Abstract：
Antiviral agents with activity against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) have played a critical role in disease management; however, little is known regarding the efficacy of these medications in the treatment of SARS-CoV-2 infection in immunocompromised patients, particularly in the management of persistent SARS-CoV-2 positivity. This narrative review discusses the management of persistent coronavirus disease 2019 in immunocompromised hosts, with a focus on antiviral therapies. We identified 84 cases from the literature describing a variety of approaches, including prolonged antiviral therapy (n = 11), combination antivirals (n = 13), and mixed therapy with antiviral and antibody treatments (n = 60). A high proportion had an underlying haematologic malignancy (n = 67, 80%), and were in receipt of anti-CD20 agents (n = 51, 60%). Success was reported in 70 cases (83%) which varied according to the therapy type. Combination therapies with antivirals may be an effective approach for individuals with persistent SARS-CoV-2 positivity, particularly those that incorporate treatments aimed at increasing neutralizing antibody levels. Any novel approaches taken to this difficult management dilemma should be mindful of the emergence of antiviral resistance.
摘要：
具有抗严重急性呼吸道综合征冠状病毒2（SARS-CoV-2）活性的抗病毒药物在疾病管理中发挥了关键作用；然而，关于这些药物在治疗免疫功能低下患者的SARS-CoV-2感染中的疗效知之甚少，特别是在持续SARS-CoV-2阳性的管理中。这篇叙述性综述讨论了2019年持续冠状病毒病在免疫受损宿主中的管理，专注于抗病毒治疗。我们从描述各种方法的文献中确定了84例，包括长期抗病毒治疗（n=11），联合抗病毒药物（n=13），以及抗病毒和抗体治疗的混合治疗（n=60）。高比例患有潜在的血液系统恶性肿瘤（n=67，80％），并接受了抗CD20药物（n=51，60%）。成功报告70例（83％），根据治疗类型而有所不同。抗病毒药物的联合治疗可能是持续SARS-CoV-2阳性个体的有效方法。特别是那些纳入旨在增加中和抗体水平的治疗。任何新的方法采取这种困难的管理困境应该注意抗病毒耐药性的出现。
