Prolonged SARS-CoV-2 infection associated with long-term corticosteroid use in a patient with impaired B-cell immunity

Momoko Morishita; Manabu Suzuki; Akihiro Matsunaga; Keishi Ishizhima; Tsukasa Yamamoto; Yudai Kuroda; Takayuki Kanno; Yoshie Tsujimoto; Akane Ishida; Masao Hashimoto; Satoru Ishii; Jin Takasaki; Go Naka; Motoyasu Iikura; Shinyu Izumi; Tadaki Suzuki; Ken Maeda; Yukihito Ishizaka; Masayuki Hojo; Haruhito Sugiyama

doi:10.1016/j.jiac.2022.02.006

Prolonged SARS-CoV-2 infection associated with long-term corticosteroid use in a patient with impaired B-cell immunity

Momoko Morishita, Manabu Suzuki, Akihiro Matsunaga, Keishi Ishizhima, Tsukasa Yamamoto, Yudai Kuroda, Takayuki Kanno, Yoshie Tsujimoto, Akane Ishida, Masao Hashimoto, Satoru Ishii, Jin Takasaki, Go Naka, Motoyasu Iikura, Shinyu Izumi, Tadaki Suzuki, Ken Maeda, Yukihito Ishizaka, Masayuki Hojo, Haruhito Sugiyama

Research output: Contribution to journal › Article › peer-review

9 Scopus citations

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.

Original language	English
Pages (from-to)	971-974
Number of pages	4
Journal	Journal of Infection and Chemotherapy
Volume	28
Issue number	7
DOIs	https://doi.org/10.1016/j.jiac.2022.02.006
State	Published - Jul 2022
Externally published	Yes

Keywords

COVID-19
Corticosteroids
Immunocompromised
Rituximab
SARS-CoV-2 infection
Viral shedding

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1016/j.jiac.2022.02.006

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Morishita, M., Suzuki, M., Matsunaga, A., Ishizhima, K., Yamamoto, T., Kuroda, Y., Kanno, T., Tsujimoto, Y., Ishida, A., Hashimoto, M., Ishii, S., Takasaki, J., Naka, G., Iikura, M., Izumi, S., Suzuki, T., Maeda, K., Ishizaka, Y., Hojo, M., & Sugiyama, H. (2022). Prolonged SARS-CoV-2 infection associated with long-term corticosteroid use in a patient with impaired B-cell immunity. Journal of Infection and Chemotherapy, 28(7), 971-974. https://doi.org/10.1016/j.jiac.2022.02.006

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title = "Prolonged SARS-CoV-2 infection associated with long-term corticosteroid use in a patient with impaired B-cell immunity",

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.",

keywords = "COVID-19, Corticosteroids, Immunocompromised, Rituximab, SARS-CoV-2 infection, Viral shedding",

author = "Momoko Morishita and Manabu Suzuki and Akihiro Matsunaga and Keishi Ishizhima and Tsukasa Yamamoto and Yudai Kuroda and Takayuki Kanno and Yoshie Tsujimoto and Akane Ishida and Masao Hashimoto and Satoru Ishii and Jin Takasaki and Go Naka and Motoyasu Iikura and Shinyu Izumi and Tadaki Suzuki and Ken Maeda and Yukihito Ishizaka and Masayuki Hojo and Haruhito Sugiyama",

note = "Publisher Copyright: {\textcopyright} 2022 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases",

year = "2022",

month = jul,

doi = "10.1016/j.jiac.2022.02.006",

language = "英語",

volume = "28",

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journal = "Journal of Infection and Chemotherapy",

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Morishita, M, Suzuki, M, Matsunaga, A, Ishizhima, K, Yamamoto, T, Kuroda, Y, Kanno, T, Tsujimoto, Y, Ishida, A, Hashimoto, M, Ishii, S, Takasaki, J, Naka, G, Iikura, M, Izumi, S, Suzuki, T, Maeda, K, Ishizaka, Y, Hojo, M & Sugiyama, H 2022, 'Prolonged SARS-CoV-2 infection associated with long-term corticosteroid use in a patient with impaired B-cell immunity', Journal of Infection and Chemotherapy, vol. 28, no. 7, pp. 971-974. https://doi.org/10.1016/j.jiac.2022.02.006

TY - JOUR

T1 - Prolonged SARS-CoV-2 infection associated with long-term corticosteroid use in a patient with impaired B-cell immunity

AU - Morishita, Momoko

AU - Suzuki, Manabu

AU - Matsunaga, Akihiro

AU - Ishizhima, Keishi

AU - Yamamoto, Tsukasa

AU - Kuroda, Yudai

AU - Kanno, Takayuki

AU - Tsujimoto, Yoshie

AU - Ishida, Akane

AU - Hashimoto, Masao

AU - Ishii, Satoru

AU - Takasaki, Jin

AU - Naka, Go

AU - Iikura, Motoyasu

AU - Izumi, Shinyu

AU - Suzuki, Tadaki

AU - Maeda, Ken

AU - Ishizaka, Yukihito

AU - Hojo, Masayuki

AU - Sugiyama, Haruhito

PY - 2022/7

Y1 - 2022/7

N2 - 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.

AB - 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.

KW - COVID-19

KW - Corticosteroids

KW - Immunocompromised

KW - Rituximab

KW - SARS-CoV-2 infection

KW - Viral shedding

UR - https://www.scopus.com/pages/publications/85124821201

U2 - 10.1016/j.jiac.2022.02.006

DO - 10.1016/j.jiac.2022.02.006

M3 - 記事

C2 - 35184976

AN - SCOPUS:85124821201

SN - 1341-321X

VL - 28

SP - 971

EP - 974

JO - Journal of Infection and Chemotherapy

JF - Journal of Infection and Chemotherapy

IS - 7

ER -

Prolonged SARS-CoV-2 infection associated with long-term corticosteroid use in a patient with impaired B-cell immunity

Abstract

Keywords

UN SDGs

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