Antiviral combination regimens as rescue therapy in immunocompromised hosts with persistent COVID-19.

IF 1.9 4区医学 Q3 INFECTIOUS DISEASES

Journal of Chemotherapy Pub Date : 2025-04-01 Epub Date: 2024-06-14 DOI:10.1080/1120009X.2024.2367935

Roberta Maria Antonello, Davide Marangoni, Filippo Ducci, Anna Barbiero, Tommaso Manciulli, Lucia Graziani, Nicoletta Di Lauria, Lorenzo Menicacci, Lorenzo Paci, Benedetta Sordi, Lorenzo Zammarchi, Alessandro Morettini, Sara Tomassetti, Gian Maria Rossolini, Alessandro Bartoloni, Michele Spinicci

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引用次数: 0

Abstract

The management of severe/prolonged SARS-CoV-2 infections in immunocompromised hosts is still challenging. We describe nine patients with hematologic malignancies with a history of unsuccessful SARS-CoV-2 treatment receiving antiviral combination treatment for persistent infection at a tertiary hospital in central Italy (University Hospital of Careggi, Florence). Combination treatments consisted of nirmatrelvir/ritonavir plus molnupiravir (n = 4), nirmatrelvir/ritonavir plus remdesivir (n = 4) or remdesivir plus molnupiravir (n = 1) for 10 days, in some cases associated with sotrovimab. Combinations were generally well tolerated. One patient obtained viral clearance but died due to the underlying disease. In eight cases, clinical and virological success was confirmed by radiological follow-up. Antivirals combination is likely to become a mainstay in the future management of COVID-19 among immunocompromised patients, but knowledge in this field is still very limited and prospective studies on larger cohorts are urgently warranted.

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将抗病毒联合疗法作为对持续感染 COVID-19 的免疫功能低下宿主的拯救疗法。

对免疫功能低下的宿主进行严重/长期的 SARS-CoV-2 感染治疗仍然具有挑战性。我们描述了在意大利中部一家三甲医院（佛罗伦萨卡雷吉大学医院）接受抗病毒联合治疗的九名血液系统恶性肿瘤患者的情况，这些患者曾接受过不成功的 SARS-CoV-2 治疗，但感染持续存在。联合治疗包括尼尔马特雷韦/利托那韦加莫仑吡韦（4 例）、尼尔马特雷韦/利托那韦加雷米替韦（4 例）或雷米替韦加莫仑吡韦（1 例），疗程为 10 天，部分病例同时使用索托维单抗。联合用药的耐受性普遍良好。一名患者病毒清除，但因潜在疾病而死亡。8例患者的临床和病毒学治疗成功通过放射学随访得到证实。抗病毒药物联合治疗很可能成为未来治疗免疫功能低下患者COVID-19的主要方法，但这一领域的知识仍然非常有限，迫切需要对更大的群体进行前瞻性研究。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Chemotherapy 医学-药学

CiteScore

3.70

自引率

0.00%

发文量

144

审稿时长

6-12 weeks

期刊介绍： The Journal of Chemotherapy is an international multidisciplinary journal committed to the rapid publication of high quality, peer-reviewed, original research on all aspects of antimicrobial and antitumor chemotherapy. The Journal publishes original experimental and clinical research articles, state-of-the-art reviews, brief communications and letters on all aspects of chemotherapy, providing coverage of the pathogenesis, diagnosis, treatment, and control of infection, as well as the use of anticancer and immunomodulating drugs. Specific areas of focus include, but are not limited to: · Antibacterial, antiviral, antifungal, antiparasitic, and antiprotozoal agents; · Anticancer classical and targeted chemotherapeutic agents, biological agents, hormonal drugs, immunomodulatory drugs, cell therapy and gene therapy; · Pharmacokinetic and pharmacodynamic properties of antimicrobial and anticancer agents; · The efficacy, safety and toxicology profiles of antimicrobial and anticancer drugs; · Drug interactions in single or combined applications; · Drug resistance to antimicrobial and anticancer drugs; · Research and development of novel antimicrobial and anticancer drugs, including preclinical, translational and clinical research; · Biomarkers of sensitivity and/or resistance for antimicrobial and anticancer drugs; · Pharmacogenetics and pharmacogenomics; · Precision medicine in infectious disease therapy and in cancer therapy; · Pharmacoeconomics of antimicrobial and anticancer therapies and the implications to patients, health services, and the pharmaceutical industry.