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
{"title":"病例报告：1例B细胞淋巴瘤患者因对瑞德西韦耐药而对抗病毒治疗难治性持续COVID-19","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","doi":"10.1016/j.idcr.2025.e02199","DOIUrl":null,"url":null,"abstract":"<div><h3><em>Background</em></h3><div>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.</div></div><div><h3>Case presentation</h3><div>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.</div></div><div><h3>Conclusions</h3><div>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.</div></div>","PeriodicalId":47045,"journal":{"name":"IDCases","volume":"40 ","pages":"Article e02199"},"PeriodicalIF":1.1000,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Case report: Persistent COVID-19 in a patient with B cell lymphoma refractory to antiviral treatment due to resistance to Remdesivir\",\"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\",\"doi\":\"10.1016/j.idcr.2025.e02199\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3><em>Background</em></h3><div>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.</div></div><div><h3>Case presentation</h3><div>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.</div></div><div><h3>Conclusions</h3><div>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.</div></div>\",\"PeriodicalId\":47045,\"journal\":{\"name\":\"IDCases\",\"volume\":\"40 \",\"pages\":\"Article e02199\"},\"PeriodicalIF\":1.1000,\"publicationDate\":\"2025-01-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"IDCases\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S221425092500054X\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"INFECTIOUS DISEASES\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"IDCases","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S221425092500054X","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"INFECTIOUS DISEASES","Score":null,"Total":0}
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 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.
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