Successful treatment of prolonged COVID-19 with remdesivir and nirmatrelvir/ritonavir in a patient with a history of diffuse large B-cell lymphoma: a case report.

IF 1.8 Q3 ONCOLOGY

Journal of the Egyptian National Cancer Institute Pub Date : 2025-06-30 DOI:10.1186/s43046-025-00291-1

Nadia Bouhamdani, Dominique Bouhamdani, Cynthia Léger, Josiane Stadler, Nancy Saulnier

{"title":"Successful treatment of prolonged COVID-19 with remdesivir and nirmatrelvir/ritonavir in a patient with a history of diffuse large B-cell lymphoma: a case report.","authors":"Nadia Bouhamdani, Dominique Bouhamdani, Cynthia Léger, Josiane Stadler, Nancy Saulnier","doi":"10.1186/s43046-025-00291-1","DOIUrl":null,"url":null,"abstract":"Background: Immunocompromised individuals, such as those affected by and treated for hematological malignancies, face a higher risk of prolonged SARS-CoV-2 infection. Increased disease risk is further compounded by limited treatment options. Currently, approved antiviral monotherapies against COVID-19 include remdesivir (Veklury) and nirmatrelvir/ritonavir (Paxlovid) which have stringent recommended prescribing windows within 7 and 5 days of symptom onset, respectively. Furthermore, these two antiviral therapies are approved for treatment lengths of 3 (remdesivir) and 5 days (Paxlovid).Case presentation: Herein, we describe the successful treatment of prolonged COVID-19 in a patient with a history of diffuse large B-cell lymphoma with an extended combination therapy; remdesivir and nirmatrelvir/ritonavir. The patient presented with symptomatic COVID-19 that was unsuccessfully treated with a 10-day course of remdesivir. After 2 months of symptomatic infection, the patient was treated with remdesivir in combination with nirmatrelvir/ritonavir for 10 days, which quickly resolved the cough and cleared viral load.Conclusion: Our case highlights the efficacy of administrating a combination treatment of remdesivir and nirmatrelvir/ritonavir outside recommended guidelines for the treatment of persistent COVID-19 infection in an immunocompromised individual. High-quality studies evaluating the usefulness of this combinatory therapy as a longer-course treatment in patients with neoplasms is warranted.","PeriodicalId":17301,"journal":{"name":"Journal of the Egyptian National Cancer Institute","volume":"37 1","pages":"32"},"PeriodicalIF":1.8000,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of the Egyptian National Cancer Institute","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1186/s43046-025-00291-1","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"ONCOLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Background: Immunocompromised individuals, such as those affected by and treated for hematological malignancies, face a higher risk of prolonged SARS-CoV-2 infection. Increased disease risk is further compounded by limited treatment options. Currently, approved antiviral monotherapies against COVID-19 include remdesivir (Veklury) and nirmatrelvir/ritonavir (Paxlovid) which have stringent recommended prescribing windows within 7 and 5 days of symptom onset, respectively. Furthermore, these two antiviral therapies are approved for treatment lengths of 3 (remdesivir) and 5 days (Paxlovid).

Case presentation: Herein, we describe the successful treatment of prolonged COVID-19 in a patient with a history of diffuse large B-cell lymphoma with an extended combination therapy; remdesivir and nirmatrelvir/ritonavir. The patient presented with symptomatic COVID-19 that was unsuccessfully treated with a 10-day course of remdesivir. After 2 months of symptomatic infection, the patient was treated with remdesivir in combination with nirmatrelvir/ritonavir for 10 days, which quickly resolved the cough and cleared viral load.

Conclusion: Our case highlights the efficacy of administrating a combination treatment of remdesivir and nirmatrelvir/ritonavir outside recommended guidelines for the treatment of persistent COVID-19 infection in an immunocompromised individual. High-quality studies evaluating the usefulness of this combinatory therapy as a longer-course treatment in patients with neoplasms is warranted.

查看原文本刊更多论文

瑞德西韦联合尼马特利韦/利托那韦成功治疗弥漫性大b细胞淋巴瘤患者1例

背景：免疫功能低下的个体，如血液学恶性肿瘤患者和接受过治疗的患者，长期感染SARS-CoV-2的风险更高。有限的治疗选择进一步加剧了疾病风险的增加。目前，已批准的针对COVID-19的抗病毒单一疗法包括remdesivir （Veklury）和nirmatrelvir/ritonavir (Paxlovid)，它们分别在症状出现后7天和5天内具有严格的推荐处方窗口。此外，这两种抗病毒疗法被批准的治疗时间为3天（remdesivir）和5天（Paxlovid）。病例介绍：在此，我们描述了一名有弥漫性大b细胞淋巴瘤病史的患者通过延长联合治疗成功治疗延长的COVID-19；Remdesivir和nirmatrelvir/ritonavir。该患者出现症状性COVID-19，经10天疗程的瑞德西韦治疗无效。症状性感染2个月后，患者采用瑞德西韦联合尼马特利韦/利托那韦治疗10天，咳嗽迅速消失，病毒载量清除。结论：本病例强调了在免疫功能低下个体治疗持续性COVID-19感染的推荐指南之外，联合使用瑞德西韦和尼马特利韦/利托那韦的疗效。有必要进行高质量的研究，评估这种联合疗法作为肿瘤患者长期治疗的有效性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Journal of the Egyptian National Cancer Institute ONCOLOGY-

CiteScore

3.50

自引率

0.00%

发文量

审稿时长

11 weeks

期刊介绍： As the official publication of the National Cancer Institute, Cairo University, the Journal of the Egyptian National Cancer Institute (JENCI) is an open access peer-reviewed journal that publishes on the latest innovations in oncology and thereby, providing academics and clinicians a leading research platform. JENCI welcomes submissions pertaining to all fields of basic, applied and clinical cancer research. Main topics of interest include: local and systemic anticancer therapy (with specific interest on applied cancer research from developing countries); experimental oncology; early cancer detection; randomized trials (including negatives ones); and key emerging fields of personalized medicine, such as molecular pathology, bioinformatics, and biotechnologies.