Recovery from severe persistent COVID-19 without evidence of an anti-SARS-CoV-2 antibody response in a man with mantle cell lymphoma treated with rituximab

Horiuchi, Hiroki; Sasaki, Hiroaki; Miyazaki, Kazuhito; Miyata, Nobuyuki; Yoshimura, Yukihiro; Tachikawa, Natsuo

doi:10.1016/j.jiac.2021.11.018

Cited by 8 publications

(6 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…However, several case reports of persistent COVID-19 have shown that immunocompromised patients did not improve with remdesivir alone ( 1 , 3 - 6 , 8 , 12 , 15 , 16 ). In a recent report of patients hospitalized with COVID-19, REGEN-COV reduced the 28-day mortality rate ( 29 ).…”

Section: Discussionmentioning

confidence: 99%

“…Persistent SARS-CoV-2 infection may occur in immunocompromised individuals, and these patients tend to remain infectious for !3 weeks. Table 2 lists reported cases of persistent SARS-CoV-2 infection in patients under anti-CD20 therapy, including this case (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15). Most case reports are of malignant lymphoma or chronic lymphocytic leukemia, and rarely of other diseases.…”

Section: Discussionmentioning

confidence: 99%

“…The coronavirus disease 2019 (COVID-19) pandemic continues to affect the global population. There have been several reports of immunocompromised patients developing persistent and prolonged severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16).…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Persistent SARS-CoV-2 Infection in a Patient with Nephrotic Syndrome under Rituximab Therapy: Successful Treatment with a Combination of Remdesivir and Monoclonal Antibodies

et al. 2022

View full text Add to dashboard Cite

Rituximab is an effective treatment for frequently relapsing/steroid-dependent nephrotic syndrome, but there is concern about infections caused by humoral immunodeficiency. We herein report a case of prolonged (>7 weeks) severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. A 24-year-old man with minimal-change disease treated with rituximab developed SARS-CoV-2 infection. The clinical response to remdesivir was soon transiently abolished. Treatment with casirivimab and imdevimab (REGEN-COV) monoclonal antibodies in combination with remdesivir resulted in complete clearance of the infection. The REGEN-COV antibody cocktail may improve the outcome of SARS-CoV-2 infection in patients with humoral immunodeficiency.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Persistent SARS-CoV-2 Infection in a Patient with Nephrotic Syndrome under Rituximab Therapy: Successful Treatment with a Combination of Remdesivir and Monoclonal Antibodies

et al. 2022

View full text Add to dashboard Cite

show abstract

“…The appropriateness of using anti-CD20 monoclonal antibody rituximab remains controversial because of its negative impact on the production of nAb against COVID-19, 21–23 although the role of nAb in patients recovering from COVID-19 infection also remains controversial. 10 , 21 , 24 Because of the high risk of thrombotic complications with COVID-19 infection, 25 , 26 the use of thrombopoietin receptor agonists when managing ITP during infection with COVID-19 requires caution. Of the 13 reported patients, 4 received prophylactic anticoagulants and none reported thrombotic complications.…”

Section: Discussionmentioning

confidence: 99%

Clinical Implication of the Effect of the Production of Neutralizing Antibodies Against SARS-Cov-2 for Chronic Immune Thrombocytopenia Flare-Up Associated with COVID-19 Infection: A Case Report and the Review of Literature

Maekura¹,

Muramatsu²,

Nagata³

et al. 2022

IDR

View full text Add to dashboard Cite

Previous studies have demonstrated that the appropriate production of serum anti-severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2) neutralizing antibody (nAb) plays a critical role in the recovery from coronavirus disease 2019 (COVID-19); however, the role of nAb production in the recovery from a flare-up of chronic immune thrombocytopenia (ITP) has been unknown. We here report the first retrospectively investigated case of serum anti-SARS-Cov-2 nAb production during chronic ITP flare-up triggered by COVID-19. A 79-year-old woman with a history of corticosteroid-refractory ITP visited our hospital complaining of fever, cough, and sore throat for 4 days. Although chronic ITP was controlled by 12.5 mg of eltrombopag (EPAG) every other day, laboratory tests showed a decreased peripheral blood platelet count of 15.0 × 10 9 /L, which indicated worsening thrombocytopenia. Meanwhile, PCR testing of a nasopharyngeal swab revealed that the patient was positive for SARS-Cov-2, and a computed tomography scan revealed bilateral pneumonia. On the basis of the flare-up of chronic ITP associated with COVID-19 pneumonia which was determined as a moderately severe status according to the WHO clinical progression scale, intravenous immunoglobulin therapy for 5 days (days 0–4) and antiviral therapy were added on top of EPAG, which only resulted in a transient increase in the platelet count for several days. After decreasing to 8.0 × 10 9 /L on day 13, the platelet count increased from day 16, coinciding with a positive detection for serum nAb against SARS-Cov-2. Although the increased dose up to 50 mg/day of EPAG was challenged during the clinical course, rapid dose reduction did not cause another relapse. In addition, no thrombotic or bleeding event was seen. These collectively suggest the vital role of the production of anti-SARS-Cov-2 nAb and improvement of clinical symptoms for recovery from a flare-up of chronic ITP in our case.

show abstract

“…Four patients cleared SARS-CoV-2, and one patient passed away after a prolonged hospital stay after. Another case was successfully treated with interferon beta-1b in combination with RDV and IVIg [74].…”

Section: Othermentioning

confidence: 99%

Immunocompromised Patients with Protracted COVID-19: a Review of “Long Persisters”

2022

View full text Add to dashboard Cite

Purpose of Review Certain immunocompromised individuals are at risk for protracted COVID-19, in which SARS-CoV-2 leads to a chronic viral infection. However, the pathogenesis, diagnosis, and management of this phenomenon remain ill-defined. Recent Findings Herein, we review key aspects of protracted SARS-CoV-2 infection in immunocompromised individuals, or the so-called long persisters, and describe the clinical presentation, risk factors, diagnosis, and treatment modalities of this condition, as well as intra-host viral evolution. Based on the available data, we also propose a framework of criteria with which to approach this syndrome. Summary Protracted COVID-19 is an uncharacterized syndrome affecting patients with B-cell depletion; our proposed diagnostic approach and definitions will inform much needed future research.

show abstract

Recovery from severe persistent COVID-19 without evidence of an anti-SARS-CoV-2 antibody response in a man with mantle cell lymphoma treated with rituximab

Cited by 8 publications

References 13 publications

Persistent SARS-CoV-2 Infection in a Patient with Nephrotic Syndrome under Rituximab Therapy: Successful Treatment with a Combination of Remdesivir and Monoclonal Antibodies

Persistent SARS-CoV-2 Infection in a Patient with Nephrotic Syndrome under Rituximab Therapy: Successful Treatment with a Combination of Remdesivir and Monoclonal Antibodies

Clinical Implication of the Effect of the Production of Neutralizing Antibodies Against SARS-Cov-2 for Chronic Immune Thrombocytopenia Flare-Up Associated with COVID-19 Infection: A Case Report and the Review of Literature

Immunocompromised Patients with Protracted COVID-19: a Review of “Long Persisters”

Contact Info

Product

Resources

About