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Prolonged viral pneumonia and high mortality in COVID-19 patients on anti-CD20 monoclonal antibody therapy.
Feuth, Eeva; Nieminen, Valtteri; Palomäki, Antti; Ranti, Juha; Sucksdorff, Marcus; Finnilä, Taru; Oksi, Jarmo; Vuorinen, Tytti; Feuth, Thijs.
Afiliación
  • Feuth E; Department of Infectious Diseases, Turku University Hospital and University of Turku, Turku, Finland.
  • Nieminen V; Department of Pulmonary Diseases and Clinical Allergology, Turku University Hospital and University of Turku, Turku, Finland.
  • Palomäki A; Centre for Rheumatology and Clinical Immunology, and Department of Medicine, Turku University Hospital and University of Turku, Turku, Finland.
  • Ranti J; Department of Haematology, Turku University Hospital, Turku, Finland.
  • Sucksdorff M; Turku PET Centre, and Division of Clinical Neurosciences, Turku University Hospital and University of Turku, Turku, Finland.
  • Finnilä T; Department of Hospital Hygiene & Infection Control, Turku University Hospital, Turku, Finland.
  • Oksi J; Department of Infectious Diseases, Turku University Hospital and University of Turku, Turku, Finland.
  • Vuorinen T; Department of Clinical Microbiology, Turku University Hospital and Institute of Biomedicine, University of Turku, Turku, Finland.
  • Feuth T; Department of Pulmonary Diseases and Clinical Allergology, Turku University Hospital and University of Turku, Turku, Finland. matfeu@utu.fi.
Eur J Clin Microbiol Infect Dis ; 43(4): 723-734, 2024 Apr.
Article en En | MEDLINE | ID: mdl-38358552
ABSTRACT

PURPOSE:

In clinical practice, we observed an apparent overrepresentation of COVID-19 patients on anti-CD20 monoclonal antibody therapy. The aim of this study was to characterize the clinical picture of COVID-19 in these patients.

METHODS:

All adult patients from Turku University Hospital, Turku, Finland, with COVID-19 diagnosis and/or positive SARS-CoV-2 PCR test result up to March 2023, and with anti-CD20 therapy within 12 months before COVID-19 were included. Data was retrospectively obtained from electronic patient records.

RESULTS:

Ninety-eight patients were identified. 44/93 patients (47.3%) were hospitalized due to COVID-19. Patients with demyelinating disorder (n = 20) were youngest (median age 36.5 years, interquartile range 33-45 years), had less comorbidities, and were least likely to be hospitalized (2/20; 10.0%) or die (n = 0). COVID-19 mortality was 13.3% in the whole group, with age and male sex as independent risk factors. Persistent symptoms were documented in 33/94 patients (35.1%) alive by day 30, in 21/89 patients (23.6%) after 60 days, and in 15/85 after 90 days (17.6%), mostly in patients with haematological malignancy or connective tissue disease. Prolonged symptoms after 60 days predisposed to persistent radiological findings (odds ratio 64.0; 95% confidence interval 6.3-711; p < 0.0001) and persistently positive PCR (odds ratio 45.5, 95% confidence interval 4.0-535; p < 0.0001). Several patients displayed rapid response to late antiviral therapy.

CONCLUSION:

Anti-CD20 monoclonal antibody therapy is associated with high COVID-19 mortality and with a phenotype consistent with prolonged viral pneumonia. Our study provides rationale for retesting of immunocompromised patients with prolonged COVID-19 symptoms and considering antiviral therapy.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neumonía Viral / COVID-19 / Antineoplásicos Tipo de estudio: Prognostic_studies / Risk_factors_studies Límite: Adult / Humans / Male / Middle aged Idioma: En Revista: Eur J Clin Microbiol Infect Dis Asunto de la revista: DOENCAS TRANSMISSIVEIS / MICROBIOLOGIA Año: 2024 Tipo del documento: Article País de afiliación: Finlandia Pais de publicación: Alemania
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neumonía Viral / COVID-19 / Antineoplásicos Tipo de estudio: Prognostic_studies / Risk_factors_studies Límite: Adult / Humans / Male / Middle aged Idioma: En Revista: Eur J Clin Microbiol Infect Dis Asunto de la revista: DOENCAS TRANSMISSIVEIS / MICROBIOLOGIA Año: 2024 Tipo del documento: Article País de afiliación: Finlandia Pais de publicación: Alemania