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Protracted severe COVID-19 pneumonia following rituximab treatment: caution needed
The outcomes of COVID-19 in patients treated with biologic agents are a subject of intense investigation. Recent data indicated that patients under rituximab (RTX) may carry an increased risk of serious disease. We performed an electronic search in Medline and Scopus using the keywords rituximab and...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer Berlin Heidelberg
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8373601/ https://www.ncbi.nlm.nih.gov/pubmed/34409510 http://dx.doi.org/10.1007/s00296-021-04969-2 |
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author | Daoussis, Dimitrios Leonidou, Lydia Kalogeropoulou, Christina Paliogianni, Fotini Tzouvelekis, Argyrios |
author_facet | Daoussis, Dimitrios Leonidou, Lydia Kalogeropoulou, Christina Paliogianni, Fotini Tzouvelekis, Argyrios |
author_sort | Daoussis, Dimitrios |
collection | PubMed |
description | The outcomes of COVID-19 in patients treated with biologic agents are a subject of intense investigation. Recent data indicated that patients under rituximab (RTX) may carry an increased risk of serious disease. We performed an electronic search in Medline and Scopus using the keywords rituximab and COVID-19. We present a rare case of severe, protracted COVID-19 pneumonia in a patient with mixed connective tissue disease (MCTD) who was infected a few days following RTX treatment. In a relevant literature search, we identified 18 cases of patients with rheumatic diseases (6 RA, 8 ANCA vasculitis, 3 systemic sclerosis and 1 polymyositis) treated with RTX who experienced an atypical and/or prolonged course of COVID-19 pneumonia with no evidence of cytokine storm. Our case indicates that RTX may unfavorably affect outcomes following SARS-CoV-2 infection. B cell depletion may dampen the humoral response against the virus; we may hypothesize that B cell-depleted patients may be protected from cytokine storm but on the other hand may have difficulties in virus clearance leading to a protracted course. Taking into account that COVID-19 vaccines are available we may consider delaying RTX infusions at least in patients without life threatening disease, until vaccination is completed. |
format | Online Article Text |
id | pubmed-8373601 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Springer Berlin Heidelberg |
record_format | MEDLINE/PubMed |
spelling | pubmed-83736012021-08-19 Protracted severe COVID-19 pneumonia following rituximab treatment: caution needed Daoussis, Dimitrios Leonidou, Lydia Kalogeropoulou, Christina Paliogianni, Fotini Tzouvelekis, Argyrios Rheumatol Int Case Based Review The outcomes of COVID-19 in patients treated with biologic agents are a subject of intense investigation. Recent data indicated that patients under rituximab (RTX) may carry an increased risk of serious disease. We performed an electronic search in Medline and Scopus using the keywords rituximab and COVID-19. We present a rare case of severe, protracted COVID-19 pneumonia in a patient with mixed connective tissue disease (MCTD) who was infected a few days following RTX treatment. In a relevant literature search, we identified 18 cases of patients with rheumatic diseases (6 RA, 8 ANCA vasculitis, 3 systemic sclerosis and 1 polymyositis) treated with RTX who experienced an atypical and/or prolonged course of COVID-19 pneumonia with no evidence of cytokine storm. Our case indicates that RTX may unfavorably affect outcomes following SARS-CoV-2 infection. B cell depletion may dampen the humoral response against the virus; we may hypothesize that B cell-depleted patients may be protected from cytokine storm but on the other hand may have difficulties in virus clearance leading to a protracted course. Taking into account that COVID-19 vaccines are available we may consider delaying RTX infusions at least in patients without life threatening disease, until vaccination is completed. Springer Berlin Heidelberg 2021-08-19 2021 /pmc/articles/PMC8373601/ /pubmed/34409510 http://dx.doi.org/10.1007/s00296-021-04969-2 Text en © The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2021 This article is made available via the PMC Open Access Subset for unrestricted research re-use and secondary analysis in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the World Health Organization (WHO) declaration of COVID-19 as a global pandemic. |
spellingShingle | Case Based Review Daoussis, Dimitrios Leonidou, Lydia Kalogeropoulou, Christina Paliogianni, Fotini Tzouvelekis, Argyrios Protracted severe COVID-19 pneumonia following rituximab treatment: caution needed |
title | Protracted severe COVID-19 pneumonia following rituximab treatment: caution needed |
title_full | Protracted severe COVID-19 pneumonia following rituximab treatment: caution needed |
title_fullStr | Protracted severe COVID-19 pneumonia following rituximab treatment: caution needed |
title_full_unstemmed | Protracted severe COVID-19 pneumonia following rituximab treatment: caution needed |
title_short | Protracted severe COVID-19 pneumonia following rituximab treatment: caution needed |
title_sort | protracted severe covid-19 pneumonia following rituximab treatment: caution needed |
topic | Case Based Review |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8373601/ https://www.ncbi.nlm.nih.gov/pubmed/34409510 http://dx.doi.org/10.1007/s00296-021-04969-2 |
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