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Prolonged SARS-CoV-2 Illness in a Patient Receiving Ocrelizumab for Multiple Sclerosis
Elena G Gibson1, Melissa Pender2, Michael Angerbauer3
1Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, Utah, USA.
Open Forum Infectious Diseases
|July 14, 2021
Summary
Patients on ocrelizumab may face prolonged severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Treatment with convalescent plasma and antivirals aided resolution, highlighting the role of humoral immunity.
Area of Science:
- Immunology
- Virology
- Neurology
Background:
- Ocrelizumab is an anti-CD-20 monoclonal antibody used to treat multiple sclerosis.
- B-cell depletion with anti-CD-20 therapy can impact humoral immune responses.
- Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection can be prolonged in immunocompromised individuals.
Purpose of the Study:
- To report a case of prolonged SARS-CoV-2 infection in a patient treated with ocrelizumab.
- To investigate the clinical course and management of persistent SARS-CoV-2 infection in this context.
- To explore the potential role of humoral immunity in the resolution of SARS-CoV-2 infection.
Main Methods:
- Case report detailing a patient with multiple sclerosis on ocrelizumab.
- Monitoring of viral RNA shedding, clinical signs, and symptoms over 69 days.
- Administration of convalescent plasma and antiviral therapy for treatment.
Main Results:
- The patient experienced a 69-day period of persistent SARS-CoV-2 infection, including viral shedding, signs, and symptoms.
- Resolution of infection was achieved following treatment with convalescent plasma and antiviral therapy.
- The case highlights a potential risk for prolonged SARS-CoV-2 infection in patients receiving anti-CD-20 therapy.
Conclusions:
- Patients treated with anti-CD-20 monoclonal antibodies, such as ocrelizumab, may be at risk for persistent SARS-CoV-2 infection.
- Humoral immunity appears to play a crucial role in the resolution of SARS-CoV-2 infection.
- Convalescent plasma and antiviral therapy can be effective in managing prolonged viral infections in immunocompromised patients.
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