We have published a case report about an immunocompromised patient (treated with Rituximab against multiple sclerosis) with longterm fever, hypoxia and low-grade SARS-CoV-2 infection. The patient was hospitalized three times over a period of 102 days.
The case report describes the clinical and diagnostic challenges and the interdisciplinary team work needed to distinguish hyperinflammation from low-grade, ongoing viremia. We successfully treated the patient with late corses of antiviral agents (off-label), however, we believe that the patients’ own immune system was crucial to clear the infection. Paradoxically, her immunocompromised state may also have protected her from developing severe COVID-19 disease. There is limited knowledge of immunological mechanisms prolonging acute SARS-CoV-2 infections in patients with profound immune dysregulation, which challenge clinical diagnostics and treatment options. Careful patient-customized antiviral therapy may have a role beyond the initial days of infection in patients with protracted COVID-19 disease.
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Special Issue: https://www.mdpi.com/journal/viruses/special_issues/Virology_Norway