• Internal medicine · Dec 2022

    Case Reports

    Persistent SARS-CoV-2 Infection in a Patient with Nephrotic Syndrome under Rituximab Therapy: Successful Treatment with a Combination of Remdesivir and Monoclonal Antibodies.

    • Akihiro Shimizu, Izumi Shirai, Kyohei Ogawa, Akane Miura, Kotaro Haruhara, Kentaro Oshiro, Akihiko Hamaguchi, Shinya Yokote, Masahiro Okabe, Hiroyuki Ueda, Nobuo Tsuboi, Masato Ikeda, and Takashi Yokoo.
    • Division of Nephrology and Hypertension, Department of Internal Medicine, The Jikei University Kashiwa Hospital, Japan.
    • Intern. Med. 2022 Dec 15; 61 (24): 370337083703-3708.

    AbstractRituximab is an effective treatment for frequently relapsing/steroid-dependent nephrotic syndrome, but there is concern about infections caused by humoral immunodeficiency. We herein report a case of prolonged (>7 weeks) severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. A 24-year-old man with minimal change disease treated with rituximab developed SARS-CoV-2 infection. The clinical response to remdesivir was soon transiently abolished. Treatment with casirivimab and imdevimab (REGEN-COV) monoclonal antibodies in combination with remdesivir resulted in complete clearance of the infection. The REGEN-COV antibody cocktail may improve the outcome of SARS-CoV-2 infection in patients with humoral immunodeficiency.

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