Prolonged SARS-CoV-2 Infection in Patients Receiving Anti-CD20 Monoclonal Antibodies: A Diagnostic Challenged by Negative Nasopharyngeal RT-PCR and Successful Treatment with COVID-19 High-Titer Convalescent Plasma

Viruses. 2023 Nov 7;15(11):2220. doi: 10.3390/v15112220.

Abstract

We highlighted in this current paper similar prolonged respiratory presentation with COVID-19 pneumonia in four severely immunocompromised patients currently being treated with anti-CD20 monoclonal antibodies (mAbs), such as ocrelizumab and rituximab, for multiple sclerosis or rheumatoid polyarthritis. Real-time reverse transcription-polymerase chain reaction on a nasopharyngeal swab specimen was negative in all patients. SARS-CoV-2 infection was confirmed from bronchoalveolar lavage fluid. A high titer of post-vaccine COVID-19 convalescent plasma was administered with complete recovery in all patients.

Keywords: COVID-19; SARS-CoV-2; convalescent plasma; humoral immunity; ocrelizumab; rituximab.

Publication types

  • Case Reports

MeSH terms

  • Antibodies, Monoclonal / therapeutic use
  • Antibodies, Viral
  • Antineoplastic Agents*
  • COVID-19 Serotherapy
  • COVID-19 Testing
  • COVID-19* / diagnosis
  • COVID-19* / therapy
  • Humans
  • Nasopharynx
  • Reverse Transcriptase Polymerase Chain Reaction
  • SARS-CoV-2 / genetics

Substances

  • Antibodies, Monoclonal
  • Antineoplastic Agents
  • Antibodies, Viral

Grants and funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.