Reinfection with SARS-CoV-2 in a patient undergoing chemotherapy for lymphoma: Case report

Author:

Côté Florence1,Bestman-Smith Julie1,Gourdeau Marie1,Simpson Shawn M2,Hamelin Marie-Ève3,Carbonneau Julie3,Chiasson Antoine4,Rozendaal Marieke2,Smith Martin A25,Boivin Guy3ORCID

Affiliation:

1. Département de microbiologie et infectiologie, Hôpital de l’Enfant-Jésus, CHU de Québec – Université Laval, Quebec, Quebec, Canada

2. CHU Sainte-Justine Research Centre, Montreal, Quebec, Canada

3. CHU de Québec – Université Laval and Centre de recherche en infectiologie, Quebec, Quebec, Canada

4. Centre de santé et services sociaux de Chicoutimi, Hôpital de Chicoutimi, Chicoutimi, Quebec, Canada

5. Département de biochimie et médecine moléculaire, Université de Montréal, Montreal, Quebec, Canada

Abstract

BACKGROUND: COVID-19 is usually a time-limited disease. However, prolonged infections and reinfections can occur among immunocompromised patients. It can be difficult to distinguish a prolonged infection from a new one, especially when reinfection occurs early. METHODS: We report the case of a 57-year-old man infected with SARS-CoV-2 while undergoing chemotherapy for follicular lymphoma. He experienced prolonged symptomatic infection for 3 months despite a 5-day course of remdesivir and eventually deteriorated and died. RESULTS: Viral genome sequencing showed that his final deterioration was most likely due to reinfection. Serologic studies confirmed that the patient did not seroconvert. CONCLUSIONS: This case report highlights that reinfection can occur rapidly (62–67 d) among immunocompromised patients after a prolonged disease. We provide substantial proof of prolonged infection through repeated nucleic acid amplification tests and positive viral culture at day 56 of the disease course, and we put forward evidence of reinfection with viral genome sequencing.

Publisher

University of Toronto Press Inc. (UTPress)

Subject

Infectious Diseases,Microbiology (medical)

Reference22 articles.

1. 1. National Institutes of Health. Therapeutic management of hospitalized adults with COVID-19. https://www.covid19treatmentguidelines.nih.gov/management/clinical-management/hospitalized-adults-therapeutic-management/ (Accessed March 4, 2022).

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

3. Remdesivir for the Treatment of Covid-19 — Final Report

4. Repurposed Antiviral Drugs for Covid-19 — Interim WHO Solidarity Trial Results

5. Effect of Remdesivir vs Standard Care on Clinical Status at 11 Days in Patients With Moderate COVID-19

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