Zhang YX, Tang J, Zhu D, Wu CY, Liang ML, Huang YT. Prolonged course of Paxlovid administration in a centenarian with COVID-19: A case report. World J Radiol 2024; 16(9): 489-496 [PMID: 39355387 DOI: 10.4329/wjr.v16.i9.489]
Corresponding Author of This Article
Yuan-Tao Huang, Doctor, Chief Doctor, Department of Healthcare, Haikou Affiliated Hospital of Central South University Xiangya School of Medicine, No. 43 Renmin Avenue, Meilan District, Haikou 570208, Hainan Province, China. hyt951232@163.com
Research Domain of This Article
Pharmacology & Pharmacy
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Radiol. Sep 28, 2024; 16(9): 489-496 Published online Sep 28, 2024. doi: 10.4329/wjr.v16.i9.489
Prolonged course of Paxlovid administration in a centenarian with COVID-19: A case report
Yi-Xue Zhang, Juan Tang, Dan Zhu, Chun-Yan Wu, Mei-Lan Liang, Yuan-Tao Huang
Yi-Xue Zhang, Juan Tang, Chun-Yan Wu, Mei-Lan Liang, Yuan-Tao Huang, Department of Healthcare, Haikou Affiliated Hospital of Central South University Xiangya School of Medicine, Haikou 570208, Hainan Province, China
Dan Zhu, Department of Healthcare, Hainan Chengmei Hospital, Haikou 570000, Hainan Province, China
Author contributions: Zhang YX collected and recorded patient data and wrote the manuscript; Tang J, Zhu D, Wu CY, Liang ML reviewed the literature; Huang YT modified the manuscript. All authors have read and approved the final manuscript.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yuan-Tao Huang, Doctor, Chief Doctor, Department of Healthcare, Haikou Affiliated Hospital of Central South University Xiangya School of Medicine, No. 43 Renmin Avenue, Meilan District, Haikou 570208, Hainan Province, China. hyt951232@163.com
Received: July 30, 2024 Revised: August 27, 2024 Accepted: September 10, 2024 Published online: September 28, 2024 Processing time: 58 Days and 16.1 Hours
Abstract
BACKGROUND
According to the population statistics in 2023, there were 110000 people aged over 100 years in China, and the experience of using Paxlovid (nirmatrelvir/ritonavir) for centenarians is particularly valuable. This article reports our experience of using Paxlovid in a centenarian with the novel coronavirus disease 2019 (COVID-19) infection.
CASE SUMMARY
A 103-year-old female with mild COVID-19 and renal insufficiency was given sufficient Paxlovid for 2 days and a half dose for 3 days. During treatment, the patient was complicated with lung infection and heart failure, and nucleic acid remained positive. After expert consultation, a full dose of Paxlovid was given again on the 9th day of admission for 2 days and a half dose for 3 days. Meanwhile, anti-heart failure and antibiotics were administered; the heart failure and pulmonary infection were improved. Finally, on the 33th day of admission, nucleic acid turned negative, body temperature returned to normal, cough and sputum, fatigue, poor appetite and other symptoms basically improved. The patient was given Paxlovid via nasal feeding for 2 courses without deterioration of liver and kidney function, diarrhea, nausea and vomiting, myalgia, chest tightness and other side effects, and was discharged from hospital with good recovery.
CONCLUSION
This case suggests that Paxlovid can be used cautiously in centenarians with renal insufficiency and two courses of treatment can be considered in patients with persistent positive nucleic acid.
Core Tip: We report a 103-year-old female with renal insufficiency and a history of hypertension. The patient was treated with two courses of Paxlovid at a full dose for 2 days and a half dose for 3 days. Although she had lung infection and heart failure during the treatment, they all improved after treatment and she was discharged from hospital 40 days after admission. This case suggested that Paxlovid can be applied cautiously in centenarians with coronavirus disease 2019 patients with renal insufficiency, and but the liver and kidney function of the patient should be closely monitored.
