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 inJournal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy Vol. 28; no. 7; pp. 971 - 974
Main Authors Morishita, Momoko, Suzuki, Manabu, Matsunaga, Akihiro, Ishizhima, Keishi, Yamamoto, Tsukasa, Kuroda, Yudai, Kanno, Takayuki, Tsujimoto, Yoshie, Ishida, Akane, Hashimoto, Masao, Ishii, Satoru, Takasaki, Jin, Naka, Go, Iikura, Motoyasu, Izumi, Shinyu, Suzuki, Tadaki, Maeda, Ken, Ishizaka, Yukihito, Hojo, Masayuki, Sugiyama, Haruhito
Format Journal Article
LanguageEnglish
Published Netherlands Elsevier Ltd 01.07.2022
Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases. Published by Elsevier Ltd
Subjects
Antibodies, Viral
Case Report
Corticosteroids
COVID-19
COVID-19 Drug Treatment
Humans
Immunocompromised
Immunocompromised Host
Male
Rituximab
Rituximab - adverse effects
SARS-CoV-2
SARS-CoV-2 infection
Viral shedding
COVID-19
SARS-CoV-2 infection
Rituximab
Corticosteroids
Viral shedding
Immunocompromised
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Summary: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.
Bibliography:ObjectType-Case Study-2
SourceType-Scholarly Journals-1
ObjectType-Feature-4
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ObjectType-Report-1
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ISSN:1341-321X
1437-7780
1437-7780
DOI:10.1016/j.jiac.2022.02.006