高度易感宿主的连续SARS-CoV-2突变：持续病毒血症和死亡病例报告

IF 1.9 4区医学 Q3 INFECTIOUS DISEASES

Journal of Infection and Chemotherapy Pub Date : 2025-05-24 DOI:10.1016/j.jiac.2025.102737

Yuko Danzuka , Keiji Nakamura , Shinya Matsumoto , Yoshitaka Etoh , Sho Yamasaki , Koji Takayama , Masayuki Murata , Nobuyuki Shimono

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引用次数: 0

摘要

1例71岁女性治疗后滤泡性淋巴瘤并发COVID-19并持续性病毒血症。尽管在第23天开始使用瑞德西韦，但她仍呈SARS-CoV-2 pcr阳性，并最终于第79天死于呼吸衰竭。对死后鼻咽拭子提取的RNA进行全基因组分析，发现了多个突变，包括增强病毒复制的P323L/G671S和与瑞德西韦耐药性相关的V792I。该病例突出了在免疫功能低下患者中管理持续的SARS-CoV-2感染的挑战，并强调了延迟治疗和抗病毒药物耐药性的影响。

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Successive SARS-CoV-2 mutations in a highly susceptible host: A case report of persistent viremia and fatality

A 71-year-old female with post-treatment follicular lymphoma developed COVID-19 with persistent viremia. Despite the initiation of remdesivir on day 23, she remained SARS-CoV-2 PCR-positive and ultimately succumbed to respiratory failure on day 79. Whole-genome analysis of RNA extracted from a post-mortem nasopharyngeal swab identified multiple mutations, including P323L/G671S, which enhances viral replication, and V792I, associated with remdesivir resistance. This case highlights the challenges of managing persistent SARS-CoV-2 infection in immunocompromised patients and underscores the impact of delayed treatment and antiviral resistance.

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来源期刊

Journal of Infection and Chemotherapy INFECTIOUS DISEASES-PHARMACOLOGY & PHARMACY

CiteScore

4.10

自引率

4.50%

发文量

303

审稿时长

47 days

期刊介绍： The Journal of Infection and Chemotherapy (JIC) — official journal of the Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases — welcomes original papers, laboratory or clinical, as well as case reports, notes, committee reports, surveillance and guidelines from all parts of the world on all aspects of chemotherapy, covering the pathogenesis, diagnosis, treatment, and control of infection, including treatment with anticancer drugs. Experimental studies on animal models and pharmacokinetics, and reports on epidemiology and clinical trials are particularly welcome.