TO the Editor—We read with interest the case report by Trottier and colleagues about successfully combining 20 days of nirmatrelvir/ritonavir and remdesivir for treatment of persistent coronavirus disease 2019 (COVID-19), published online in Clinical Infectious Diseases. Another recent publication reported success with a combination of monoclonal antibodies, 7 days of remdesivir, and 5 days of nirmatrelvir/ritonavir. Influenced by the report from Trottier et al, we started using combination treatment in our tertiary referral center and can now report similar outcomes. Eligible for combination treatment are patients who have tested polymerase chain reaction (PCR) positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) for at least 6 weeks despite having received at least 1 course of antiviral treatment, and either have ongoing respiratory symptoms or are being planned to receive severe immuno-suppressive treatment (Table 1).
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