Nirmatrelvir/Ritonavir and Subsequent PCR Negativity in Patients With B-Cell Lymphoma and Prolonged SARS-CoV-2 PCR Positivity: A Case Series

Prolonged SARS-CoV-2 PCR positivity is increasingly recognized in immunocompromised patients. We retrospectively analyzed four patients with B-cell lymphoma and prior anti-CD20 antibody therapy who exhibited prolonged PCR positivity after COVID-19 diagnosis. The median duration of PCR positivity was 57 days (range, 47-78 days); lymphoma treatment was interrupted in one patient and could not be resumed in another. Three patients received nirmatrelvir/ritonavir and became PCR negative 5-14 days after treatment initiation. These findings suggest that prolonged SARS-CoV-2 PCR positivity may disrupt lymphoma treatment and that PCR negativity was observed shortly after nirmatrelvir/ritonavir treatment in selected patients.