Seki Masafumi, Kubosawa Chie, Ono Makoto, Kamoshita Fumitaka, Shimizu Atsuko, Mitsutake Kotaro
Division of Infectious Diseases and Infection Control, Saitama Medical University International Medical Center, Hidaka City, Japan.
Infect Drug Resist. 2024 Nov 11;17:5011-5015. doi: 10.2147/IDR.S485976. eCollection 2024.
Repeat positive results for SARS-CoV-2 by antigen detection test/RT-PCR in recovered COVID-19 patients were not very rare even when omicron variants became dominant, but the clinical features of patients with recurrent COVID-19 during hospitalization are still unclear.
The clinical characteristics of patients with recurrent COVID-19 during hospitalization were retrospectively investigated from January 2023 to December 2023.
Recurrence of COVID-19 was found in 7 of 275 (2.5%) patients during hospitalization. Their mean age was 80.3 (74-89) years, and 4 of 7 (57.1%) patients were hospitalized on the hematology ward with B cell/non-Hodgkin lymphoma. These 4 lymphoma patients had been vaccinated, but the other 3 patients hospitalized on the emergency ward and the neurology ward had not been vaccinated. Of the 7 patients, 6 (85.7%) were initially treated with remdesivir (RDV), but only 3 patients were re-treated with RDV, and the other 4 patients were successfully re-treated with oral 3C-like protease inhibitors, such as ensitrelvir (ESV) and nirmatrelvir/ritonavir (N/R).
These data suggest that COVID-19 recurrence was found in patients with hematological disorders, such as lymphoma, and/or patients with no vaccination history. However, these patients were treated successfully by re-administration of anti-SARS-CoV-2 agents, including ESV and N/R.
即使在奥密克戎变异株占主导地位时,新冠康复患者通过抗原检测试验/逆转录聚合酶链反应检测出的SARS-CoV-2重复阳性结果也并不罕见,但住院期间复发性新冠肺炎患者的临床特征仍不清楚。
回顾性调查2023年1月至2023年12月住院期间复发性新冠肺炎患者的临床特征。
275例患者中有7例(2.5%)在住院期间出现新冠肺炎复发。他们的平均年龄为80.3岁(74 - 89岁),7例患者中有4例(57.1%)因B细胞/非霍奇金淋巴瘤入住血液科病房。这4例淋巴瘤患者已接种疫苗,但在急诊科和神经科病房住院的另外3例患者未接种疫苗。7例患者中,6例(85.7%)最初接受了瑞德西韦(RDV)治疗,但只有3例患者再次接受了RDV治疗,另外4例患者成功地再次接受了口服3C样蛋白酶抑制剂治疗,如恩赛特韦(ESV)和奈玛特韦/利托那韦(N/R)。
这些数据表明,在患有血液系统疾病(如淋巴瘤)和/或无疫苗接种史的患者中发现了新冠肺炎复发。然而,通过再次给予包括ESV和N/R在内的抗SARS-CoV-2药物,这些患者得到了成功治疗。