tetano
Editor, Senior Moderator
Cureus
. 2022 Dec 14;14(12):e32523.
doi: 10.7759/cureus.32523. eCollection 2022 Dec.
Prolonged COVID-19 in a Multiple Sclerosis Patient Treated With Rituximab
Nikos Kintrilis[SUP] 1 [/SUP], Charilaos P Gkinos[SUP] 2 [/SUP], Iosif Galinos[SUP] 3 [/SUP]
Affiliations
Abstract
Immunocompromised patients commonly present prolonged viral shedding of the novel coronavirus SARS-CoV-2, detected through reverse transcriptase-polymerase chain reaction (RT-PCR) in nasopharyngeal or oropharyngeal swabs. The detection and estimation of the viral load in patients with COVID-19 is of utmost importance, not only for the effective isolation of the patient but also from a therapeutic point of view. In the current study, we present the case of an immunocompromised patient receiving rituximab infusions for the treatment of multiple sclerosis who exhibited COVID-19 clinical symptomatology for an extended period of time along with prolonged viral shedding while at the same time being unable to organize sufficient humoral immunity. Despite being fully vaccinated and having suffered symptomatic SARS-CoV-2 infections, antibodies against the virus remained undetected. Clinical relapse of his symptoms led to the trialing of a multitude of therapeutic interventions in order to combat the disease, with an extended remdesivir regimen proving the most efficacious in the alleviation of his symptoms. This case demonstrates how immunocompromised COVID-19 patients should be regarded under a different scope when it comes to the diagnosis, management, and resolution of their SARS-CoV-2 infection.
Keywords: coronavirus disease; covid-19; humoral immunity; immunosuppression; long covid; novel coronavirus; remdesivir; rituximab; sars-cov-2; vaccine.
. 2022 Dec 14;14(12):e32523.
doi: 10.7759/cureus.32523. eCollection 2022 Dec.
Prolonged COVID-19 in a Multiple Sclerosis Patient Treated With Rituximab
Nikos Kintrilis[SUP] 1 [/SUP], Charilaos P Gkinos[SUP] 2 [/SUP], Iosif Galinos[SUP] 3 [/SUP]
Affiliations
- PMID: 36654638
- PMCID: PMC9840416
- DOI: 10.7759/cureus.32523
Abstract
Immunocompromised patients commonly present prolonged viral shedding of the novel coronavirus SARS-CoV-2, detected through reverse transcriptase-polymerase chain reaction (RT-PCR) in nasopharyngeal or oropharyngeal swabs. The detection and estimation of the viral load in patients with COVID-19 is of utmost importance, not only for the effective isolation of the patient but also from a therapeutic point of view. In the current study, we present the case of an immunocompromised patient receiving rituximab infusions for the treatment of multiple sclerosis who exhibited COVID-19 clinical symptomatology for an extended period of time along with prolonged viral shedding while at the same time being unable to organize sufficient humoral immunity. Despite being fully vaccinated and having suffered symptomatic SARS-CoV-2 infections, antibodies against the virus remained undetected. Clinical relapse of his symptoms led to the trialing of a multitude of therapeutic interventions in order to combat the disease, with an extended remdesivir regimen proving the most efficacious in the alleviation of his symptoms. This case demonstrates how immunocompromised COVID-19 patients should be regarded under a different scope when it comes to the diagnosis, management, and resolution of their SARS-CoV-2 infection.
Keywords: coronavirus disease; covid-19; humoral immunity; immunosuppression; long covid; novel coronavirus; remdesivir; rituximab; sars-cov-2; vaccine.