Key result
Remdesivir triggers SARS-CoV-2 RdRP mutation in an immunodeficient patient, while convalescent plasma achieves viral clearance.
Why the study?
SARS-CoV-2 is a newly discovered virus for which remdesivir is the only antiviral available, prompting reporting on treatment-emergent viral mutations.
Does convalescent plasma supplementation achieve cure in a B-cell immunodeficient patient with persistent SARS-CoV-2 viremia and an emerging remdesivir-associated RdRP mutation?
Population
One 76-year-old female with post-rituximab B-cell immunodeficiency and persistent SARS-CoV-2 viremia
Comparison
Remdesivir treatment followed by convalescent plasma supplementation
Design
Case report
Authors
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May select for RdRP mutations during remdesivir in immunocompromised persistent infection; hypothesis-generating for resistance monitoring.
Case Report (n=1)
Does convalescent plasma supplementation achieve cure in a B-cell immunodeficient patient with persistent SARS-CoV-2 viremia and an emerging remdesivir-associated RdRP mutation?
Convalescent plasma can successfully clear persistent SARS-CoV-2 infection in B-cell immunodeficient patients who develop remdesivir-associated viral mutations.
Martinot et al. (2020) conducted a case report in Protracted Coronavirus Disease 2019 (n=1). Remdesivir and convalescent plasma was evaluated on Occurrence of mutation in RdRP (D484Y) and clinical cure. Treatment with remdesivir in an immunodeficient patient with persistent SARS-CoV-2 viremia led to an RdRP (D484Y) mutation, with cure achieved after convalescent plasma supplementation.
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