Frontiers in Oncology (Sep 2020)

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

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

DOI
https://doi.org/10.3389/fonc.2020.01578
Journal volume & issue
Vol. 10

Abstract

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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.

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