{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T02:18:07Z","timestamp":1785809887597,"version":"3.56.0"},"reference-count":0,"publisher":"Oxford University Press (OUP)","issue":"7","license":[{"start":{"date-parts":[[2023,5,30]],"date-time":"2023-05-30T00:00:00Z","timestamp":1685404800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"EU Horizon 2020 projects RECoVer","award":["101003589"],"award-info":[{"award-number":["101003589"]}]},{"name":"EU Horizon 2020 projects RECoVer","award":["874735"],"award-info":[{"award-number":["874735"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,7,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>Immunocompromised patients have an increased risk of severe or prolonged COVID-19. Currently available drugs are registered to treat COVID-19 during the first 5 to 7 days after symptom onset. Data on the effectivity in immunocompromised patients with chronic non-resolving COVID-19 are urgently needed. Here, we report the outcome of patients treated with nirmatrelvir\/ritonavir together with high-titer convalescent plasma (CP) in six immunocompromised patients with non-resolving COVID-19.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Immunocompromised patients with persisting COVID-19 (positive PCR with Ct values &amp;lt;30 for \u226520 days) received off-label therapy with nirmatrelvir\/ritonavir. It was combined with CP containing BA.5 neutralizing titers of \u22651\/640 whenever available. Follow-up was done by PCR and sequencing on nasopharyngeal swabs on a weekly basis until viral genome was undetectable consecutively.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Five immunocompromised patients were treated with high-titer CP and 5 days of nirmatrelvir\/ritonavir. One patient received nirmatrelvir\/ritonavir monotherapy. Median duration of SARS-CoV-2 PCR positivity was 70 (range 20\u2013231) days before nirmatrelvir\/ritonavir treatment. In four patients receiving combination therapy, no viral genome of SARS-CoV-2 was detected on day 7 and 14 after treatment while the patient receiving nirmatrelvir\/ritonavir monotherapy, the day 7 Ct value increased to 34 and viral genome was undetectable thereafter. Treatment was unsuccessful in one patient. In this patient, sequencing after nirmatrelvir\/ritonavir treatment did not show protease gene mutations.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>In immunocompromised patients with non-resolving COVID-19, the combination of nirmatrelvir\/ritonavir and CP may be an effective treatment. Larger prospective studies are needed to confirm these preliminary results and should compare different treatment durations.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/jac\/dkad144","type":"journal-article","created":{"date-parts":[[2023,5,30]],"date-time":"2023-05-30T04:56:38Z","timestamp":1685422598000},"page":"1644-1648","source":"Crossref","is-referenced-by-count":24,"title":["High-titer convalescent plasma plus nirmatrelvir\/ritonavir treatment for non-resolving COVID-19 in six immunocompromised patients"],"prefix":"10.1093","volume":"78","author":[{"given":"Sammy","family":"Huygens","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Section of Infectious Diseases and Department of Medical Microbiology and Infectious Diseases, Erasmus MC, University Medical Center , Dr. Molewaterplein 40 3015 GD, Rotterdam , The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arvind","family":"Gharbharan","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Section of Infectious Diseases and Department of Medical Microbiology and Infectious Diseases, Erasmus MC, University Medical Center , Dr. Molewaterplein 40 3015 GD, Rotterdam , The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasmina","family":"Serroukh","sequence":"additional","affiliation":[{"name":"Department of Hematology, Erasmus MC, University Medical Center , Rotterdam , The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Britt","family":"Snoek","sequence":"additional","affiliation":[{"name":"Department of Hematology, Erasmus MC, University Medical Center , Rotterdam , The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bas","family":"Franken","sequence":"additional","affiliation":[{"name":"Department of Hematology, Medical Center Leeuwarden , Leeuwarden , The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bas B","family":"Oude Munnink","sequence":"additional","affiliation":[{"name":"Department of Viroscience, Erasmus MC, University Medical Center , Rotterdam , The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P Martin","family":"Van Hagen","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Immunology, Erasmus MC, University Medical Center , Rotterdam , The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susanne","family":"Bogers","sequence":"additional","affiliation":[{"name":"Department of Viroscience, Erasmus MC, University Medical Center , Rotterdam , The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Corine H","family":"Geurtsvankessel","sequence":"additional","affiliation":[{"name":"Department of Viroscience, Erasmus MC, University Medical Center , Rotterdam , The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3343-9610","authenticated-orcid":false,"given":"Bart J A","family":"Rijnders","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Section of Infectious Diseases and Department of Medical Microbiology and Infectious Diseases, Erasmus MC, University Medical Center , Dr. Molewaterplein 40 3015 GD, Rotterdam , The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2023,5,30]]},"container-title":["Journal of Antimicrobial Chemotherapy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/jac\/article-pdf\/78\/7\/1644\/50792365\/dkad144.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jac\/article-pdf\/78\/7\/1644\/50792365\/dkad144.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,7,5]],"date-time":"2023-07-05T07:57:03Z","timestamp":1688543823000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jac\/article\/78\/7\/1644\/7185842"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,5,30]]},"references-count":0,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2023,5,30]]},"published-print":{"date-parts":[[2023,7,5]]}},"URL":"https:\/\/doi.org\/10.1093\/jac\/dkad144","relation":{},"ISSN":["0305-7453","1460-2091"],"issn-type":[{"value":"0305-7453","type":"print"},{"value":"1460-2091","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2023,7]]},"published":{"date-parts":[[2023,5,30]]}}}