Successful management of persistent COVID-19 using combination antiviral therapy (nirmatrelvir/ritonavir and remdesivir) and intravenous immunoglobulin transfusion in an immunocompromised host who had received CD20 depleting therapy for follicular lymphoma.
Taketomo MarukiHidetoshi NomotoNoriko IwamotoKei YamamotoMasami KurokawaKiyoko Iwatsuki-HorimotoSeiya YamayoshiYutaka SuzukiYoshihiro KawaokaNorio OhmagariPublished in: Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy (2024)
The management of persistent symptomatic coronavirus disease 2019 (COVID-19) infections in immunocompromised patients remains unclear. Here, we present the first case of successful antiviral therapy (nirmatrelvir/ritonavir and remdesivir) in combination with intravenous immunoglobulin (IVIg) in a patient who had received CD20 depleting therapy for follicular lymphoma and experienced recurrent COVID-19 relapses. After the patient received IVIg treatment, the viral load decreased without recurrence. Subsequently, it was found that the anti-spike antibody titer in the administered immunoglobulin was high at 9528.0 binding antibody units/mL. Our case highlights the potential of combination therapy with selective IVIg and antiviral drugs for relapsed immunocompromised COVID-19 patients who have received CD20 depleting therapy.
Keyphrases
- coronavirus disease
- sars cov
- combination therapy
- respiratory syndrome coronavirus
- case report
- high dose
- stem cells
- ejection fraction
- newly diagnosed
- acute lymphoblastic leukemia
- respiratory failure
- antiretroviral therapy
- low dose
- diffuse large b cell lymphoma
- transcription factor
- intensive care unit
- multiple myeloma
- climate change
- acute kidney injury
- cell therapy
- mesenchymal stem cells
- peritoneal dialysis
- mechanical ventilation