Intractable Coronavirus Disease 2019 (COVID-19) and Prolonged Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Replication in a Chimeric Antigen Receptor-Modified T-Cell Therapy Recipient: A Case Study

The authors present a case of prolonged SARS-CoV-2 infection in a patient with multiple myeloma who received CAR T cells targeting the B-cell maturation antigen (BCMA). They characterize viral persistence, intrahost viral evolution, and immune profiles from longitudinal samples and demonstrate that the patient experienced high-level SARS-CoV-2 RNAemia and viral replication for > 2 months, viral diversification, and massive lung infection before dying from the infection.