TY - JOUR
T1 - Successive SARS-CoV-2 mutations in a highly susceptible host
T2 - A case report of persistent viremia and fatality
AU - Danzuka, Yuko
AU - Nakamura, Keiji
AU - Matsumoto, Shinya
AU - Etoh, Yoshitaka
AU - Yamasaki, Sho
AU - Takayama, Koji
AU - Murata, Masayuki
AU - Shimono, Nobuyuki
N1 - Publisher Copyright:
© 2025 Japanese Society of Chemotherapy, Japanese Association for Infectious Diseases, and Japanese Society for Infection Prevention and Control
PY - 2025/7
Y1 - 2025/7
N2 - A 71-year-old female with post-treatment follicular lymphoma developed COVID-19 with persistent viremia. Despite the initiation of remdesivir on day 23, she remained SARS-CoV-2 PCR-positive and ultimately succumbed to respiratory failure on day 79. Whole-genome analysis of RNA extracted from a post-mortem nasopharyngeal swab identified multiple mutations, including P323L/G671S, which enhances viral replication, and V792I, associated with remdesivir resistance. This case highlights the challenges of managing persistent SARS-CoV-2 infection in immunocompromised patients and underscores the impact of delayed treatment and antiviral resistance.
AB - A 71-year-old female with post-treatment follicular lymphoma developed COVID-19 with persistent viremia. Despite the initiation of remdesivir on day 23, she remained SARS-CoV-2 PCR-positive and ultimately succumbed to respiratory failure on day 79. Whole-genome analysis of RNA extracted from a post-mortem nasopharyngeal swab identified multiple mutations, including P323L/G671S, which enhances viral replication, and V792I, associated with remdesivir resistance. This case highlights the challenges of managing persistent SARS-CoV-2 infection in immunocompromised patients and underscores the impact of delayed treatment and antiviral resistance.
KW - Genetic mutations
KW - Immunocompromised patients
KW - Persistent viremia
KW - Remdesivir resistance
KW - SARS-CoV-2
KW - Whole-genome sequencing
UR - https://www.scopus.com/pages/publications/105006611504
UR - https://www.scopus.com/pages/publications/105006611504#tab=citedBy
U2 - 10.1016/j.jiac.2025.102737
DO - 10.1016/j.jiac.2025.102737
M3 - Article
C2 - 40419190
AN - SCOPUS:105006611504
SN - 1341-321X
VL - 31
JO - Journal of Infection and Chemotherapy
JF - Journal of Infection and Chemotherapy
IS - 7
M1 - 102737
ER -
