Fig. 1.

Summary of patient’s clinical course and treatment based on the N2 cycle threshold (Ct) values of SARS-CoV-2 in nasopharyngeal swabs (NPS). On day 1, the patient had a fever, cough, and anorexia. The N2 Ct value of a nasopharyngeal swab (NPS) on real-time polymerase chain reaction (RT-PCR) was 23.1, demonstrating a medium viral load. A five-day, single, standard dose of remdesivir therapy achieved defervescence, but the cough remained. The patient was discharged on day 11. On day 26, the fever recurred, and the cough worsened. The patient was readmitted on day 32 with diffuse, bilateral ground-glass opacites and a N2 Ct value on NPS RT-PCR of 28.2, demonstrating a persistent, medium, viral load. Dual antiviral therapy with a three-day standard dose of remdesivir following a five-day course of oral ensitrelvir was begun. On day 36, the fever abated. The patient fully recovered and was finally discharged on day 38 after RT-PCR of NPS returned negative, and the lung lesions had resolved. Thereafter, the patient has been in stable condition, and RT-PCR tests of NPS consistently returned negative. Abbreviations: ND, not detected; CXR, chest X-ray; CT, lung computed tomography.