Remdesivir failure with SARS-CoV-2 RNA-dependent RNA-polymerase mutation in a B-cell immunodeficient patient with protracted Covid-19

Clin Infect Dis. 2020 Sep 28;ciaa1474. doi: 10.1093/cid/ciaa1474. Online ahead of print.

Abstract

SARS-CoV-2 is a new pandemic virus for which Remdesivir is the only antiviral available. We report the occurrence of a mutation in the RdRP (D484Y) following failure of remdesivir in a 76-year-old woman with a post-rituximab B-cell immunodeficiency and persistent SARS-CoV-2 viremia. Cure was reached after supplementation with convalescent plasma.

Keywords: COVID-19; CoVID-19 convalescent plasma; Remdesivir; SARS-CoV-2; SARS-CoV-2 RNA-dependent RNA-polymerase mutation.