Persistent Severe Acute Respiratory Syndrome Coronavirus 2 Pneumonia in Patients Treated With Anti-CD20 Monoclonal Antibodies

Nadav Furie; Michal Mandelboim; Neta Zuckerman; Ana Belkin; Lior Seluk; Inbal Shafran; Ronen Mass; Liran Levy; Sumit Chatterji; Erik Baltaxe; Michael Peled; Tiberiu Shulimzon; Abraham Avigdor; Sharon Amit; Amir Onn; Edith M Marom; Galia Rahav; Michael J Segel

doi:10.1093/ofid/ofad464

Persistent Severe Acute Respiratory Syndrome Coronavirus 2 Pneumonia in Patients Treated With Anti-CD20 Monoclonal Antibodies

Open Forum Infect Dis. 2023 Sep 15;10(10):ofad464. doi: 10.1093/ofid/ofad464. eCollection 2023 Oct.

Authors

Nadav Furie^{1

2}, Michal Mandelboim^{2

3}, Neta Zuckerman^{2

3}, Ana Belkin^{4

5}, Lior Seluk^{1

2}, Inbal Shafran^{1

2}, Ronen Mass¹, Liran Levy^{1

2}, Sumit Chatterji¹, Erik Baltaxe^{1

2}, Michael Peled^{1

2}, Tiberiu Shulimzon¹, Abraham Avigdor^{2

6}, Sharon Amit⁷, Amir Onn^{1

2}, Edith M Marom^{2

8}, Galia Rahav^{2

5}, Michael J Segel^{1

2}

Affiliations

¹ Institute of Pulmonology, Sheba Medical Center, Tel Hashomer, Israel.
² Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel.
³ Central Virology Laboratory, Public Health Services, Ministry of Health and Sheba Medical Center, Tel-Hashomer, Israel.
⁴ Internal Medicine D, Sheba Medical Center, Tel Hashomer, Israel.
⁵ Infectious Diseases Unit, Sheba Medical Center, Tel Hashomer, Israel.
⁶ Division of Hematology and Bone-Marrow Transplantation, Sheba Medical Center, Ramat Gan, Israel.
⁷ Microbiology Laboratory, Sheba Medical Center, Tel Hashomer, Israel.
⁸ Department of Diagnostic Radiology, Sheba Medical Center, Tel Hashomer, Israel.

Abstract

We report 8 cases of persistent severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pneumonia in patients previously treated with anti-CD20 monoclonal antibodies. Polymerase chain reaction of nasopharyngeal swabs for SARS-CoV-2 was negative in most cases; viral cell cultures confirmed that viable SARS-Co-2 virus was present. Four patients were treated with anti-SARS-CoV-2 hyperimmune globulins with rapid resolution of disease.

Keywords: COVID19; SARS-CoV-2; antibody therapy; immune globulins; monoclonal antibody.