Bouhamdani Nadia, Bouhamdani Dominique, Léger Cynthia, Stadler Josiane, Saulnier Nancy
Vitalité Health Network, Moncton, Canada.
Atlantic Cancer Research Institute, Moncton, Canada.
J Egypt Natl Canc Inst. 2025 Jun 30;37(1):32. doi: 10.1186/s43046-025-00291-1.
Immunocompromised individuals, such as those affected by and treated for hematological malignancies, face a higher risk of prolonged SARS-CoV-2 infection. Increased disease risk is further compounded by limited treatment options. Currently, approved antiviral monotherapies against COVID-19 include remdesivir (Veklury) and nirmatrelvir/ritonavir (Paxlovid) which have stringent recommended prescribing windows within 7 and 5 days of symptom onset, respectively. Furthermore, these two antiviral therapies are approved for treatment lengths of 3 (remdesivir) and 5 days (Paxlovid).
Herein, we describe the successful treatment of prolonged COVID-19 in a patient with a history of diffuse large B-cell lymphoma with an extended combination therapy; remdesivir and nirmatrelvir/ritonavir. The patient presented with symptomatic COVID-19 that was unsuccessfully treated with a 10-day course of remdesivir. After 2 months of symptomatic infection, the patient was treated with remdesivir in combination with nirmatrelvir/ritonavir for 10 days, which quickly resolved the cough and cleared viral load.
Our case highlights the efficacy of administrating a combination treatment of remdesivir and nirmatrelvir/ritonavir outside recommended guidelines for the treatment of persistent COVID-19 infection in an immunocompromised individual. High-quality studies evaluating the usefulness of this combinatory therapy as a longer-course treatment in patients with neoplasms is warranted.
免疫功能低下的个体，如那些患有血液系统恶性肿瘤并接受治疗的患者，面临着更长时间感染严重急性呼吸综合征冠状病毒2（SARS-CoV-2）的更高风险。有限的治疗选择进一步加剧了疾病风险。目前，已获批的针对2019冠状病毒病（COVID-19）的抗病毒单药疗法包括瑞德西韦（Veklury）和奈玛特韦/利托那韦（Paxlovid），它们分别在症状出现后的7天和5天内有严格的推荐用药窗口期。此外，这两种抗病毒疗法的获批治疗时长分别为3天（瑞德西韦）和5天（奈玛特韦/利托那韦）。
在此，我们描述了一名有弥漫性大B细胞淋巴瘤病史的患者，通过延长联合疗法（瑞德西韦和奈玛特韦/利托那韦）成功治疗了长时间的COVID-19。该患者出现有症状的COVID-19，接受了为期10天的瑞德西韦治疗但未成功。在出现症状感染2个月后，该患者接受了瑞德西韦联合奈玛特韦/利托那韦治疗10天，咳嗽迅速缓解，病毒载量清除。
我们的病例突出了在免疫功能低下个体中，超出推荐指南使用瑞德西韦和奈玛特韦/利托那韦联合治疗持续性COVID-19感染的疗效。有必要开展高质量研究，评估这种联合疗法作为肿瘤患者更长疗程治疗的有效性。
