ArticleRMD open2025
Persistent-relapsing SARS-CoV-2 infection following rituximab treatment for autoimmune rheumatic diseases: diagnosis and outcomes.
Article in RMD open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed.
- Diagnostic Pitfall: Prolonged COVID-19 Presenting as Organising Pneumonia in a Rituximab-Treated Patient with Rheumatoid Arthritis.Mediterranean journal of rheumatology · 2026Article
- Intrahost viral evolution of SARS-CoV-2 infections in rheumatic versus hematological patients with severe iatrogenic immunosuppression.Frontiers in medicine · 2026Article
- Rituximab in Connective Tissue Disease-Associated Interstitial Lung Disease: From Immunopathogenesis to Therapeutic Implications.International journal of molecular sciences · 2025Review
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Authors and funding
12 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundCOVID-19 may persist or relapse in patients on B-cell depleting biologic therapies.
objectiveTo examine the rate and outcome of persistent-relapsing COVID-19 (prCOVID-19) in patients with autoimmune rheumatic diseases (AIRD) treated with rituximab (RTX).
methodsSingle-centre, retrospective cohort study of patients diagnosed with prCOVID-19 (June 2021 to January 2025). prCOVID-19 was defined as persistence of symptoms and lung imaging findings for >30 days, along with persistently positive or PCR-based conversion in upper or lower respiratory tract samples.
results26 out of 225 (11.6%) AIRD patients, previously diagnosed with COVID-19 during RTX treatment period, developed 27 prCOVID-19 events (females: 20 (76.9%), median age: 61 years, median disease duration: 5.5 years, ≥3 COVID-19 vaccine doses: 20 (76.9%)). No prCOVID-19 infection in a control sample of 661 patients treated with other biologic/targeted synthetic/conventional synthetic disease-modifying antirheumatic drugs was documented. Median cumulative RTX dose was 12 g, while in 17 (68%) prCOVID-19 events, IgG levels were below 700 mg/L. Median duration of prCOVID-19 infection was 65 (IQR 74) days and median duration of hospitalisation 10.5 (IQR 14) days. 11 patients (42.3%) had ≥2 hospitalisations, 3 patients needed mechanical ventilation and 4 deaths were recorded. 59 of 113 (52.2%) nasopharyngeal PCR samples (NPS) and 12/17 (70.6%) bronchoalveolar lavage (BAL) PCR samples were positive during prCOVID-19. Bronchoscopy established the diagnosis of prCOVID-19 in 33% of events.
conclusionAIRD patients treated with RTX are at risk for prCOVID-19. In such patients, the diagnostic accuracy of NPS PCR is suboptimal, necessitating PCR testing in BAL when prCOVID-19 is highly suspected.
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