Prolonged SARS-CoV-2 infection associated with long-term corticosteroid use in a patient with impaired B-cell immunity
Corticosteroids are widely used to treat severe COVID-19, but in immunocompromised individuals, who are susceptible to persistent infection, long term corticosteroid use may delay viral clearance. We present a case of prolonged SARS-CoV-2 infection in a man with significantly impaired B-cell immunit...
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| Published in | Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy Vol. 28; no. 7; pp. 971 - 974 |
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| Main Authors | , , , , , , , , , , , , , , , , , , , |
| Format | Journal Article |
| Language | English |
| Published |
Netherlands
Elsevier Ltd
01.07.2022
Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases. Published by Elsevier Ltd |
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| Online Access | Get full text |
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| Abstract | Corticosteroids are widely used to treat severe COVID-19, but in immunocompromised individuals, who are susceptible to persistent infection, long term corticosteroid use may delay viral clearance. We present a case of prolonged SARS-CoV-2 infection in a man with significantly impaired B-cell immunity due to non-Hodgkin lymphoma which had been treated with rituximab. SARS-CoV-2 shedding persisted, despite treatment with remdesivir. Viral sequencing confirmed the persistence of the same viral strain, ruling out the possibility of reinfection. Although SARS-CoV-2 IgG, IgA and IgM remained negative throughout the treatment period, after reduction of the corticosteroid dose, PCR became negative. Long-term corticosteroid treatment, especially in immunocompromised individuals, may result in suppression of cell-mediated immunity and prolonged SARS-CoV-2 infection. |
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| AbstractList | Corticosteroids are widely used to treat severe COVID-19, but in immunocompromised individuals, who are susceptible to persistent infection, long term corticosteroid use may delay viral clearance. We present a case of prolonged SARS-CoV-2 infection in a man with significantly impaired B-cell immunity due to non-Hodgkin lymphoma which had been treated with rituximab. SARS-CoV-2 shedding persisted, despite treatment with remdesivir. Viral sequencing confirmed the persistence of the same viral strain, ruling out the possibility of reinfection. Although SARS-CoV-2 IgG, IgA and IgM remained negative throughout the treatment period, after reduction of the corticosteroid dose, PCR became negative. Long-term corticosteroid treatment, especially in immunocompromised individuals, may result in suppression of cell-mediated immunity and prolonged SARS-CoV-2 infection. Corticosteroids are widely used to treat severe COVID-19, but in immunocompromised individuals, who are susceptible to persistent infection, long term corticosteroid use may delay viral clearance. We present a case of prolonged SARS-CoV-2 infection in a man with significantly impaired B-cell immunity due to non-Hodgkin lymphoma which had been treated with rituximab. SARS-CoV-2 shedding persisted, despite treatment with remdesivir. Viral sequencing confirmed the persistence of the same viral strain, ruling out the possibility of reinfection. Although SARS-CoV-2 IgG, IgA and IgM remained negative throughout the treatment period, after reduction of the corticosteroid dose, PCR became negative. Long-term corticosteroid treatment, especially in immunocompromised individuals, may result in suppression of cell-mediated immunity and prolonged SARS-CoV-2 infection.Corticosteroids are widely used to treat severe COVID-19, but in immunocompromised individuals, who are susceptible to persistent infection, long term corticosteroid use may delay viral clearance. We present a case of prolonged SARS-CoV-2 infection in a man with significantly impaired B-cell immunity due to non-Hodgkin lymphoma which had been treated with rituximab. SARS-CoV-2 shedding persisted, despite treatment with remdesivir. Viral sequencing confirmed the persistence of the same viral strain, ruling out the possibility of reinfection. Although SARS-CoV-2 IgG, IgA and IgM remained negative throughout the treatment period, after reduction of the corticosteroid dose, PCR became negative. Long-term corticosteroid treatment, especially in immunocompromised individuals, may result in suppression of cell-mediated immunity and prolonged SARS-CoV-2 infection. |
| Author | Ishida, Akane Izumi, Shinyu Kuroda, Yudai Suzuki, Tadaki Kanno, Takayuki Iikura, Motoyasu Hojo, Masayuki Tsujimoto, Yoshie Sugiyama, Haruhito Takasaki, Jin Yamamoto, Tsukasa Suzuki, Manabu Ishii, Satoru Ishizaka, Yukihito Hashimoto, Masao Ishizhima, Keishi Morishita, Momoko Maeda, Ken Matsunaga, Akihiro Naka, Go |
| Author_xml | – sequence: 1 givenname: Momoko orcidid: 0000-0002-6357-9465 surname: Morishita fullname: Morishita, Momoko email: moyamamoto@hosp.ncgm.go.jp organization: Department of Respiratory Medicine, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo, 162-8655, Japan – sequence: 2 givenname: Manabu orcidid: 0000-0001-8515-6466 surname: Suzuki fullname: Suzuki, Manabu email: manabu@nms.ac.jp organization: Department of Respiratory Medicine, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo, 162-8655, Japan – sequence: 3 givenname: Akihiro orcidid: 0000-0002-9405-2009 surname: Matsunaga fullname: Matsunaga, Akihiro organization: Department of Intractable Diseases, Research Institute, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo, 162-8655, Japan – sequence: 4 givenname: Keishi surname: Ishizhima fullname: Ishizhima, Keishi organization: Department of Veterinary Science, National Institute of Infectious Disease, 1-23-1 Toyama, Shinjuku-ku, Tokyo, 162-8640, Japan – sequence: 5 givenname: Tsukasa surname: Yamamoto fullname: Yamamoto, Tsukasa organization: Department of Veterinary Science, National Institute of Infectious Disease, 1-23-1 Toyama, Shinjuku-ku, Tokyo, 162-8640, Japan – sequence: 6 givenname: Yudai surname: Kuroda fullname: Kuroda, Yudai organization: Department of Veterinary Science, National Institute of Infectious Disease, 1-23-1 Toyama, Shinjuku-ku, Tokyo, 162-8640, Japan – sequence: 7 givenname: Takayuki orcidid: 0000-0002-5151-3012 surname: Kanno fullname: Kanno, Takayuki organization: Department of Pathology, National Institute of Infectious Disease, 1-23-1 Toyama, Shinjuku-ku, Tokyo, 162-8640, Japan – sequence: 8 givenname: Yoshie surname: Tsujimoto fullname: Tsujimoto, Yoshie organization: Department of Respiratory Medicine, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo, 162-8655, Japan – sequence: 9 givenname: Akane surname: Ishida fullname: Ishida, Akane organization: Department of Respiratory Medicine, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo, 162-8655, Japan – sequence: 10 givenname: Masao surname: Hashimoto fullname: Hashimoto, Masao organization: Department of Respiratory Medicine, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo, 162-8655, Japan – sequence: 11 givenname: Satoru surname: Ishii fullname: Ishii, Satoru organization: Department of Respiratory Medicine, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo, 162-8655, Japan – sequence: 12 givenname: Jin surname: Takasaki fullname: Takasaki, Jin organization: Department of Respiratory Medicine, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo, 162-8655, Japan – sequence: 13 givenname: Go surname: Naka fullname: Naka, Go organization: Department of Respiratory Medicine, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo, 162-8655, Japan – sequence: 14 givenname: Motoyasu surname: Iikura fullname: Iikura, Motoyasu organization: Department of Respiratory Medicine, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo, 162-8655, Japan – sequence: 15 givenname: Shinyu orcidid: 0000-0002-6384-5022 surname: Izumi fullname: Izumi, Shinyu organization: Department of Respiratory Medicine, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo, 162-8655, Japan – sequence: 16 givenname: Tadaki orcidid: 0000-0002-3820-9542 surname: Suzuki fullname: Suzuki, Tadaki organization: Department of Pathology, National Institute of Infectious Disease, 1-23-1 Toyama, Shinjuku-ku, Tokyo, 162-8640, Japan – sequence: 17 givenname: Ken orcidid: 0000-0002-3488-5439 surname: Maeda fullname: Maeda, Ken organization: Department of Veterinary Science, National Institute of Infectious Disease, 1-23-1 Toyama, Shinjuku-ku, Tokyo, 162-8640, Japan – sequence: 18 givenname: Yukihito surname: Ishizaka fullname: Ishizaka, Yukihito organization: Department of Intractable Diseases, Research Institute, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo, 162-8655, Japan – sequence: 19 givenname: Masayuki orcidid: 0000-0002-9595-9657 surname: Hojo fullname: Hojo, Masayuki organization: Department of Respiratory Medicine, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo, 162-8655, Japan – sequence: 20 givenname: Haruhito surname: Sugiyama fullname: Sugiyama, Haruhito organization: Department of Respiratory Medicine, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo, 162-8655, Japan |
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| Copyright | 2022 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases Copyright © 2022 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases. Published by Elsevier Ltd. All rights reserved. 2022 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases. Published by Elsevier Ltd. All rights reserved. 2022 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases |
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| Title | Prolonged SARS-CoV-2 infection associated with long-term corticosteroid use in a patient with impaired B-cell immunity |
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