COVID-19 in a Severely Immunosuppressed Patient With Life-Threatening Eosinophilic Granulomatosis With Polyangiitis

Front Immunol. 2020 Aug 28:11:2086. doi: 10.3389/fimmu.2020.02086. eCollection 2020.

Abstract

Immunosuppressive therapies increase the susceptibility of patients to infections. The current pandemic with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) compels clinicians to develop recommendations for successful clinical management and surveillance of immunocompromised patients at high risk for severe disease progression. With only few case studies published on SARS-CoV-2 infection in patients with rheumatic diseases, we report a 25-year-old male who developed moderate coronavirus disease 2019 (COVID-19) with fever, mild dyspnea, and no major complications despite having received high-dose prednisolone, cyclophosphamide, and rituximab for the treatment of highly active, life-threatening eosinophilic granulomatosis with polyangiitis (EGPA).

Keywords: COVID-19; EGPA; SARS-CoV-2; cyclophosphamide; eosinophilic granulomatosis with polyangiitis; immunosuppression; rituximab; vasculitis.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Antiviral Agents / therapeutic use
  • Betacoronavirus / genetics*
  • COVID-19
  • Churg-Strauss Syndrome / complications*
  • Churg-Strauss Syndrome / drug therapy*
  • Coronavirus Infections / complications*
  • Coronavirus Infections / drug therapy
  • Coronavirus Infections / virology
  • Cyclophosphamide / therapeutic use*
  • Drug Therapy, Combination
  • Glucocorticoids / therapeutic use
  • Granulomatosis with Polyangiitis / complications*
  • Granulomatosis with Polyangiitis / drug therapy*
  • Humans
  • Immunocompromised Host
  • Immunosuppressive Agents / therapeutic use*
  • Male
  • Pandemics
  • Pneumonia, Viral / complications*
  • Pneumonia, Viral / drug therapy
  • Pneumonia, Viral / virology
  • Prednisolone / therapeutic use
  • RNA, Viral / genetics
  • Reverse Transcriptase Polymerase Chain Reaction
  • Rituximab / therapeutic use
  • SARS-CoV-2
  • Treatment Outcome

Substances

  • Antiviral Agents
  • Glucocorticoids
  • Immunosuppressive Agents
  • RNA, Viral
  • Rituximab
  • Cyclophosphamide
  • Prednisolone