Post-acute COVID-19 associated with evidence of bystander T-cell activation and a recurring antibiotic-resistant bacterial pneumonia

Abstract

Here, we describe the case of a COVID-19 patient who developed recurring ventilator-associated pneumonia caused by <i>Pseudomonas aeruginosa</i> that acquired increasing levels of antimicrobial resistance (AMR) in response to treatment. Metagenomic analysis revealed the AMR genotype, while immunological analysis revealed massive and escalating levels of T-cell activation. These were both SARS-CoV-2 and <i>P. aeruginosa</i> specific, and bystander activated, which may have contributed to this patient's persistent symptoms and radiological changes.