Dual anti-viral treatment for persistent COVID-19 in immunocompromised hemato-oncological patients is associated with a favorable prognosis and minor side effects

Suzy E. Meijer*, Ora Halutz, Amos Adler, Katya Levytskyi, Luba Tau, Michal Dekel, Ronit Cohen-Poradosu, Evgene Katchman, David Shasha, Jacob Ablin, Guy Choshen, Giris Jacob, Asaf Wasserman, Merav Ingbir, Yael C. Cohen, Chava Perry, Ron Ram, Yair Herishanu, Yael Bar On, Elma van ThijnNatalie Rutsinsky, Sheri Harari, Adi Stern, Ronen Ben-Ami, Yael Paran

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

4 Scopus citations

Abstract

In hemato-oncological patients, COVID-19 can present as a persistent infection with ongoing symptoms and viral replication over a prolonged period of time. Data are scarce on the preferred treatment options for these patients. We describe our experience with a five-day course of dual anti-viral treatment with remdesivir and nirmatrelvir/ritonavir for hemato-oncological immunocompromised patients with persistent COVID-19. Fifteen patients with a history of lymphoma, CLL, and MM were included. Eight were male, median age was 74. All patients had an immediate clinical and virological response. In 73 % of patients, PCR for SARS-CoV-2 became negative at the end of treatment and the rest had an increase in PCR cycle threshold (CT) values, with a median increase of 6 cycles. After a follow-up of three months, 60 % of patients remained in full clinical and virological remission. None required invasive mechanical ventilation or died. The side effects we observed, neutropenia, lactatemia and elevated transaminases, were mild and almost all transient in nature. We conclude that dual anti-viral treatment appears to be a valid treatment option for persistent COVID-19.

Original languageEnglish
Pages (from-to)271-275
Number of pages5
JournalJournal of Infection and Chemotherapy
Volume30
Issue number3
DOIs
StatePublished - Mar 2024

Funding

FundersFunder number
Ministry of Health, State of Israel

    Keywords

    • Dual anti-viral therapy
    • Hemato-oncological patients
    • Immunocompromised patients
    • Persistent COVID-19

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