Prolonged SARS-CoV-2 Illness in a Patient Receiving Ocrelizumab for Multiple Sclerosis

Elena G Gibson; Melissa Pender; Michael Angerbauer; Craig Cook; Barbara Jones; Adam M Spivak; Emily S Spivak; Sankar Swaminathan

doi:10.1093/ofid/ofab176

Prolonged SARS-CoV-2 Illness in a Patient Receiving Ocrelizumab for Multiple Sclerosis

Open Forum Infect Dis. 2021 Apr 8;8(7):ofab176. doi: 10.1093/ofid/ofab176. eCollection 2021 Jul.

Authors

Elena G Gibson¹, Melissa Pender², Michael Angerbauer³, Craig Cook⁴, Barbara Jones⁴, Adam M Spivak², Emily S Spivak^{2

5}, Sankar Swaminathan^{2

5}

Affiliations

¹ Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, Utah, USA.
² Division of Infectious Diseases, Department of Medicine, University of Utah School of Medicine, Salt Lake City, Utah, USA.
³ School of Medicine, University of Utah School of Medicine, Salt Lake City, Utah, USA.
⁴ Pulmonary and Critical Care, University of Utah School of Medicine, Salt Lake City, Utah, USA.
⁵ Department of Medicine, George E. Wahlen Veterans Affairs Medical Center, Salt Lake City, Utah, USA.

Abstract

We describe a case of prolonged severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in a patient receiving ocrelizumab for multiple sclerosis. Viral RNA shedding, signs, and symptoms persisted for 69 days with resolution after administration of convalescent plasma and antiviral therapy. This case suggests risk for persistent SARS-CoV-2 infection in patients treated with anti-CD-20 monoclonal antibodies and supports a role for humoral immunity in disease resolution.

Keywords: COVID-19; SARS-CoV-2; humoral immunity; ocrelizumab.