tetano
Editor, Senior Moderator
Open Forum Infect Dis
. 2023 Dec 7;11(1)
fad612.
doi: 10.1093/ofid/ofad612. eCollection 2024 Jan. A Multinational Case Series Describing Successful Treatment of Persistent Severe Acute Respiratory Syndrome Coronavirus 2 Infection Caused by Omicron Sublineages With Prolonged Courses of Nirmatrelvir/Ritonavir
Luke B Snell[SUP] 1 2 [/SUP], Aimee McGreal-Bellone[SUP] 3 [/SUP], Clemency Nye[SUP] 4 [/SUP], Sarah Gage[SUP] 5 [/SUP], Prijay Bakrania[SUP] 2 [/SUP], Tom G S Williams[SUP] 2 [/SUP], Emma Aarons[SUP] 2 [/SUP], Alina Botgros[SUP] 2 [/SUP], Samuel T Douthwaite[SUP] 2 [/SUP], Patrick Mallon[SUP] 6 [/SUP], Iain Milligan[SUP] 2 [/SUP], Catherine Moore[SUP] 7 [/SUP], Brendan O'Kelly[SUP] 3 8 [/SUP], Jonathan Underwood[SUP] 5 9 [/SUP], Eoghan de Barra[SUP] 3 10 [/SUP], Gaia Nebbia[SUP] 1 2 [/SUP]
Affiliations
The optimum treatment for persistent infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is not known. Our case series, across 5 hospitals in 3 countries, describes 11 cases where persistent SARS-CoV-2 infection was successfully treated with prolonged courses (median, 10 days [range, 10-18 days]) of nirmatrelvir/ritonavir (Paxlovid). Most cases (9/11) had hematological malignancy and 10 (10/11) had received CD20-depleting therapy. The median duration of infection was 103 days (interquartile range, 85-138 days). The majority (10/11) were hospitalized, and 7 (7/11) had severe/critical disease. All survived and 9 of 11 demonstrated viral clearance, almost half (4/9) of whom received nirmatrelvir/ritonavir as monotherapy. This case series suggests that prolonged nirmatrelvir/ritonavir has a role in treating persistent infection.
Keywords: COVID-19; Immunocompromise; SARS-CoV-2.
. 2023 Dec 7;11(1)
fad612.doi: 10.1093/ofid/ofad612. eCollection 2024 Jan. A Multinational Case Series Describing Successful Treatment of Persistent Severe Acute Respiratory Syndrome Coronavirus 2 Infection Caused by Omicron Sublineages With Prolonged Courses of Nirmatrelvir/Ritonavir
Luke B Snell[SUP] 1 2 [/SUP], Aimee McGreal-Bellone[SUP] 3 [/SUP], Clemency Nye[SUP] 4 [/SUP], Sarah Gage[SUP] 5 [/SUP], Prijay Bakrania[SUP] 2 [/SUP], Tom G S Williams[SUP] 2 [/SUP], Emma Aarons[SUP] 2 [/SUP], Alina Botgros[SUP] 2 [/SUP], Samuel T Douthwaite[SUP] 2 [/SUP], Patrick Mallon[SUP] 6 [/SUP], Iain Milligan[SUP] 2 [/SUP], Catherine Moore[SUP] 7 [/SUP], Brendan O'Kelly[SUP] 3 8 [/SUP], Jonathan Underwood[SUP] 5 9 [/SUP], Eoghan de Barra[SUP] 3 10 [/SUP], Gaia Nebbia[SUP] 1 2 [/SUP]
Affiliations
- PMID: 38269048
- PMCID: PMC10807981
- DOI: 10.1093/ofid/ofad612
The optimum treatment for persistent infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is not known. Our case series, across 5 hospitals in 3 countries, describes 11 cases where persistent SARS-CoV-2 infection was successfully treated with prolonged courses (median, 10 days [range, 10-18 days]) of nirmatrelvir/ritonavir (Paxlovid). Most cases (9/11) had hematological malignancy and 10 (10/11) had received CD20-depleting therapy. The median duration of infection was 103 days (interquartile range, 85-138 days). The majority (10/11) were hospitalized, and 7 (7/11) had severe/critical disease. All survived and 9 of 11 demonstrated viral clearance, almost half (4/9) of whom received nirmatrelvir/ritonavir as monotherapy. This case series suggests that prolonged nirmatrelvir/ritonavir has a role in treating persistent infection.
Keywords: COVID-19; Immunocompromise; SARS-CoV-2.