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本文引用的文献

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Persistent SARS-CoV-2 infection with multiple clinical relapses in two patients with follicular lymphoma treated with bendamustine and obinutuzumab or rituximab.两例滤泡性淋巴瘤患者在接受苯达莫司汀和奥滨尤妥珠单抗或利妥昔单抗治疗后出现持续性 SARS-CoV-2 感染和多次临床复发。
Infection. 2023 Oct;51(5):1577-1581. doi: 10.1007/s15010-023-02039-2. Epub 2023 Apr 19.
2
Triple Combination Therapy With 2 Antivirals and Monoclonal Antibodies for Persistent or Relapsed Severe Acute Respiratory Syndrome Coronavirus 2 Infection in Immunocompromised Patients.免疫功能低下患者持续性或复发性严重急性呼吸综合征冠状病毒 2 感染的 2 种抗病毒药物和单克隆抗体三联疗法。
Clin Infect Dis. 2023 Jul 26;77(2):280-286. doi: 10.1093/cid/ciad181.
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Sequential Treatment by Antiviral Drugs Followed by Immunosuppressive Agents for COVID-19 Patients with Hematological Malignancy.血液系统恶性肿瘤COVID-19患者先接受抗病毒药物序贯治疗,后接受免疫抑制剂治疗
Infect Drug Resist. 2022 Dec 5;15:7117-7124. doi: 10.2147/IDR.S393198. eCollection 2022.
4
Efficacy and Safety of Ensitrelvir in Patients With Mild-to-Moderate Coronavirus Disease 2019: The Phase 2b Part of a Randomized, Placebo-Controlled, Phase 2/3 Study.恩赛特韦在轻至中度 2019 冠状病毒病患者中的疗效和安全性:一项随机、安慰剂对照、2/3 期研究的 2b 期部分。
Clin Infect Dis. 2023 Apr 17;76(8):1403-1411. doi: 10.1093/cid/ciac933.
5
A Randomized Phase 2/3 Study of Ensitrelvir, a Novel Oral SARS-CoV-2 3C-Like Protease Inhibitor, in Japanese Patients with Mild-to-Moderate COVID-19 or Asymptomatic SARS-CoV-2 Infection: Results of the Phase 2a Part.一项评估新型口服 SARS-CoV-2 3CL 蛋白酶抑制剂恩赛特韦(ensitrelvir)在日本轻至中度 COVID-19 或无症状 SARS-CoV-2 感染患者中的疗效和安全性的随机 2/3 期研究:2a 期部分结果。
Antimicrob Agents Chemother. 2022 Oct 18;66(10):e0069722. doi: 10.1128/aac.00697-22. Epub 2022 Sep 13.
6
Safety, Tolerability, and Pharmacokinetics of the Novel Antiviral Agent Ensitrelvir Fumaric Acid, a SARS-CoV-2 3CL Protease Inhibitor, in Healthy Adults.新型抗病毒药物恩赛特韦富马酸,一种 SARS-CoV-2 3CL 蛋白酶抑制剂,在健康成年人中的安全性、耐受性和药代动力学。
Antimicrob Agents Chemother. 2022 Oct 18;66(10):e0063222. doi: 10.1128/aac.00632-22. Epub 2022 Sep 12.
7
Efficacy and safety of intramuscular administration of tixagevimab-cilgavimab for early outpatient treatment of COVID-19 (TACKLE): a phase 3, randomised, double-blind, placebo-controlled trial.替沙格韦单抗-西加韦单抗肌内注射用于 COVID-19 早期门诊治疗的疗效和安全性(TACKLE):一项 3 期、随机、双盲、安慰剂对照试验。
Lancet Respir Med. 2022 Oct;10(10):985-996. doi: 10.1016/S2213-2600(22)00180-1. Epub 2022 Jun 7.
8
SARS-CoV-2 Omicron variant escapes neutralizing antibodies and T cell responses more efficiently than other variants in mild COVID-19 convalescents.新冠病毒奥密克戎变异株比其他变异株更有效地逃避中和抗体和 T 细胞反应,在轻症 COVID-19 康复者中也是如此。
Cell Rep Med. 2022 Jun 21;3(6):100651. doi: 10.1016/j.xcrm.2022.100651. Epub 2022 May 17.
9
Higher mortality of hospitalized haematologic patients with COVID-19 compared to non-haematologic is driven by thrombotic complications and development of ARDS: An age-matched cohorts study.与非血液学患者相比,新冠肺炎住院血液学患者的死亡率更高,这是由血栓并发症和急性呼吸窘迫综合征的发生所驱动的:一项年龄匹配队列研究。
Clin Infect Pract. 2022 Jan;13:100137. doi: 10.1016/j.clinpr.2022.100137. Epub 2022 Feb 15.
10
Oral Nirmatrelvir for High-Risk, Nonhospitalized Adults with Covid-19.奈玛特韦片/利托那韦片组合包装口服药用于伴有进展为重症高风险因素的 COVID-19 门诊患者。
N Engl J Med. 2022 Apr 14;386(15):1397-1408. doi: 10.1056/NEJMoa2118542. Epub 2022 Feb 16.

奥密克戎变异株激增期间住院的新冠病毒感染复发患者的临床特征

Clinical Features of Patients with COVID-19 Recurrence During Hospitalization in the Omicron Variant Surge.

作者信息

Seki Masafumi, Kubosawa Chie, Ono Makoto, Kamoshita Fumitaka, Shimizu Atsuko, Mitsutake Kotaro

机构信息

Division of Infectious Diseases and Infection Control, Saitama Medical University International Medical Center, Hidaka City, Japan.

出版信息

Infect Drug Resist. 2024 Nov 11;17:5011-5015. doi: 10.2147/IDR.S485976. eCollection 2024.

DOI:10.2147/IDR.S485976
PMID:39554473
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11568766/
Abstract

BACKGROUND

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.

METHODS

The clinical characteristics of patients with recurrent COVID-19 during hospitalization were retrospectively investigated from January 2023 to December 2023.

RESULTS

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).

CONCLUSION

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.

摘要

背景

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。

方法

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。

结果

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)。

结论

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。