Combination treatment of persistent COVID-19 in immunocompromised patients with remdesivir, nirmaltrevir/ritonavir and tixegavimab/cilgavimab

J Microbiol Immunol Infect. 2024 Feb;57(1):189-194. doi: 10.1016/j.jmii.2023.09.004. Epub 2023 Sep 27.

Abstract

We present a retrospective study on the treatment outcomes of severely immunocompromised patients with persistent COVID-19. The study analyzed data from 14 patients who received a combination of tixegavimab/cilgavimab and antiviral medications. Response was evaluated based on symptom improvement, PCR cycle-threshold values, and C-reactive protein levels. Eleven patients achieved complete clinical and virological resolution, while three showed partial responses. The study suggests a potential association between non-response and tixegavimab/cilgavimab neutralization. The findings underscore the need for tailored treatment approaches and further research on optimal strategies for managing persistent COVID-19, as well as the development of antivirals and variant-specific monoclonal antibodies.

Keywords: COVID-19; Immunocompromised; Nirmatrelvir; Remdesivir; Tixegavimab/cilgavimab.

MeSH terms

  • Adenosine Monophosphate / analogs & derivatives*
  • Alanine / analogs & derivatives*
  • Antibodies, Monoclonal
  • Antiviral Agents / therapeutic use
  • COVID-19 Drug Treatment
  • COVID-19*
  • Humans
  • Immunocompromised Host
  • Retrospective Studies
  • Ritonavir* / therapeutic use

Substances

  • remdesivir
  • cilgavimab
  • Ritonavir
  • Antibodies, Monoclonal
  • Antiviral Agents
  • Adenosine Monophosphate
  • Alanine