Prolonged Course of COVID-19-Associated Pneumonia in a B-Cell Depleted Patient After Rituximab

• Published in: Frontiers in oncology Vol. 10; p. 1578
• Main Authors: Kos, Igor, Balensiefer, Benedikt, Roth, Sophie, Ahlgrimm, Manfred, Sester, Martina, Schmidt, Tina, Thurner, Lorenz, Bewarder, Moritz, Bals, Robert, Lammert, Frank, Stilgenbauer, Stephan, Kaddu-Mulindwa, Dominic
• Format: Journal Article
• Language: English
• Published: Frontiers Media S.A 02.09.2020
• Subjects: B-NHL; COVID-19; lymphoma; Oncology; SARS-CoV-2; T-cell activation
• ISSN: 2234-943X; 2234-943X
• DOI: 10.3389/fonc.2020.01578

Patients with pre-existing comorbidities and immunosuppression are at greater risk for SARS-CoV-2 infection and severe manifestations of COVID-19. This also includes cancer patients, who are shown to have a poor prognosis after infection. Here, we describe the case of a 72-year old male patient with B-cell depletion after maintenance treatment with rituximab for non-Hodgkin-lymphoma who had a prolonged COVID-19 course and initial false negative test results. Our case highlights the diagnostic pitfalls in diagnosing COVID-19 in B-cell depleted patients and discuss the role of B-cell depletion in the course and treatment of COVID-19. Furthermore, we investigated peripheral blood monocytes and SARS-CoV-2 specific T cells in our patient. In conclusion, our case report can help physicians to avoid diagnostic pitfalls for COVID-19 in hemato-oncological patients under chemoimmunotherapy and tries to explain the role of B-cell depletion and SARS-CoV-2 specific T cells in this context.Patients with pre-existing comorbidities and immunosuppression are at greater risk for SARS-CoV-2 infection and severe manifestations of COVID-19. This also includes cancer patients, who are shown to have a poor prognosis after infection. Here, we describe the case of a 72-year old male patient with B-cell depletion after maintenance treatment with rituximab for non-Hodgkin-lymphoma who had a prolonged COVID-19 course and initial false negative test results. Our case highlights the diagnostic pitfalls in diagnosing COVID-19 in B-cell depleted patients and discuss the role of B-cell depletion in the course and treatment of COVID-19. Furthermore, we investigated peripheral blood monocytes and SARS-CoV-2 specific T cells in our patient. In conclusion, our case report can help physicians to avoid diagnostic pitfalls for COVID-19 in hemato-oncological patients under chemoimmunotherapy and tries to explain the role of B-cell depletion and SARS-CoV-2 specific T cells in this context.