"Clinical characteristics and symptom duration among outpatients with COVID-19","volume":"50","author":"Lane","year":"2022","journal-title":"Am J Infect Control"},{"key":"2023123021454067000_16.12.e255255.3","doi-asserted-by":"crossref","unstructured":"Baek MS , Lee M-T , Kim W-Y , et al . 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