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The Longest Persistence of Viable SARS-CoV-2 With Recurrence of Viremia and Relapsing Symptomatic COVID-19 in an Immunocompromised Patient-A Case Study.

Chiara SepulcriChiara DentoneMalgorzata MikulskaBianca BruzzoneAlessia LaiDaniela FenoglioFederica BozzanoAnnalisa BergnaAlessia ParodiTiziana AltosoleEmanuele DelfinoGiulia BartalucciAndrea OrsiAntonio Di BiagioGiangluglielmo ZehenderFilippo BalleriniStefano BonoraAlessandro SetteRaffaele De PalmaGuido SilvestriAndrea De MariaMatteo Bassetti
Published in: Open forum infectious diseases (2021)
In our patient, SARS-CoV-2 persisted with proven infectivity for >8 months. Viremia was associated with COVID-19 relapses, and remdesivir treatment was effective in viremia clearance and symptom remission, although it was unable to clear the virus from the upper respiratory airways. During the viremic phase, we observed a low frequency of terminal effector CD8+ T lymphocytes in peripheral blood; these are probably recruited in inflammatory tissue for viral eradication. In addition, we found a high level of NK-cell repertoire perturbation with relevant involvement during SARS-CoV-2 viremia.
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