Roberta Maria Antonello, Davide Marangoni, Filippo Ducci, Anna Barbiero, Tommaso Manciulli, Lucia Graziani, Nicoletta Di Lauria, Lorenzo Menicacci, Lorenzo Paci, Benedetta Sordi, Lorenzo Zammarchi, Alessandro Morettini, Sara Tomassetti, Gian Maria Rossolini, Alessandro Bartoloni, Michele Spinicci
{"title":"将抗病毒联合疗法作为对持续感染 COVID-19 的免疫功能低下宿主的拯救疗法。","authors":"Roberta Maria Antonello, Davide Marangoni, Filippo Ducci, Anna Barbiero, Tommaso Manciulli, Lucia Graziani, Nicoletta Di Lauria, Lorenzo Menicacci, Lorenzo Paci, Benedetta Sordi, Lorenzo Zammarchi, Alessandro Morettini, Sara Tomassetti, Gian Maria Rossolini, Alessandro Bartoloni, Michele Spinicci","doi":"10.1080/1120009X.2024.2367935","DOIUrl":null,"url":null,"abstract":"<p><p>The management of severe/prolonged SARS-CoV-2 infections in immunocompromised hosts is still challenging. We describe nine patients with hematologic malignancies with a history of unsuccessful SARS-CoV-2 treatment receiving antiviral combination treatment for persistent infection at a tertiary hospital in central Italy (University Hospital of Careggi, Florence). Combination treatments consisted of nirmatrelvir/ritonavir plus molnupiravir (<i>n</i> = 4), nirmatrelvir/ritonavir plus remdesivir (<i>n</i> = 4) or remdesivir plus molnupiravir (<i>n</i> = 1) for 10 days, in some cases associated with sotrovimab. Combinations were generally well tolerated. One patient obtained viral clearance but died due to the underlying disease. In eight cases, clinical and virological success was confirmed by radiological follow-up. Antivirals combination is likely to become a mainstay in the future management of COVID-19 among immunocompromised patients, but knowledge in this field is still very limited and prospective studies on larger cohorts are urgently warranted.</p>","PeriodicalId":15338,"journal":{"name":"Journal of Chemotherapy","volume":" ","pages":"1-5"},"PeriodicalIF":1.9000,"publicationDate":"2024-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Antiviral combination regimens as rescue therapy in immunocompromised hosts with persistent COVID-19.\",\"authors\":\"Roberta Maria Antonello, Davide Marangoni, Filippo Ducci, Anna Barbiero, Tommaso Manciulli, Lucia Graziani, Nicoletta Di Lauria, Lorenzo Menicacci, Lorenzo Paci, Benedetta Sordi, Lorenzo Zammarchi, Alessandro Morettini, Sara Tomassetti, Gian Maria Rossolini, Alessandro Bartoloni, Michele Spinicci\",\"doi\":\"10.1080/1120009X.2024.2367935\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>The management of severe/prolonged SARS-CoV-2 infections in immunocompromised hosts is still challenging. We describe nine patients with hematologic malignancies with a history of unsuccessful SARS-CoV-2 treatment receiving antiviral combination treatment for persistent infection at a tertiary hospital in central Italy (University Hospital of Careggi, Florence). Combination treatments consisted of nirmatrelvir/ritonavir plus molnupiravir (<i>n</i> = 4), nirmatrelvir/ritonavir plus remdesivir (<i>n</i> = 4) or remdesivir plus molnupiravir (<i>n</i> = 1) for 10 days, in some cases associated with sotrovimab. Combinations were generally well tolerated. One patient obtained viral clearance but died due to the underlying disease. In eight cases, clinical and virological success was confirmed by radiological follow-up. Antivirals combination is likely to become a mainstay in the future management of COVID-19 among immunocompromised patients, but knowledge in this field is still very limited and prospective studies on larger cohorts are urgently warranted.</p>\",\"PeriodicalId\":15338,\"journal\":{\"name\":\"Journal of Chemotherapy\",\"volume\":\" \",\"pages\":\"1-5\"},\"PeriodicalIF\":1.9000,\"publicationDate\":\"2024-06-14\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Chemotherapy\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1080/1120009X.2024.2367935\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"INFECTIOUS DISEASES\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Chemotherapy","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1080/1120009X.2024.2367935","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"INFECTIOUS DISEASES","Score":null,"Total":0}
Antiviral combination regimens as rescue therapy in immunocompromised hosts with persistent COVID-19.
The management of severe/prolonged SARS-CoV-2 infections in immunocompromised hosts is still challenging. We describe nine patients with hematologic malignancies with a history of unsuccessful SARS-CoV-2 treatment receiving antiviral combination treatment for persistent infection at a tertiary hospital in central Italy (University Hospital of Careggi, Florence). Combination treatments consisted of nirmatrelvir/ritonavir plus molnupiravir (n = 4), nirmatrelvir/ritonavir plus remdesivir (n = 4) or remdesivir plus molnupiravir (n = 1) for 10 days, in some cases associated with sotrovimab. Combinations were generally well tolerated. One patient obtained viral clearance but died due to the underlying disease. In eight cases, clinical and virological success was confirmed by radiological follow-up. Antivirals combination is likely to become a mainstay in the future management of COVID-19 among immunocompromised patients, but knowledge in this field is still very limited and prospective studies on larger cohorts are urgently warranted.
期刊介绍：
The Journal of Chemotherapy is an international multidisciplinary journal committed to the rapid publication of high quality, peer-reviewed, original research on all aspects of antimicrobial and antitumor chemotherapy.
The Journal publishes original experimental and clinical research articles, state-of-the-art reviews, brief communications and letters on all aspects of chemotherapy, providing coverage of the pathogenesis, diagnosis, treatment, and control of infection, as well as the use of anticancer and immunomodulating drugs.
Specific areas of focus include, but are not limited to:
· Antibacterial, antiviral, antifungal, antiparasitic, and antiprotozoal agents;
· Anticancer classical and targeted chemotherapeutic agents, biological agents, hormonal drugs, immunomodulatory drugs, cell therapy and gene therapy;
· Pharmacokinetic and pharmacodynamic properties of antimicrobial and anticancer agents;
· The efficacy, safety and toxicology profiles of antimicrobial and anticancer drugs;
· Drug interactions in single or combined applications;
· Drug resistance to antimicrobial and anticancer drugs;
· Research and development of novel antimicrobial and anticancer drugs, including preclinical, translational and clinical research;
· Biomarkers of sensitivity and/or resistance for antimicrobial and anticancer drugs;
· Pharmacogenetics and pharmacogenomics;
· Precision medicine in infectious disease therapy and in cancer therapy;
· Pharmacoeconomics of antimicrobial and anticancer therapies and the implications to patients, health services, and the pharmaceutical industry.
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