Protracted SARS‐CoV‐2 pneumonia with rituximab treatment: About two cases

Immunostimulation with interferon‐γ in protracted SARS‐CoV‐2 pneumonia

“…Dear Editor, We read with great interest the recent publication describing two coronavirus disease 2019 (COVID-19) patients with protracted severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pneumonia with rituximab treatment treated by convalescent plasma (CP) by Gerber et al 1 Deep immunosuppression is a major hallmark of those patients with altered interferon (IFN)-release, low monocyte HLA-DR expression (mHLA-DR), and profound lymphopenia accompanied by functional CD8 + T cell impairments. [2][3][4] In this context, patients under chronic use of immunomodulatory therapeutics with pre-existent altered immune surveillance and defective antiviral immunity may be at increased risk for protracted SARS-CoV-2 pneumonia.…”

Immune thrombotic thrombocytopenic purpura: Personalized therapy using ADAMTS‐13 activity and autoantibodies

“…In this case, availability of caplacizumab with timely and prospective monitoring of ADAMTS-13 activity allowed judicious use of rituximab, that may increase the risk of infections including COVID-19-related death and complications. [17][18][19][20] Finally, a drop in platelet count was observed in all patients soon after caplacizumab discontinuation, in absence of disease exacerbation/relapse. Whether this phenomenon was related to early caplacizumab discontinuation, with persistence of circulating VWF multimers, or to other variables, remains to be clarified.…”

Use of convalescent plasma inCOVID‐19 patients with immunosuppression

“…Using an a posteriori approach, studies were further restricted to include only the following: (1) hypogammaglobulinemia or x‐linked agammaglobulinemia, (2) common variable immune deficiency, (3) hematological malignancy, or (4) solid organ transplants. Although our search yielded articles describing use of COVID‐19 convalescent plasma in the context of other potentially relevant conditions (myasthenia gravis, 22 trisomy 21, 23 Sjögrens syndrome, 24 hemodialysis, 25 and rheumatoid arthritis 26,27 ), there were very few represented patient cases, thus, our a posteriori restriction provided more robust evidence on fewer cohorts of patients. Two reviewers (J.W.S and S.A.K.)…”