Severe acute respiratory syndrome coronavirus-2 Alpha variant (B.1.1.7), original wild-type severe acute respiratory syndrome coronavirus 2, and cytomegalovirus co-infection in a young adult with acute lymphoblastic leukemia, case report, and review of the possible cytomegalovirus reactivation mechanisms

Amanati, Ali; Shahriari, Mahdi; Bordbar, Mohammad Reza; Hedayati, Seyyed Bozorgmehr; Ziyaeyan, Mazyar; Jamalidoust, Marzieh; Kalani, Mehdi; Heydari Marandi, Nahid

doi:10.1186/s13256-022-03750-8

Journal of Medical Case Reports

Table 2 Virological characteristics of different clinical samples obtained from a young adult patient with acute lymphoblastic leukemia (ALL) during his inpatient and outpatient monitoring

From: Severe acute respiratory syndrome coronavirus-2 Alpha variant (B.1.1.7), original wild-type severe acute respiratory syndrome coronavirus 2, and cytomegalovirus co-infection in a young adult with acute lymphoblastic leukemia, case report, and review of the possible cytomegalovirus reactivation mechanisms

Date	Sample type	Test	Result	Cycle threshold	Variant
19 December 2020	Nasopharyngeal	SARS-CoV-2	Positive	31	Alpha variant (B.1.1.7)*
28 December 2020	Stool	CMV	Positive	25
28 December 2020	Blood	CMV	Positive	29
30 December 2020	Urine	CMV	Negative	─
30 December 2020	CSF	CMV	Negative	─
3 January 2021	Stool	CMV	Positive	31.5
3 January 2021	Blood	CMV	Positive	29
4 January 2021	Stool	SARS-CoV-2	Positive	34
19 January 2021	Stool	SARS-CoV-2	Negative	─
19 January 2021	Stool	CMV	Negative	─
20 January 2021	Blood	CMV	Positive	35
13 February 2021	Blood	CMV	Positive	36
14 February 2021	Stool	CMV	Negative	─
14 February 2021	Stool	SARS-CoV-2	Negative	─
15 February 2021	Blood	CMV	Negative	─
16 February 2021	Stool	CMV	Negative	─
17 March 2021	Nasopharyngeal	SARS-CoV-2	Positive	29	Alpha variant (B.1.1.7)
24 March 2021	Blood	CMV	Negative	─
24 March 2021	Stool	CMV	Positive	32
24 March 2021	Stool	SARS-CoV-2	Positive	33
24 March 2021	Nasopharyngeal	SARS-CoV-2	Positive	21	Alpha variant (B.1.1.7)
10 April 2021	Nasopharyngeal	SARS-CoV-2	Positive	28	Wuhan strain
10 April 2021	Blood	CMV	Positive	34
11 April 2021	Stool	CMV	Positive	35
11 April 2021	Stool	SARS-CoV-2	Negative	─
21 April 2021	Ileum (1)	CMV	Positive	30
21 April 2021	Ileum (1)	SARS-CoV-2	Positive	28	Wuhan strain
21 April 2021	Right colon (2)	CMV	Positive	25
21 April 2021	Right colon (2)	SARS-CoV-2	Positive	28	Alpha variant (B.1.1.7)
21 April 2021	Rectum (3)	CMV	Positive	29
21 April 2021	Rectum (3)	SARS-CoV-2	Positive	42	Alpha variant (B.1.1.7)
10 May 2021	Blood	CMV	Negative	─
10 May 2021	Stool	CMV	Positive	35
10 May 2021	Stool	SARS-CoV-2	Negative	─
12 May 2021	Nasopharyngeal	SARS-CoV-2	Negative	─
27 July 2021	Nasopharyngeal	SARS-CoV-2	Positive	29	Delta variant?**
27 July 2021	Blood	CMV	Positive	31
27 July 2021	Stool	CMV	Positive	31.6

CMV, cytomegalovirus; *UK variant: SARS-CoV-2 B.1.1.7 variant; **The last nasopharyngeal SARS-CoV-2 RT-PCR was done during Delta-variant outbreak in Shiraz, while more than 80% of our cases related to Delta variant. Unfortunately, the patient died, and the variant investigation was not performed for the last specimen

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ISSN: 1752-1947

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