Covid-19 in a patient with ANCA-associated systemic vasculitis, receiving anti-B cell therapy (rituximab)
Open Access
- 4 September 2020
- journal article
- Published by Mediar Press in Rheumatology Science and Practice
- Vol. 58 (4), 456-462
- https://doi.org/10.47360/1995-4484-2020-456-462
Abstract
Despite numerous publications on COVID-19, at present, conceptual thinking of the problem is only at a nascence stage. Treatment of patients with ANCA-associated systemic vasculitis (AAV) during the COVID-19 pandemic is one of the relevant issues. Management of COVID-19 in AAV patients undergoing anti-B cell therapy with rituximab (RTM) requires comprehensive reasoning. This paper presents a case report about COVID-19 in a 59-year-old female with AAV in remission, who was previously treated with RTM. COVID-19 was diagnosed one month after the last RTM administration; there were moderate bilateral pneumonia, fever, and extrapulmonary manifestations, including lesions of the gastrointestinal tract and central nervous system. Clinical outcome of COVID-19 was favorable, with no signs of respiratory failure, and CRP values did not exceed 29 mg/l. We discuss published data on RTM use during COVID-19 pandemic and the effects of B cells and their depletion on the course and outcomes of COVID-19. Our case report and available published data do not allow to consider RTM therapy as a factor associated with severe course of COVID-19 and adverse outcome. Further analysis of COVID-19 in patients with AAV and other rheumatic diseases is important.Keywords
This publication has 36 references indexed in Scilit:
- Classification of the cutaneous manifestations of COVID ‐19: a rapid prospective nationwide consensus study in Spain with 375 casesBritish Journal of Dermatology, 2020
- Neurologic Manifestations of Hospitalized Patients With Coronavirus Disease 2019 in Wuhan, ChinaJAMA Neurology, 2020
- Facing COVID-19 in the ICU: vascular dysfunction, thrombosis, and dysregulated inflammationIntensive Care Medicine, 2020
- Coagulopathy and Antiphospholipid Antibodies in Patients with Covid-19The New England Journal of Medicine, 2020
- Complement associated microvascular injury and thrombosis in the pathogenesis of severe COVID-19 infection: A report of five casesTranslational Research, 2020
- COVID-19 Pulmonary Involvement: Is Really an Interstitial Pneumonia?Academic Radiology, 2020
- Radiological findings from 81 patients with COVID-19 pneumonia in Wuhan, China: a descriptive studyThe Lancet Infectious Diseases, 2020
- Abnormal coagulation parameters are associated with poor prognosis in patients with novel coronavirus pneumoniaJournal of Thrombosis and Haemostasis, 2020
- Clinical characteristics of 140 patients infected with SARS‐CoV‐2 in Wuhan, ChinaAllergy, 2020
- Risk of Cardiovascular Disease and Venous Thromboembolism Among Patients With Incident ANCA-Associated Vasculitis: A 20-Year Population-Based Cohort StudyMayo Clinic Proceedings, 2018