{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,11]],"date-time":"2025-09-11T21:14:48Z","timestamp":1757625288498,"version":"3.44.0"},"reference-count":11,"publisher":"American Society for Microbiology","issue":"2","license":[{"start":{"date-parts":[[2025,3,4]],"date-time":"2025-03-04T00:00:00Z","timestamp":1741046400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,3,4]],"date-time":"2025-03-04T00:00:00Z","timestamp":1741046400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.asm.org\/non-commercial-tdm-license"}],"content-domain":{"domain":["journals.asm.org"],"crossmark-restriction":true},"short-container-title":["ASM Case Rep"],"published-print":{"date-parts":[[2025,3,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n          <jats:sec>\n            <jats:title\/>\n            <jats:sec>\n              <jats:title>Background<\/jats:title>\n              <jats:p>Immunocompromised individuals are infected with persistent severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and often refractory to treatment.<\/jats:p>\n            <\/jats:sec>\n            <jats:sec>\n              <jats:title>Case Summary<\/jats:title>\n              <jats:p>A 56-year-old woman undergoing chemotherapy for follicular lymphoma experienced relapsing pulmonary infiltrates and a consistently low cycle threshold value of nasal swab SARS-CoV-2 PCR over a 5-month period. Despite repeated remdesivir and glucocorticoid therapy, her respiratory symptoms worsened and progressed to respiratory failure. Viral genome analysis revealed that the variant strain at onset was XBB, whereas the strains repeatedly detected more than 2 months after onset were XBB.2.3.<\/jats:p>\n            <\/jats:sec>\n            <jats:sec>\n              <jats:title>Conclusion<\/jats:title>\n              <jats:p>The genome analysis indicated that genomic mutations accumulate due to continuous XBB infection. The patient recovered after treatment with nirmatrelvir\/ritonavir for 20 days.<\/jats:p>\n            <\/jats:sec>\n          <\/jats:sec>","DOI":"10.1128\/asmcr.00049-24","type":"journal-article","created":{"date-parts":[[2025,1,21]],"date-time":"2025-01-21T09:00:12Z","timestamp":1737450012000},"update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":0,"title":["Refractory pneumonia due to persistent SARS-CoV-2 infection in an immunocompromised host successfully treated with extended course nirmatrelvir\/ritonavir"],"prefix":"10.1128","volume":"1","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9184-5679","authenticated-orcid":false,"given":"Shiro","family":"Sonoda","sequence":"first","affiliation":[{"name":"Department of Respiratory Medicine, Institute of Science Tokyo","place":["Tokyo, Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8417-5577","authenticated-orcid":true,"given":"Sho","family":"Shimada","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, Institute of Science Tokyo","place":["Tokyo, Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Atsushi","family":"Sawada","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, Institute of Science Tokyo","place":["Tokyo, Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tomoka","family":"Yasuda","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, Institute of Science Tokyo","place":["Tokyo, Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tsuyoshi","family":"Shirai","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, Institute of Science Tokyo","place":["Tokyo, Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Haruhiko","family":"Furusawa","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, Institute of Science Tokyo","place":["Tokyo, Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yukie","family":"Tanaka","sequence":"additional","affiliation":[{"name":"Department of Molecular Microbiology and Immunology, Graduate School of Medical and Dental Sciences, Institute of Science Tokyo","place":["Tokyo, Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kousuke","family":"Tanimoto","sequence":"additional","affiliation":[{"name":"Department of High-risk Infectious Disease Control, Institute of Science Tokyo","place":["Tokyo, Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hiroaki","family":"Takeuchi","sequence":"additional","affiliation":[{"name":"Department of High-risk Infectious Disease Control, Institute of Science Tokyo","place":["Tokyo, Japan"]},{"name":"Institute of Science Tokyo, Center for Infectious Disease Education and Analysis (TCIDEA)","place":["Tokyo, Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9073-9815","authenticated-orcid":true,"given":"Yasunari","family":"Miyazaki","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, Institute of Science Tokyo","place":["Tokyo, Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"235","reference":[{"key":"e_1_3_1_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(23)00815-0"},{"key":"e_1_3_1_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijid.2020.12.050"},{"key":"e_1_3_1_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.eclinm.2023.102040"},{"key":"e_1_3_1_5_2","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciac868"},{"key":"e_1_3_1_6_2","doi-asserted-by":"publisher","DOI":"10.1093\/ofid\/ofad189"},{"key":"e_1_3_1_7_2","unstructured":"Minister of Health Labour and Welfare. 2023 Guidelines for the clinical management of COVID-19. Available from: https:\/\/www.mhlw.go.jp\/content\/000936655.pdf"},{"key":"e_1_3_1_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijid.2023.09.021"},{"key":"e_1_3_1_9_2","doi-asserted-by":"publisher","DOI":"10.3390\/v15020291"},{"key":"e_1_3_1_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jiac.2022.02.006"},{"key":"e_1_3_1_11_2","doi-asserted-by":"publisher","DOI":"10.1002\/ueg2.12417"},{"key":"e_1_3_1_12_2","doi-asserted-by":"publisher","DOI":"10.1093\/ofid\/ofac382"}],"container-title":["ASM Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.asm.org\/doi\/pdf\/10.1128\/asmcr.00049-24","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.asm.org\/doi\/pdf\/10.1128\/asmcr.00049-24","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,9]],"date-time":"2025-09-09T17:28:40Z","timestamp":1757438920000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.asm.org\/doi\/10.1128\/asmcr.00049-24"}},"subtitle":[],"editor":[{"given":"Nicholas M.","family":"Moore","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2025,3,4]]},"references-count":11,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2025,3,4]]}},"alternative-id":["10.1128\/asmcr.00049-24"],"URL":"https:\/\/doi.org\/10.1128\/asmcr.00049-24","relation":{},"ISSN":["2996-2684"],"issn-type":[{"type":"electronic","value":"2996-2684"}],"subject":[],"published":{"date-parts":[[2025,3,4]]},"assertion":[{"value":"2024-09-29","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-12-16","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-01-21","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e00049-24"}}