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Anti-Infective Agents

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ISSN (Print): 2211-3525
ISSN (Online): 2211-3533

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Case Report

Successful Combination of Remdesivir and Convalescent Plasma to Treat a Patient with Rituximab-Related B-Cell Deficiency and Prolonged COVID-19: A Case Report

Author(s): Giorgio Raho*, William Cordeddu, Davide Firinu, Stefano Del Giacco and Goffredo Angioni

Volume 21, Issue 2, 2023

Published on: 08 November, 2022

Article ID: e220922209048 Pages: 7

DOI: 10.2174/2211352520666220922091227

Price: $65

Abstract

Background: Treatment of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in immuno-compromised patients with complete B cell depletion can be really challenging due to the lack of seroconversion and long-lasting disease.

Case Report: We describe a case of long-lasting coronavirus disease (COVID-19) in a female patient with rheumatoid arthritis who was treated with rituximab and continued to show B-cell depletion. An ongoing replication of SARS-CoV-2 was demonstrated for a period of 8 months when nasopharyngeal swabs were tested. She was treated once with remdesivir but without lasting resolution, and she was then treated with convalescent plasma but with a similar effect. Only with a combination of both treatments was clinical resolution achieved. The patient's lack of seroconversion and the prolonged course of the disease illustrate the importance of humoral immunity in resolving SARS-CoV-2 infection. This case report highlights challenges in managing immunocompromised hosts, who may act as persistent shedders and sources of transmission.

Conclusion: The combination of remdesivir and convalescent plasma resulted in successfully achieving clinical resolution of SARS-CoV-2 infection in our patient.

Keywords: SARS-CoV-2, COVID19, immunocompromised, rituximab, convalescent plasma, rheumatoid arthritis.

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