High-titre convalescent plasma therapy for an immunocompromised patient with systemic lupus erythematosus with protracted SARS-CoV-2 infection.
Sara Moutinho-PereiraRaquel CalistoFederico SabioLuísa GuerreiroPublished in: BMJ case reports (2021)
A 39-year-old woman with systemic lupus erythematosus treated with anti-CD20 monoclonal antibody rituximab was admitted to our hospital with COVID-19 pneumonia. Despite receiving dexamethasone, she developed hypoxaemia and persistent lung opacities. As bronchoalveolar lavage was suggestive of cryptogenic organising pneumonia, high-dose corticosteroid was administered, and she received antimicrobial therapy for opportunistic infections without improvement. Reverse transcription PCR was repeatedly positive for SARS-CoV-2, and virus replication was confirmed in cell cultures. As no anti-SARS-CoV-2 antibodies were detected more than 100 days after symptom onset, she was treated with convalescent plasma with fast clinical improvement, returning home days later. Our case shows that persistent SARS-CoV-2 infection in an immunocompromised patient may be overturned with the appropriate treatment.
Keyphrases
- sars cov
- systemic lupus erythematosus
- respiratory syndrome coronavirus
- high dose
- monoclonal antibody
- respiratory failure
- disease activity
- coronavirus disease
- case report
- healthcare
- low dose
- single cell
- staphylococcus aureus
- stem cell transplantation
- diffuse large b cell lymphoma
- intensive care unit
- extracorporeal membrane oxygenation
- cell therapy
- mesenchymal stem cells
- newly diagnosed
- mechanical ventilation
- transcription factor
- acute respiratory distress syndrome
- drug induced