More than a 'Hundred Days War': Persistent SARS-CoV-2 infection in a patient with ANCA-associated vasculitis.
In: Journal of the Association of Medical Microbiology and Infectious Disease Canada = Journal officiel de l'Association pour la microbiologie medicale et l'infectiologie Canada, Jg. 7 (2022-06-03), Heft 2, S. 131
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Zugriff:
Background: Few reports exist on the characteristics and outcomes of persistent severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in immunocompromised hosts.
Methods: A 49-year-old patient with granulomatosis with polyangiitis (GPA) and a renal transplant experienced multiple hospitalizations for coronavirus disease 2019 (COVID-19) pneumonia and relapses between October 2020 and February 2021. Careful chart review of medical history, hospitalizations, and microbiological testing including SARS-CoV-2 cycle threshold values, therapies, and imaging was undertaken. SARS-CoV-2 genome sequencing was performed in five viral samples to distinguish persistent infection from re-infection with a different strain.
Results: Sequencing confirmed that all samples tested were from the same viral lineage, indicating a long-term, persistent infection rather than re-infection with a new strain. The patient ultimately stabilized after two courses of remdesivir plus dexamethasone, replacement intravenous immunoglobulin, and bamlanivimab. Rituximab maintenance therapy for vasculitis remains on hold.
Conclusions: SARS-CoV-2 may persist for several months in immunocompromised hosts and may go unrecognized as an ongoing active infection. More studies are needed to determine how to optimize COVID-19 treatment in this vulnerable population.
Competing Interests: TC Lee reports funds from Fonds de Recherche Quebec-Santé and Canadian Institutes of Health Research during the conduct of the study. MP Cheng reports grants from the McGill Interdisciplinary Initiative in Infection and Immunity and Canadian Institutes of Health Research during the conduct of the study and personal fees from GEn1E Lifesciences (as a member of the scientific advisory board) and nplex biosciences (as a member of the scientific advisory board), both outside the submitted work. He is the co-founder of Kanvas Biosciences and owns equity in the company. In addition, MP Cheng has a pending patent for ‘Methods for detecting tissue damage, graft versus host disease, and infections using cell-free DNA profiling’ and a pending patent for ‘Methods for assessing the severity and progression of SARS-CoV-2 infections using cell-free DNA.’ The other authors have nothing to disclose.
(Copyright © 2022, Association of Medical Microbiology and Infectious Disease Canada (AMMI Canada).)
| Titel: |
More than a 'Hundred Days War': Persistent SARS-CoV-2 infection in a patient with ANCA-associated vasculitis.
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| Autor/in / Beteiligte Person: | Mendel, A ; Colmegna, I ; Bourque, G ; Rajda, E ; Lee, TC ; Gálvez, JH ; Vinet, É ; Cheng, MP |
| Zeitschrift: | Journal of the Association of Medical Microbiology and Infectious Disease Canada = Journal officiel de l'Association pour la microbiologie medicale et l'infectiologie Canada, Jg. 7 (2022-06-03), Heft 2, S. 131 |
| Veröffentlichung: | [Toronto, ON, Canada] : University of Toronto Press, [2016]-, 2022 |
| Medientyp: | academicJournal |
| ISSN: | 2371-0888 (electronic) |
| DOI: | 10.3138/jammi-2021-0033 |
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