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IDCases . Antiviral combination treatment of SARS-CoV-2 after repeated treatment failures of remdesivir monotherapy: A case report

tetano

Editor, Senior Moderator
IDCases


. 2024 Nov 13:38:e02118.
doi: 10.1016/j.idcr.2024.e02118. eCollection 2024. Antiviral combination treatment of SARS-CoV-2 after repeated treatment failures of remdesivir monotherapy: A case report

Anne Cathrine Bay[SUP] 1 [/SUP], Michael R Clausen[SUP] 2 [/SUP], Birgit Thorup Røge[SUP] 1 [/SUP], Thomas V Sydenham[SUP] 3 4 [/SUP], Kat Steinke[SUP] 3 4 [/SUP], Rune Micha Pedersen[SUP] 3 4 [/SUP], Line L Bang[SUP] 3 4 [/SUP], Thomas E Andersen[SUP] 3 4 [/SUP], Anders Jensen[SUP] 5 [/SUP], Lone W Madsen[SUP] 1 6 7 [/SUP]



Affiliations
Abstract

Immunocompromised patients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can have a longer duration of viral shedding and persistence of symptoms. The optimal treatment strategy for these patients remains to be established. This case describes a male in his late sixties with follicular lymphoma and persistent symptoms of infection with SARS-CoV-2 variant BA.2 who was treated with remdesivir five times over a period of six months. The clinical effect of remdesivir treatment decreased over time, and further viral sequencing revealed the emergence of mutations across the SARS-CoV-2 genome. Due to the lack of other treatment options, the patient was treated with a combination of remdesivir and molnupiravir for 10 days, and epcoritamab was discontinued, which led to the cessation of symptoms. This case illustrates the risk of a diminished effect of remdesivir with prolonged use and the need for treatment guidelines for immunocompromised patients with persistent COVID-19.

Keywords: Case report; Combination therapy; Covid-19; Hematologic malignancy; Immunocompromised.

 
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