Persistent COVID-19 in an Immunocompromised Patient Temporarily Responsive to Two Courses of Remdesivir Therapy

Marie Helleberg; Carsten Utoft Niemann; Kasper Moestrup; Ole Kirk; Anne-Mette Lebech; Clifford Lane; Jens Lundgren

doi:10.1093/infdis/jiaa446

Persistent COVID-19 in an Immunocompromised Patient Temporarily Responsive to Two Courses of Remdesivir Therapy

Marie Helleberg, Carsten Utoft Niemann, Kasper Moestrup, Ole Kirk, Anne-Mette Lebech, Clifford Lane, Jens Lundgren

134 Citations (Scopus)

Abstract

The antiviral drug remdesivir has been shown clinically effective for treatment of COVID-19. We here demonstrate suppressive but not curative effect of remdesivir in an immunocompromised patient. A man in his fifties treated with chemoimmunotherapy for chronic lymphocytic leukemia experienced a 9-week course of COVID-19 with high fever and severe viral pneumonia. During two 10-day courses of remdesivir starting 24 and 45 days after fever onset, pneumonia and spiking fevers remitted, but relapsed after discontinuation. Kinetics of temperature, C-reactive protein, and lymphocyte counts mirrored the remitting/relapsing SARS-CoV-2 infection. Combination therapy or longer treatment duration may be needed in immunocompromised patients.

Original language	English
Journal	The Journal of infectious diseases
Volume	222
Issue number	7
Pages (from-to)	1103-1107
Number of pages	5
ISSN	0022-1899
DOIs	https://doi.org/10.1093/infdis/jiaa446
Publication status	Published - 1 Sept 2020

Keywords

Adenosine Monophosphate/analogs & derivatives
Alanine/analogs & derivatives
Antiviral Agents/therapeutic use
Betacoronavirus/drug effects
COVID-19
Coronavirus Infections/complications
Fever/drug therapy
Humans
Immunocompromised Host
Leukemia, Lymphocytic, Chronic, B-Cell/complications
Male
Middle Aged
Pandemics
Pneumonia, Viral/complications
SARS-CoV-2
Severe Acute Respiratory Syndrome/drug therapy
Time Factors
Treatment Outcome
case report
immunocompromised
remdesivir
Immunocompromised
Case report
Remdesivir

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10.1093/infdis/jiaa446

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abstract = "The antiviral drug remdesivir has been shown clinically effective for treatment of COVID-19. We here demonstrate suppressive but not curative effect of remdesivir in an immunocompromised patient. A man in his fifties treated with chemoimmunotherapy for chronic lymphocytic leukemia experienced a 9-week course of COVID-19 with high fever and severe viral pneumonia. During two 10-day courses of remdesivir starting 24 and 45 days after fever onset, pneumonia and spiking fevers remitted, but relapsed after discontinuation. Kinetics of temperature, C-reactive protein, and lymphocyte counts mirrored the remitting/relapsing SARS-CoV-2 infection. Combination therapy or longer treatment duration may be needed in immunocompromised patients.",

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AU - Lane, Clifford

AU - Lundgren, Jens

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Persistent COVID-19 in an Immunocompromised Patient Temporarily Responsive to Two Courses of Remdesivir Therapy

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