Internal medicine

Drug holiday

Virus

Discontinuation

Disease

Coronavirus disease 2019 (COVID-19)

Infectious disease (medical specialty)

Outbreak

Virology

Immunology

Chronic lymphocytic leukemia

Pneumonia

Leukemia

2019-20 coronavirus outbreak

Chemoimmunotherapy

Antiviral therapy

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)

Human immunodeficiency virus (HIV)

Chronic hepatitis

Medicine

The Journal of Infectious Diseases

The antiviral drug remdesivir has been shown clinically effective for treatment of COVID-19. We here demonstrate suppressive but not curative effect of remdesivir in an immunocompromised patient. A man in his fifties treated with chemoimmunotherapy for chronic lymphocytic leukemia experienced a 9-week course of COVID-19 with high fever and severe viral pneumonia. During two 10-day courses of remdesivir starting 24 and 45 days after fever onset, pneumonia and spiking fevers remitted, but relapsed after discontinuation. Kinetics of temperature, C-reactive protein, and lymphocyte counts mirrored the remitting/relapsing SARS-CoV-2 infection. Combination therapy or longer treatment duration may be needed in immunocompromised patients.

Persistent COVID-19 in an Immunocompromised Patient Temporarily Responsive to Two Courses of Remdesivir Therapy