Prolonged Course of COVID-19-Associated Pneumonia in a B-Cell Depleted Patient After Rituximab
Igor Age Kos, Benedikt Balensiefer, Sophie Roth, Manfred Ahlgrimm, Martina Sester, Tina Schmidt, Lorenz Thurner, Moritz Bewarder, Robert Bals, Frank Lammert, Stephan Stilgenbauer, Dominic Kaddu‐Mulindwa
Abstract
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.