AUTHOR=Martínez-Chinchilla Carlos , Vazquez-Montero Lucía , Palazón-Carrión Natalia , Fernández-Román Isabel M. , López-Barba José , de la Cruz-Merino Luis , Rodríguez-Baño Jesús , Palacios-Baena Zaira R. 

TITLE=Persistence of SARS-CoV-2 Infection in Severely Immunocompromised Patients With Complete Remission B-Cell Lymphoma and Anti-CD20 Monoclonal Antibody Therapy: A Case Report of Two Cases

JOURNAL=Frontiers in Immunology

VOLUME=Volume 13 - 2022

YEAR=2022

URL=https://www.frontiersin.org/journals/immunology/articles/10.3389/fimmu.2022.860891

DOI=10.3389/fimmu.2022.860891

ISSN=1664-3224

ABSTRACT=Immunosuppressant conditions such as hematological malignancies increase the risk of severe SARS-CoV-2 infection. It has been described in the literature that patients on anti-CD20 maintenance therapies for lymphoid malignancies are susceptible of having recurrent flares together with viral replication or re-infections, although these cases are scarce. These patients are not well represented in randomized controlled trials and as a consequence, the evidence for the use of certain treatments in this scenario is lacking. We present two cases of patients with B-cell lymphoma on remission and treated with rituximab on maintenance. They developed at least 1 flare of COVID-19 after acute infection and always after receiving rituximab. RT-PCR was positive in nasopharyngeal swab and also in plasma. Patients were treated during flares with remdesivir, hyperimmune plasma and corticosteroids. These two cases showed the unresolved problem of COVID-19 in immunosuppressant patients and showed that despite the vast amount of information available on SARS-CoV-2, information in this subgroup of patients is lacking.