Persistent viral shedding of severe acute respiratory syndrome coronavirus 2 after treatment with bendamustine and rituximab: A case report

J Infect Chemother. 2022 Jun;28(6):810-813. doi: 10.1016/j.jiac.2022.01.014. Epub 2022 Jan 31.

Abstract

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA is detectable in nasopharyngeal specimens for up to 12-20 days regardless of the presence of chronic diseases in patients. We report a case of prolonged SARS-CoV-2 infection that lasted for more than eight weeks. The patient had persistent lymphopenia after receiving six cycles of bendamustine and rituximab (BR) therapy for follicular lymphoma; the last chemotherapy session was completed nine months before admission. The first nasopharyngeal specimen (NPS) for the SARS-CoV-2 polymerase chain reaction assay tested positive for the N501Y variant five weeks before admission. The patient's general and respiratory conditions gradually worsened; therefore, he was admitted to our hospital, and the same SARS-CoV-2 variant was subsequently identified on admission. Treatment for coronavirus disease was initiated, and the patient's condition improved; however, the NPS tested positive on day 15. The patient was discharged on day 28 and was instructed to isolate at home for a month. Hence, possible prolonged SARS-CoV-2 shedding should be considered in patients who receive BR therapy.

Keywords: Bendamustine; COVID-19; Persistent infection; Rituximab; SARS-CoV-2; Viral shedding.

Publication types

  • Case Reports

MeSH terms

  • Bendamustine Hydrochloride / therapeutic use
  • COVID-19 Drug Treatment*
  • Humans
  • Male
  • RNA, Viral
  • Rituximab / adverse effects
  • SARS-CoV-2*
  • Virus Shedding

Substances

  • RNA, Viral
  • Rituximab
  • Bendamustine Hydrochloride

Supplementary concepts

  • SARS-CoV-2 variants