Migratory Pulmonary Infiltrates in a B-Cell-Depleted COVID-19 Patient

Abstract

Wenyan Zhu,1 Tiange Xie,2 Mengru Xu,1 Ruxuan Chen,1 Ting Zhang1 1Department of Pulmonary and Critical Care Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, People’s Republic of China; 2Department of General Practice, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, People’s Republic of ChinaCorrespondence: Ting Zhang; Ruxuan Chen, Email [email protected]; [email protected]: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is still rampant around the world. Immunocompromised patients are prone to have long-term infection with coronavirus disease 2019 (COVID-19). However, it is difficult to decide on an appropriate treatment for persistent SARS-CoV-2 infection.Case Presentation: We present a case of prolonged SARS-CoV-2 infection in a patient who had undergone B-cell depletion therapy. Chest computed tomography (CT) revealed notable migratory pulmonary infiltrates, and bronchoalveolar lavage fluid was positive for SARS-CoV-2 (day-120). The patient responded well to the combination treatment of antiviral medication, convalescent plasma, and corticosteroid.Conclusion: When chest CT shows migratory pulmonary infiltrates in patients with recent COVID-19, it is necessary to be alert to the possibility of persistent SARS-CoV-2 infection, especially in B-cell-depleted immunocompromised patients. Once the diagnosis is confirmed, repeated antiviral therapy and intravenous convalescent plasma should be considered.Keywords: SARS-CoV-2, migratory pulmonary infiltrates, B-cell depletion, antiviral therapy, convalescent plasma

Keywords

• sars-cov-2
• migratory pulmonary infiltrates
• b-cell depletion
• antiviral therapy
• convalescent plasma