The following is a summary of “Evaluation of risk factors for prolonged viral shedding during anti-SARS-CoV-2 monoclonal antibodies and long-term administration of antivirals in COVID-19 patients with B-cell lymphoma treated by anti-CD20 antibody,” published in the July 2024 issue of Infectious Disease by Maruyama et al.
The COVID-19 pandemic disproportionately affected patients immunocompromised, particularly those with B-cell lymphoma, leading to persistent infection, severe outcomes, and the emergence of multi-mutational SARS-CoV-2 variants, necessitating a novel treatment approach.
Researchers conducted a retrospective study to assess the efficacy of a novel treatment for immunocompromised patients with B-cell lymphoma and persistent COVID-19 infection.
They conducted a descriptive analysis without controls, including patients with B-cell lymphoma who had received immunotherapy (anti-CD20 antibodies), diagnosed with COVID-19, and (post-January 2022). Anti-SARS-CoV-2 monoclonal antibodies were selected based on sub-variants. Viral load was tested every 5 days by RT-PCR, continuing antivirals until viral shedding was confirmed. The primary outcome was virus elimination. Multivariate Cox regression identified independent predictors of prolonged viral shedding time.
The results showed 44 patients, rituximab was administered to 35 patients, 19 received obinutuzumab, and 26 were treated with bendamustine. The median treatment duration was 10 days (IQR, 10–20 days), with 22 patients receiving combination antiviral therapy. Severe COVID-19 was observed in 16 patients, and 2 had critical illness. All patients survived, with viral shedding confirmed at a median of 28 days (IQR, 19–38 days). The use of bendamustine or its administration within 1 year of the last B-cell lymphoma treatment and multiple treatment lines for B-cell lymphoma significantly extended the time to viral shedding.
Investigators concluded that the novel treatment regimen resulted in complete viral elimination and 100% survival among 44 immunocompromised patients with B-cell lymphoma and COVID-19 infection while identifying factors associated with prolonged viral shedding.
Source: bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-024-09631-3
