{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,13]],"date-time":"2025-11-13T12:42:58Z","timestamp":1763037778016,"version":"build-2065373602"},"reference-count":48,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2022,4,29]],"date-time":"2022-04-29T00:00:00Z","timestamp":1651190400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Tong Tsung and Wei Fong Chao Foundation","award":["GT007457","GT007457"],"award-info":[{"award-number":["GT007457","GT007457"]}]},{"name":"Chau Hoi Sheun Foundation","award":["GT007457","GT007457"],"award-info":[{"award-number":["GT007457","GT007457"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Viruses"],"abstract":"<jats:p>Immunocompromised individuals are at risk of prolonged SARS-CoV-2 infection due to weaker immunity, co-morbidities, and lowered vaccine effectiveness, which may evolve highly mutated variants of SARS-CoV-2. Nonetheless, limited data are available on the immune responses elicited by SARS-CoV-2 infection, reinfections, and vaccinations with emerging variants in immunocompromised patients. We analyzed clinical samples that were opportunistically collected from eight immunocompromised individuals for mutations in SARS-CoV-2 genomes, neutralizing antibody (NAb) titers against different SARS-CoV-2 variants, and the identification of immunoreactive epitopes using a high-throughput coronavirus peptide array. The viral genome analysis revealed two SARS-CoV-2 variants (20A from a deceased patient and an Alpha variant from a recovered patient) with an eight amino-acid (aa) deletion within the N-terminal domain (NTD) of the surface glycoprotein. A higher NAb titer was present against the prototypic USA\/WA1\/2020 strain in vaccinated immunocompromised patients. NAb titer was absent against the Omicron variant and the cultured virus of the 20A variant with eight aa deletions in non-vaccinated patients. Our data suggest that fatal SARS-CoV-2 infections may occur in immunocompromised individuals even with high titers of NAb post-vaccination. Moreover, persistent SARS-CoV-2 infection may lead to the emergence of newer variants with additional mutations favoring the survival and fitness of the pathogen that include deletions in NAb binding sites in the SARS-CoV-2 surface glycoprotein.<\/jats:p>","DOI":"10.3390\/v14050934","type":"journal-article","created":{"date-parts":[[2022,5,4]],"date-time":"2022-05-04T08:21:25Z","timestamp":1651652485000},"page":"934","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["A Short Series of Case Reports of COVID-19 in Immunocompromised Patients"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1106-7342","authenticated-orcid":false,"given":"Mitali","family":"Mishra","sequence":"first","affiliation":[{"name":"Center for Infection and Immunity, Mailman School of Public Health, Columbia University, New York, NY 10032, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aleena","family":"Zahra","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Medicine, Stony Brook University, Stony Brook, NY 11794, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6901-5353","authenticated-orcid":false,"given":"Lokendra V.","family":"Chauhan","sequence":"additional","affiliation":[{"name":"Center for Infection and Immunity, Mailman School of Public Health, Columbia University, New York, NY 10032, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Riddhi","family":"Thakkar","sequence":"additional","affiliation":[{"name":"Center for Infection and Immunity, Mailman School of Public Health, Columbia University, New York, NY 10032, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James","family":"Ng","sequence":"additional","affiliation":[{"name":"Center for Infection and Immunity, Mailman School of Public Health, Columbia University, New York, NY 10032, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0235-4334","authenticated-orcid":false,"given":"Shreyas","family":"Joshi","sequence":"additional","affiliation":[{"name":"Center for Infection and Immunity, Mailman School of Public Health, Columbia University, New York, NY 10032, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8794-2441","authenticated-orcid":false,"given":"Eric D.","family":"Spitzer","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Medicine, Stony Brook University, Stony Brook, NY 11794, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luis A.","family":"Marcos","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Medicine, Stony Brook University, Stony Brook, NY 11794, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"W. Ian","family":"Lipkin","sequence":"additional","affiliation":[{"name":"Center for Infection and Immunity, Mailman School of Public Health, Columbia University, New York, NY 10032, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1177-9641","authenticated-orcid":false,"given":"Nischay","family":"Mishra","sequence":"additional","affiliation":[{"name":"Center for Infection and Immunity, Mailman School of Public Health, Columbia University, New York, NY 10032, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,4,29]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"340","DOI":"10.1093\/cid\/ciaa863","article-title":"COVID-19 in Immunocompromised Hosts: What We Know So Far","volume":"72","author":"Fung","year":"2021","journal-title":"Clin. Infect. 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