Remdesivir resistance in renal transplant patients with long COVID-19 researchsquare nyulisom SARSCov2 COVID19 RenalTransplant Remdesivir
By Dr. Priyom Bose, Ph.D.Jul 1 2022Reviewed by Aimee Molineux Scientists have devised various pharmaceutical and non-pharmaceutical strategies to protect individuals from severe acute respiratory syndrome coronavirus-2 , the causal agent of the ongoing coronavirus disease 2019 pandemic.
Remdesivir, a prodrug of the nucleoside analog GS-441524, effectively inhibits the function of RNA-dependent RNA polymerase in multiple RNA viruses. It was the first drug that was approved by the U.S Food and Drug Administration for the treatment of COVID-19. The first patient who received a renal transplant was 60 years of age and had a history of diabetes, vascular disease, and hypertension. The patient underwent a deceased donor kidney transplant after reaching end-stage renal disease . Scientists reported that before the transplant, the patient received two doses of the COVID-19 vaccine . Before the transplant, the patient was subjected to immunosuppressants, such as basiliximab and methylprednisolone.
This patient was also diagnosed with Epstein Barr virus - positive diffuse large B-cell lymphoma , consistent with the monomorphic post-transplant lymphoproliferative disorder and, thereby, chemotherapy was initiated. The patient tested SARS-CoV-2 positive after 110 days after the first COVID-19 diagnosis with Ct of 22.6, and another de novo synonymous mutation in RdRp at K890 was identified.
Implications The current study showed that despite being vaccinated, both patients suffered COVID-19 infection for a prolonged time. Ineffective immune clearance is responsible for persistent viral replication in immunocompromised hosts. This condition also enhances the chances of viral mutation.
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