Case report: Persistent COVID-19 in a patient with B cell lymphoma refractory to antiviral treatment due to resistance to Remdesivir

Case report: Persistent COVID-19 in a patient with B cell lymphoma refractory to antiviral treatment due to resistance to Remdesivir

Background: There is a significant concern of the pandemic impact of SARS-CoV-2 infection in immunocompromised patients. These patients can develop long COVID-19 due to impairment of cellular and humoral immunity. On the other hand, prolonged infection can lead to mutations in the SARS CoV-2 genome...

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Main Authors: Luiz Eduardo Ceccon Calil de Assumpção, Bruno Graciano Ponce Romeo, João Carlos de Campos Guerra, Luis Fernando Aranha Camargo, Marcelo Akira Nagaoka, Deyvid Emanuel Amgarten, Erick Gustavo Dorlass, Roberta Cardoso Petroni, Afonso Celso Almeida Cardoso, Renato de Mello Ruiz, Carolina Devite Bittante, Vanessa Damazio Teich, João Renato Rebello Pinho, André Mario Doi
Format: Article
Language:English
Published: Elsevier 2025-01-01
Series:IDCases
Subjects:
COVID
Mutation
Resistance
SARS-CoV-2
Remdesivir
Antiviral
Online Access:http://www.sciencedirect.com/science/article/pii/S221425092500054X
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Summary:Background: There is a significant concern of the pandemic impact of SARS-CoV-2 infection in immunocompromised patients. These patients can develop long COVID-19 due to impairment of cellular and humoral immunity. On the other hand, prolonged infection can lead to mutations in the SARS CoV-2 genome that can impact on the resistance to antiviral therapy. Remdesivir cases have been reported in patients receiving antiviral drug treatment. Case presentation: A 46-year-old male with previous mantle cell lymphoma resolved by autologous bone marrow transplantation without other comorbidities had SARS-CoV-2 detected in February 2022 and received the recommended antiviral treatment with Remdesivir. COVID-19 evolved in four months with worsening of the symptoms, despite an initial rapid improvements and high RT-PCR Ct values. The patient was relieved from hospital care stable and well but still maintaining positive test results. Conclusions: the patient presented prolonged COVID-19 with persistence of virus detected by RT-PCR for several months. The strain sequenced presented a mutation different from all reported previously. Although it was no possible to sequence the initial strain without these mutations, our data suggests that immunocompromised patient with prolonged COVID-19 may serve as reservoir for strains of SARS-CoV-2 with resistant components in his genome.
ISSN:2214-2509

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