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Case Reports
. 2020 Jul;190(2):185-188.
doi: 10.1111/bjh.16896. Epub 2020 Jun 22.

Persisting SARS-CoV-2 viraemia after rituximab therapy: two cases with fatal outcome and a review of the literature

Phil-Robin Tepasse  1 , Wali Hafezi  2 , Mathias Lutz  3 , Joachim Kühn  2 , Christian Wilms  1 , Rainer Wiewrodt  3 , Jan Sackarnd  4 , Martin Keller  5 , Hartmut H Schmidt  1 , Richard Vollenberg  1
Affiliations
Case Reports

Persisting SARS-CoV-2 viraemia after rituximab therapy: two cases with fatal outcome and a review of the literature

Phil-Robin Tepasse et al. Br J Haematol. 2020 Jul.

Abstract

SARS-CoV-2 infection can cause severe pneumonia (COVID-19). There is evidence that patients with comorbidities are at higher risk of a severe disease course. The role of immunosuppression in the disease course is not clear. In the present report, we first describe two cases of persisting SARS-CoV-2 viraemia with fatal outcome in patients after rituximab therapy.

Keywords: COVID-19; SARS-CoV-2; pneumonia; rituximab; viraemia.

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Figures

Fig 1
Fig 1
Chest X‐ray and thoracic CT imaging. Radiographic imaging showed bipulmonal, peripheral ground glass infiltration in both patients, a frequent finding in COVID‐19 pneumonia.
Fig 2
Fig 2
Development of pro‐inflammatory markers during disease course. C‐reactive protein (standard value <0·5 mg/l), IL‐6 (standard value <6 pg/ml) and ferritin (standard value 30–400 µg/l) increased over time. Vertical lines indicate the date of intubation. Detection of SARS‐CoV‐2 viraemia by real‐time PCR. Viral load increased over time in both patients until death. [Colour figure can be viewed at wileyonlinelibrary.com]
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