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Here, we describe the case of a COVID-19 patient who developed recurring ventilator-associated pneumonia caused by  Pseudomonas aeruginosa  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  P. aeruginosa  specific, and bystander activated, which may have contributed to this patient’s persistent symptoms and radiological changes.

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