biostudies-literatureBolis MFondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico359https://www.ebi.ac.uk/biostudies/studies/S-EPMC11907959biostudies-literatureUnknown25(1)<h4>Background</h4>Prolonged SARS-CoV-2 infection observed in immunocompromised individuals even in the presence of antiviral treatment provides opportunities for viruses to evolve in immune escape and drug-resistant variants.<h4>Case presentation</h4>A 72-year-old male with IgG4-related disease was admitted to the Emergency Department of a city Hospital in Milan and then transferred to Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico in December 2023, due to respiratory distress due to SARS-CoV-2 infection diagnosed in November 2023. After 117 days since the onset of the infection, and two cycles of sotrovimab/remdesivir combined therapy, the clinical improvement allowed the hospital discharge, notwithstanding the persistent SARS-CoV-2 positivity. Fifteen days later, the patient BMC infectious diseasesSARS-CoV-2 genomic evolution during a severe and long-lasting omicron infection under antiviral therapy.PMC11907959STOP-COVIDPastena AAlagna LAlteri CUceda Renteria SMuscatello ALiparoti APasserini BZBandera ABolis MCallegaro AParisi AfalseSARS-CoV-2 genomic evolution during a severe and long-lasting omicron infection under antiviral therapy.<h4>Background</h4>Prolonged SARS-CoV-2 infection observed in immunocompromised individuals even in the presence of antiviral treatment provides opportunities for viruses to evolve in immune escape and drug-resistant variants.<h4>Case presentation</h4>A 72-year-old male with IgG4-related disease was admitted to the Emergency Department of a city Hospital in Milan and then transferred to Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico in December 2023, due to respiratory distress due to SARS-CoV-2 infection diagnosed in November 2023. After 117 days since the onset of the infection, and two cycles of sotrovimab/remdesivir combined therapy, the clinical improvement allowed the hospital discharge, notwithstanding the persistent SARS-CoV-2 positivity. Fifteen days later, the patient 2025-01-01T00:00:00Z2025 Mar2025-04-04T14:47:59.864Z2025-04-04T14:47:59.864ZS-EPMC119079594008278410.1186/s12879-025-10740-w