1st Department of Lung Diseases, National Research Institute of Tuberculosis and Lung Diseases, 01-138 Warsaw, Poland.
Department of Radiology, National Research Institute of Tuberculosis and Lung Diseases, 01-138 Warsaw, Poland.
Viruses. 2023 Mar 7;15(3):693. doi: 10.3390/v15030693.
A Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causing coronavirus disease 2019 (COVID-19) led to a pandemic outbreak in 2019. COVID-19's course and its treatment in immunocompromised patients are uncertain. Furthermore, there is a possibility of protracted SARS-CoV-2 infection and the need for repeated antiviral treatment. Monoclonal antibodies against CD20, which are used, among other things, in the therapy of chronic lymphocytic leukaemia and follicular lymphoma, can induct immunosuppression. We present a case report of a patient with follicular lymphoma, treated with obinutuzumab, who was diagnosed with prolonged, ongoing SARS-CoV-2 infection and related organizing pneumonia. The recognition and the treatment were challenging which makes this case noteworthy. Antiviral therapy with several medications was administrated to our patient and their temporary, positive effect was observed. Moreover, high-dose intravenous immunoglobulin was applied, because slowly decreasing IgM and IgG levels were observed. The patient also received standard treatment of organizing pneumonia. We believe that such a complex approach can create an opportunity for recovery. Physicians should be conscious of the course and treatment possibilities facing similar cases.
一种严重急性呼吸系统综合征冠状病毒 2 型（SARS-CoV-2）导致的 2019 年冠状病毒病（COVID-19）大流行。COVID-19 在免疫功能低下患者中的病程和治疗尚不确定。此外，SARS-CoV-2 感染可能持续存在，需要重复抗病毒治疗。用于治疗慢性淋巴细胞白血病和滤泡性淋巴瘤等疾病的抗 CD20 单克隆抗体可诱导免疫抑制。我们报告了一例滤泡性淋巴瘤患者的病例，该患者接受奥滨尤妥珠单抗治疗，被诊断为持续的 SARS-CoV-2 感染和相关的机化性肺炎。由于观察到 IgM 和 IgG 水平缓慢下降，因此识别和治疗具有挑战性，这使得该病例值得关注。我们对患者进行了几种药物的抗病毒治疗，观察到了暂时的积极效果。此外，还应用了大剂量静脉注射免疫球蛋白。该患者还接受了机化性肺炎的标准治疗。我们相信这种复杂的方法为康复创造了机会。医生应该意识到类似病例所面临的病程和治疗可能性。
