1. 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.
- Author
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Maruki T, Nomoto H, Iwamoto N, Yamamoto K, Kurokawa M, Iwatsuki-Horimoto K, Yamayoshi S, Suzuki Y, Kawaoka Y, and Ohmagari N
- Subjects
- Humans, Male, Middle Aged, Antigens, CD20 immunology, Treatment Outcome, Drug Therapy, Combination methods, Rituximab therapeutic use, Rituximab administration & dosage, Viral Load drug effects, Antibodies, Monoclonal, Humanized, Immunocompromised Host, Lymphoma, Follicular drug therapy, Lymphoma, Follicular immunology, Alanine analogs & derivatives, Alanine therapeutic use, Adenosine Monophosphate analogs & derivatives, Adenosine Monophosphate therapeutic use, Adenosine Monophosphate administration & dosage, Ritonavir therapeutic use, Antiviral Agents therapeutic use, Immunoglobulins, Intravenous therapeutic use, COVID-19 immunology, SARS-CoV-2 immunology, COVID-19 Drug Treatment
- Abstract
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., Competing Interests: Declaration of competing interest The authors declare no conflict of interest., (Copyright © 2024 Japanese Society of Chemotherapy, Japanese Association for Infectious Diseases, and Japanese Society for Infection Prevention and Control. Published by Elsevier Ltd. All rights reserved.)
- Published
- 2024
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