Persisting SARS‐CoV‐2 viraemia after rituximab therapy: two cases with fatal outcome and a review of the literature

Abstract

Background COVID‐19 is an emerging infectious disease caused by SARS‐CoV‐2. The role of immunosuppression in disease course is not clear. Here we describe the lethal disease course in two SARS‐CoV‐2 infected patients after rituximab therapy. Methods Clinical data and laboratory findings of two SARS‐CoV‐2 infected rituximab treated patients were collected. SARS‐CoV‐2 RNA was detected in blood. Results Both patients developed severe respiratory failure. SARS‐CoV‐2 viremia persisted in both patients until they died on day 22 and 26 after admission. Conclusion Rituximab therapy leads to severe combined immunodeficiency and these two cases indicate a high risk for fatal outcome after SARS‐CoV‐2 infection.