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
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DOI：
10.3389/fonc.2020.01578
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发表时间：
2020-09-02
影响因子：
4.7
通讯作者：
Kaddu-Mulindwa, Dominic
中科院分区：
文献类型：
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作者：
Kos, Igor;Balensiefer, Benedikt;Kaddu-Mulindwa, Dominic
既有并存和免疫抑制的患者感染SARS-CoV-2和严重的新冠肺炎表现的风险更大。这也包括癌症患者，他们被证明在感染后预后很差。在此，我们描述一位72岁男性非霍奇金淋巴瘤患者，在使用利妥昔单抗维持治疗后出现B细胞耗竭，患者新冠肺炎病程延长，最初的假阴性检测结果为阴性。我们的病例强调了B细胞耗竭患者在诊断新冠肺炎时的诊断缺陷，并讨论了B细胞耗竭在新冠肺炎病程和治疗中的作用。此外，我们还检测了患者的外周血单核细胞和SARS-CoV-2特异性T细胞。总之，我们的病例报告可以帮助医生避免在接受化学免疫治疗的血液肿瘤患者中诊断新冠肺炎的陷阱，并试图解释B细胞耗尽和SARS-CoV-2特异性T细胞在这方面的作用。
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.