Covid-19 mutated inside a woman 40 times

Russian scientists from the Skolkovo Institute of Science
and Technology and other scientific organizations have
published preliminary results of a study detailing a record-long
case of coronavirus infection. Patient C was a stage 4
non-Hodgkin B-cell lymphoma and tested positive for
coronavirus in April 2020. She had close contact with patient
A, who later died of pneumonia caused by COVID-19. The first
negative test was received almost a year later - in March 2021.
During this time, the woman suffered several serious symptoms,
including fever and pneumonia. From April 30, 2020 to February
16, 2021, Patient C underwent several chemotherapy sessions
with several different regimens, including rituximab based on
monoclonal antibodies. On December 28, 2020, transplantation
of autologous hematopoietic stem cells (auto-HSCT) was
performed. In January 2021, towards the end of the study period,
the patient received three doses of plasma from COVID-19
recovered patients. Researchers isolated the live virus from swab
samples obtained on August 20, 2020 and February 19, 2021.
Scientists followed the evolution of SARS-CoV-2 in the patient's
body using genome-wide sequencing and phylogenetic analysis,
which confirmed that all this time the woman suffered from one
and the same infection. Scientists have confirmed that the woman
did not transmit the virus to anyone else. During the year, the 
virus has undergone 40 mutations, which is much faster (15.3 to 10
minus the fourth power per year) than it happens in the population.
SARS-CoV-2 has adapted to the body of one person, improving
its ability to survive and reproduce faster. The accumulated
mutations were spread across the viral genome, affecting 18 of the
26 genes of the coronavirus.