Incidence, Clinical Presentation, Relapses and Outcome of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Infection in Patients Treated With Anti-CD20 Monoclonal Antibodies
| Autor: | Isolina Baños-Pérez, María Cristina García Sánchez, Elena Múñez-Rubio, Esther Maderuelo-González, Jorge Calderón-Parra, Ana Fernández-Cruz, Marina Calvo-Salvador, Manuel Valle-Falcones, Antonio Ramos-Martínez, Marcos López-Dosil |
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| Rok vydání: | 2021 |
| Předmět: |
Microbiology (medical)
Infectivity medicine.medical_specialty business.industry medicine.drug_class SARS-CoV-2 Incidence (epidemiology) Mortality rate Incidence Antibodies Monoclonal COVID-19 Retrospective cohort study Antineoplastic Agents Monoclonal antibody Persistence (computer science) Infectious Diseases Recurrence Internal medicine medicine Humans Rituximab Presentation (obstetrics) business medicine.drug Retrospective Studies |
| Zdroj: | Clinical infectious diseases : an official publication of the Infectious Diseases Society of America. 74(10) |
| ISSN: | 1537-6591 |
| Popis: | Background Our objective is to describe the presentation and complications, including relapses, of coronavirus disease 2019 (COVID-19) in patients under anti-CD20 treatments. In addition, to describe viral clearance and determine the safety of reintroducing anti-CD20 treatment. Methods Retrospective cohort study of 422 patients under anti-CD20 treatment that was administered from 1 January 2019 to 31 December 2020. Results Fifty-seven patients were diagnosed with COVID-19 (13.5%). Twenty-five patients (43.9%) required hospital admission. Five patients died (8.8%), and 10 developed severe COVID-19 and acute respiratory distress syndrome. Mortality rate was higher among patients infected during the first 3 months following the last dose of anti-CD20 (14.7% vs 0%, P = .046). The median time of persistence of positive reverse transcription polymerase chain reaction (RT-PCR) was 22 days (IQR 13–40). Nine out of 52 survivors (17.3%) presented relapses. All of them received the last dose of anti-CD20 less than 6 months before the COVID-19 episode. Clinical presentation was fever (n = 8; 88.9%), dyspnea (n = 7; 77.8%), cough (n = 7; 77.8%), worsening of previous infiltrates (n = 5; 55.6%) and new pulmonary infiltrates (n = 8; 88.9%). An increase in lymphocytes with CD4/CD8 ratio inversion was observed in all cases. Among the 25 patients who resumed anti-CD20 drug, 4 (16.0%) presented relapses vs 5/28 among those who did not (17.9%), (P = .857). Conclusions Patients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) during the 6 months after anti-CD20 administration had a worse outcome and a higher mortality rate. The duration of infectivity may be longer. Relapses of COVID-19 occurred in more than 15% and were associated with viral replication. Once the infection is resolved, it is safe to restart treatment with anti-CD20. |
| Databáze: | OpenAIRE |
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