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

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

Martina Sester, Igor Kos, Benedikt Balensiefer, Sophie Roth, Manfred Ahlgrimm, Tina Schmidt, Lorenz Thurner, Moritz Bewarder, Robert Bals, Frank Lammert, Stephan Stilgenbauer, Dominic Kaddu-Mulindwa

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.

2020

covid-19, SARS-CoV-2, lymphoma, T-cell activation, B-NHL

10.3389/fonc.2020.01578

Epidemiology and Health

Korean Society of Epidemiology

Neoplasms. Tumors. Oncology. Including cancer and carcinogens