Recovery from severe persistent COVID-19 without evidence of an anti-SARS-CoV-2 antibody response in a man with mantle cell lymphoma treated with rituximab

• Published in: Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy Vol. 28; no. 2; pp. 329 - 332
• Main Authors: Horiuchi, Hiroshi, Sasaki, Hiroaki, Miyazaki, Kazuhito, Miyata, Nobuyuki, Yoshimura, Yukihiro, Tachikawa, Natsuo
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Ltd 01.02.2022; Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases. Published by Elsevier Ltd
• Subjects: Adult; Antibodies, Viral; Antibody; Antibody Formation; Case Report; COVID-19; Humans; Immunocompromised state; Lymphoma; Lymphoma, Mantle-Cell - drug therapy; Male; Rituximab; Rituximab - therapeutic use; SARS-CoV-2; COVID-19; Rituximab; SARS-CoV-2; Antibody; Lymphoma; Immunocompromised state
• ISSN: 1341-321X; 1437-7780; 1437-7780
• DOI: 10.1016/j.jiac.2021.11.018

Lymphoma has been reported to worsen the prognosis of COVID-19 partly because it disturbs the normal production of antibodies. We treated a man with mantle cell lymphoma treated with rituximab, who developed severe COVID-19 with viral shedding that lasted for 78 days. He stayed in the intensive care unit for 28 days and did not respond to any treatment against COVID-19. His increased oxygen demand at rest eventually resolved despite the absence of anti-SARS-CoV-2-IgG. This case illustrates that recovery from COVID-19 can occur without antibody production, and that even patients with an inability to produce antibodies can recover from severe COVID-19. It also illustrates that lymphoma patients who develop severe COVID-19 while on rituximab therapy can recover from a prolonged viral shedding state if the acute lung injury can be overcome.