{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,15]],"date-time":"2026-04-15T20:03:42Z","timestamp":1776283422864,"version":"3.50.1"},"reference-count":24,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,6,30]],"date-time":"2025-06-30T00:00:00Z","timestamp":1751241600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,6,30]],"date-time":"2025-06-30T00:00:00Z","timestamp":1751241600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Egypt Natl Canc Inst"],"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Background<\/jats:title>\n            <jats:p>Immunocompromised individuals, such as those affected by and treated for hematological malignancies, face a higher risk of prolonged SARS-CoV-2 infection. Increased disease risk is further compounded by limited treatment options. Currently, approved antiviral monotherapies against COVID-19 include remdesivir (Veklury) and nirmatrelvir\/ritonavir (Paxlovid) which have stringent recommended prescribing windows within 7 and 5\u00a0days of symptom onset, respectively. Furthermore, these two antiviral therapies are approved for treatment lengths of 3 (remdesivir) and 5\u00a0days (Paxlovid).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Case presentation<\/jats:title>\n            <jats:p>Herein, we describe the successful treatment of prolonged COVID-19 in a patient with a history of diffuse large B-cell lymphoma with an extended combination therapy; remdesivir and nirmatrelvir\/ritonavir. The patient presented with symptomatic COVID-19 that was unsuccessfully treated with a 10-day course of remdesivir. After 2 months of symptomatic infection, the patient was treated with remdesivir in combination with nirmatrelvir\/ritonavir for 10 days, which quickly resolved the cough and cleared viral load.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion<\/jats:title>\n            <jats:p>Our case highlights the efficacy of administrating a combination treatment of remdesivir and nirmatrelvir\/ritonavir outside recommended guidelines for the treatment of persistent COVID-19 infection in an immunocompromised individual. High-quality studies evaluating the usefulness of this combinatory therapy as a longer-course treatment in patients with neoplasms is warranted.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1186\/s43046-025-00291-1","type":"journal-article","created":{"date-parts":[[2025,6,29]],"date-time":"2025-06-29T23:02:04Z","timestamp":1751238124000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Successful treatment of prolonged COVID-19 with remdesivir and nirmatrelvir\/ritonavir in a patient with a history of diffuse large B-cell lymphoma: a case report"],"prefix":"10.1186","volume":"37","author":[{"given":"Nadia","family":"Bouhamdani","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dominique","family":"Bouhamdani","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cynthia","family":"L\u00e9ger","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Josiane","family":"Stadler","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nancy","family":"Saulnier","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,6,30]]},"reference":[{"issue":"4","key":"291_CR1","doi-asserted-by":"publisher","first-page":"209","DOI":"10.1007\/s40472-022-00385-y","volume":"9","author":"V Dioverti","year":"2022","unstructured":"Dioverti V, Salto-Alejandre S, Haidar G. Immunocompromised Patients with Protracted COVID-19: a Review of \u201cLong Persisters.\u201d Curr Transplant Rep. 2022;9(4):209\u201318.","journal-title":"Curr Transplant Rep"},{"key":"291_CR2","doi-asserted-by":"publisher","unstructured":"Hus, I., Szymczyk, A., Ma\u0144ko, J., & Drozd-Soko\u0142owska, J. COVID-19 in Adult Patients with Hematological Malignancies\u2014Lessons Learned after Three Years of Pandemic. Biology, 2023;12(4):545. https:\/\/doi.org\/10.3390\/biology12040545.","DOI":"10.3390\/biology12040545"},{"issue":"10","key":"291_CR3","doi-asserted-by":"publisher","first-page":"e737","DOI":"10.1016\/S2352-3026(20)30251-9","volume":"7","author":"F Passamonti","year":"2020","unstructured":"Passamonti F, Cattaneo C, Arcaini L, Bruna R, Cavo M, Merli F, et al. Clinical characteristics and risk factors associated with COVID-19 severity in patients with haematological malignancies in Italy: a retrospective, multicentre, cohort study. Lancet Haematol. 2020;7(10):e737\u201345.","journal-title":"Lancet Haematol"},{"issue":"25","key":"291_CR4","doi-asserted-by":"publisher","first-page":"2881","DOI":"10.1182\/blood.2020008824","volume":"136","author":"A Vijenthira","year":"2020","unstructured":"Vijenthira A, Gong IY, Fox TA, Booth S, Cook G, Fattizzo B, et al. Outcomes of patients with hematologic malignancies and COVID-19: a systematic review and meta-analysis of 3377 patients. Blood. 2020;136(25):2881\u201392.","journal-title":"Blood"},{"issue":"10","key":"291_CR5","doi-asserted-by":"publisher","first-page":"2885","DOI":"10.1038\/s41375-021-01302-5","volume":"35","author":"P Ljungman","year":"2021","unstructured":"Ljungman P, de la Camara R, Mikulska M, Tridello G, Aguado B, Zahrani MA, et al. COVID-19 and stem cell transplantation; results from an EBMT and GETH multicenter prospective survey. Leukemia. 2021;35(10):2885\u201394.","journal-title":"Leukemia"},{"issue":"12","key":"291_CR6","doi-asserted-by":"publisher","first-page":"3585","DOI":"10.1038\/s41375-021-01466-0","volume":"35","author":"AM Spanjaart","year":"2021","unstructured":"Spanjaart AM, Ljungman P, de La Camara R, Tridello G, Ortiz-Maldonado V, Urbano-Ispizua A, et al. Poor outcome of patients with COVID-19 after CAR T-cell therapy for B-cell malignancies: results of a multicenter study on behalf of the European Society for Blood and Marrow Transplantation (EBMT) Infectious Diseases Working Party and the European Hematology Association (EHA) Lymphoma Group. Leukemia. 2021;35(12):3585\u20138.","journal-title":"Leukemia"},{"issue":"5","key":"291_CR7","doi-asserted-by":"publisher","first-page":"1927","DOI":"10.1007\/s10787-022-01055-2","volume":"30","author":"F Ferrara","year":"2022","unstructured":"Ferrara F, Zovi A, Trama U, Vitiello A. Nirmatrelvir-remdesivir association for non-hospitalized adults with COVID-19, point of view. Inflammopharmacology. 2022;30(5):1927\u201331.","journal-title":"Inflammopharmacology"},{"key":"291_CR8","unstructured":"OntarioHealth. COVID-19 Treatment (accessed October 3rd, 2024):\u00a0https:\/\/www.ontariohealth.ca\/providing-health-care\/clinical-resources-education\/covid-19\/treatment?source=PDF&name=Ontario-Health-Recommendations-Outpatient-Use-of-Intravenous-Remdesivir-Veklury-in-Adults."},{"issue":"7","key":"291_CR9","doi-asserted-by":"publisher","first-page":"971","DOI":"10.1016\/j.jiac.2022.02.006","volume":"28","author":"M Morishita","year":"2022","unstructured":"Morishita M, Suzuki M, Matsunaga A, Ishizhima K, Yamamoto T, Kuroda Y, et al. Prolonged SARS-CoV-2 infection associated with long-term corticosteroid use in a patient with impaired B-cell immunity. J Infect Chemother. 2022;28(7):971\u20134.","journal-title":"J Infect Chemother"},{"issue":"6","key":"291_CR10","doi-asserted-by":"publisher","first-page":"455","DOI":"10.1080\/23744235.2022.2028896","volume":"54","author":"M Kajova","year":"2022","unstructured":"Kajova M, Kek\u00e4l\u00e4inen E, Anttila VJ, Paajanen J. Successful treatment with a short course of remdesivir in a case of prolonged COVID-19 in a lymphoma patient. Infect Dis (Lond). 2022;54(6):455\u20139.","journal-title":"Infect Dis (Lond)"},{"issue":"2","key":"291_CR11","doi-asserted-by":"publisher","first-page":"557","DOI":"10.1016\/j.jaci.2021.10.031","volume":"149","author":"LK Brown","year":"2022","unstructured":"Brown LK, Moran E, Goodman A, Baxendale H, Bermingham W, Buckland M, et al. Treatment of chronic or relapsing COVID-19 in immunodeficiency. J Allergy Clin Immunol. 2022;149(2):557-61.e1.","journal-title":"J Allergy Clin Immunol"},{"issue":"6","key":"291_CR12","doi-asserted-by":"publisher","DOI":"10.1016\/j.currproblcancer.2021.100739","volume":"45","author":"H Fujii","year":"2021","unstructured":"Fujii H, Tsuji T, Sugitani M, Matsumoto Y, Yuba T, Tanaka S, et al. Prolonged persistence of SARS-CoV-2 infection during A+AVD therapy for classical Hodgkin\u2019s lymphoma: A case report. Curr Probl Cancer. 2021;45(6): 100739.","journal-title":"Curr Probl Cancer"},{"issue":"4","key":"291_CR13","doi-asserted-by":"publisher","first-page":"ofad189","DOI":"10.1093\/ofid\/ofad189","volume":"10","author":"M Breeden","year":"2023","unstructured":"Breeden M, Aitken SL, Baang JH, Gravelin M, Kaul DR, Lauring AS, et al. Successful Treatment of Prolonged Severe Acute Respiratory Syndrome Coronavirus 2 Infection in Patients With Immunodeficiency With Extended Nirmatrelvir\/Ritonavir: Case Series. Open Forum Infect Dis. 2023;10(4):ofad189.","journal-title":"Open Forum Infect Dis"},{"issue":"5","key":"291_CR14","doi-asserted-by":"publisher","first-page":"926","DOI":"10.1093\/cid\/ciac868","volume":"76","author":"ES Ford","year":"2023","unstructured":"Ford ES, Simmons W, Karmarkar EN, Yoke LH, Braimah AB, Orozco JJ, et al. Successful Treatment of Prolonged, Severe Coronavirus Disease 2019 Lower Respiratory Tract Disease in a B cell Acute Lymphoblastic Leukemia Patient With an Extended Course of Remdesivir and Nirmatrelvir\/Ritonavir. Clin Infect Dis. 2023;76(5):926\u20139.","journal-title":"Clin Infect Dis"},{"issue":"1","key":"291_CR15","doi-asserted-by":"publisher","first-page":"261","DOI":"10.1038\/s43856-024-00668-8","volume":"4","author":"AK Cohen","year":"2025","unstructured":"Cohen AK, Jaudon TW, Schurman EM, Kava L, Vogel JM, Haas-Godsil J, et al. Impact of extended-course oral nirmatrelvir\/ritonavir in established Long COVID: a case series. Communications Medicine. 2025;4(1):261.","journal-title":"Communications Medicine"},{"issue":"1","key":"291_CR16","doi-asserted-by":"publisher","first-page":"564","DOI":"10.1186\/s12879-024-09466-y","volume":"24","author":"S Rotundo","year":"2024","unstructured":"Rotundo S, Berardelli L, Gull\u00ec S, La Gamba V, Lionello R, Russo A, et al. Early initiation of combined therapy in severely immunocompromised patients with COVID-19: a retrospective cohort study. BMC Infect Dis. 2024;24(1):564.","journal-title":"BMC Infect Dis"},{"key":"291_CR17","unstructured":"NIH. COVID-19 Treatment Guidelines Panel. Coronavirus Disease 2019 (COVID-19) Treatment Guidelines. National Institutes of Health. Available at https:\/\/www.covid19treatmentguidelines.nih.gov\/. 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Viruses. 2023;15(7):1577.\u00a0https:\/\/doi.org\/10.3390\/v15071577.","DOI":"10.3390\/v15071577"},{"issue":"11","key":"291_CR22","doi-asserted-by":"publisher","first-page":"1213","DOI":"10.1016\/S1473-3099(24)00353-0","volume":"24","author":"MH Choi","year":"2024","unstructured":"Choi MH, Wan EYF, Wong ICK, Chan EWY, Chu WM, Tam AR, et al. Comparative effectiveness of combination therapy with nirmatrelvir-ritonavir and remdesivir versus monotherapy with remdesivir or nirmatrelvir-ritonavir in patients hospitalised with COVID-19: a target trial emulation study. Lancet Infect Dis. 2024;24(11):1213\u201324.","journal-title":"Lancet Infect Dis"},{"key":"291_CR23","unstructured":"clinicaltrails.gov identifier NCT05587894; OPtimisation of Antiviral Therapy in Immunocompromised COVID-19 Patients: a Randomized Factorial Controlled Strategy Trial (OPTICOV). Updated 2023-03-28; Registration date: 2022-10-17. Clinical Trial Registry:EMA CTIS #CT-2022-501408-81-01. [Available from: https:\/\/clinicaltrials.gov\/study\/NCT05587894."},{"issue":"5","key":"291_CR24","doi-asserted-by":"publisher","first-page":"904","DOI":"10.1002\/hon.3206","volume":"41","author":"Z Pasquini","year":"2023","unstructured":"Pasquini Z, Toschi A, Casadei B, Pellegrini C, D\u2019Abramo A, Vita S, et al. Dual combined antiviral treatment with remdesivir and nirmatrelvir\/ritonavir in patients with impaired humoral immunity and persistent SARS-CoV-2 infection. Hematol Oncol. 2023;41(5):904\u201311.","journal-title":"Hematol Oncol"}],"container-title":["Journal of the Egyptian National Cancer Institute"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s43046-025-00291-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s43046-025-00291-1\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s43046-025-00291-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,6,29]],"date-time":"2025-06-29T23:02:06Z","timestamp":1751238126000},"score":1,"resource":{"primary":{"URL":"https:\/\/jenci.springeropen.com\/articles\/10.1186\/s43046-025-00291-1"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,6,30]]},"references-count":24,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["291"],"URL":"https:\/\/doi.org\/10.1186\/s43046-025-00291-1","relation":{},"ISSN":["2589-0409"],"issn-type":[{"value":"2589-0409","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,6,30]]},"assertion":[{"value":"26 December 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"20 April 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"30 June 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Ethics approval for the case report was obtained from the Vitalit\u00e9 Health Network Ethics Committee (case number 101951). Written informed consent was obtained from the patient for participation.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Written informed consent was obtained from the patient for publication.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"32"}}