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Prolonged SARS-CoV-2 infection associated with long-term corticosteroid use in a patient with impaired B-cell immunity.
Morishita, Momoko; Suzuki, Manabu; Matsunaga, Akihiro; Ishizhima, Keishi; Yamamoto, Tsukasa; Kuroda, Yudai; Kanno, Takayuki; Tsujimoto, Yoshie; Ishida, Akane; Hashimoto, Masao; Ishii, Satoru; Takasaki, Jin; Naka, Go; Iikura, Motoyasu; Izumi, Shinyu; Suzuki, Tadaki; Maeda, Ken; Ishizaka, Yukihito; Hojo, Masayuki; Sugiyama, Haruhito.
  • Morishita M; Department of Respiratory Medicine, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo, 162-8655, Japan. Electronic address: moyamamoto@hosp.ncgm.go.jp.
  • Suzuki M; Department of Respiratory Medicine, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo, 162-8655, Japan. Electronic address: manabu@nms.ac.jp.
  • Matsunaga A; Department of Intractable Diseases, Research Institute, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo, 162-8655, Japan.
  • Ishizhima K; Department of Veterinary Science, National Institute of Infectious Disease, 1-23-1 Toyama, Shinjuku-ku, Tokyo, 162-8640, Japan.
  • Yamamoto T; Department of Veterinary Science, National Institute of Infectious Disease, 1-23-1 Toyama, Shinjuku-ku, Tokyo, 162-8640, Japan.
  • Kuroda Y; Department of Veterinary Science, National Institute of Infectious Disease, 1-23-1 Toyama, Shinjuku-ku, Tokyo, 162-8640, Japan.
  • Kanno T; Department of Pathology, National Institute of Infectious Disease, 1-23-1 Toyama, Shinjuku-ku, Tokyo, 162-8640, Japan.
  • Tsujimoto Y; Department of Respiratory Medicine, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo, 162-8655, Japan.
  • Ishida A; Department of Respiratory Medicine, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo, 162-8655, Japan.
  • Hashimoto M; Department of Respiratory Medicine, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo, 162-8655, Japan.
  • Ishii S; Department of Respiratory Medicine, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo, 162-8655, Japan.
  • Takasaki J; Department of Respiratory Medicine, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo, 162-8655, Japan.
  • Naka G; Department of Respiratory Medicine, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo, 162-8655, Japan.
  • Iikura M; Department of Respiratory Medicine, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo, 162-8655, Japan.
  • Izumi S; Department of Respiratory Medicine, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo, 162-8655, Japan.
  • Suzuki T; Department of Pathology, National Institute of Infectious Disease, 1-23-1 Toyama, Shinjuku-ku, Tokyo, 162-8640, Japan.
  • Maeda K; Department of Veterinary Science, National Institute of Infectious Disease, 1-23-1 Toyama, Shinjuku-ku, Tokyo, 162-8640, Japan.
  • Ishizaka Y; Department of Intractable Diseases, Research Institute, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo, 162-8655, Japan.
  • Hojo M; Department of Respiratory Medicine, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo, 162-8655, Japan.
  • Sugiyama H; Department of Respiratory Medicine, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo, 162-8655, Japan.
J Infect Chemother ; 28(7): 971-974, 2022 Jul.
Article in English | MEDLINE | ID: covidwho-1828865
ABSTRACT
Corticosteroids are widely used to treat severe COVID-19, but in immunocompromised individuals, who are susceptible to persistent infection, long term corticosteroid use may delay viral clearance. We present a case of prolonged SARS-CoV-2 infection in a man with significantly impaired B-cell immunity due to non-Hodgkin lymphoma which had been treated with rituximab. SARS-CoV-2 shedding persisted, despite treatment with remdesivir. Viral sequencing confirmed the persistence of the same viral strain, ruling out the possibility of reinfection. Although SARS-CoV-2 IgG, IgA and IgM remained negative throughout the treatment period, after reduction of the corticosteroid dose, PCR became negative. Long-term corticosteroid treatment, especially in immunocompromised individuals, may result in suppression of cell-mediated immunity and prolonged SARS-CoV-2 infection.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 Drug Treatment Type of study: Case report Limits: Humans / Male Language: English Journal: J Infect Chemother Journal subject: Microbiology / Drug Therapy Year: 2022 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 Drug Treatment Type of study: Case report Limits: Humans / Male Language: English Journal: J Infect Chemother Journal subject: Microbiology / Drug Therapy Year: 2022 Document Type: Article