Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2022:29:e01528.
doi: 10.1016/j.idcr.2022.e01528. Epub 2022 Jun 7.

Treatment of persistent COVID-19 in two B-cell-depleted patients with the monoclonal antibody Sotrovimab

David Totschnig  1 , Daniel Doberer  2 , Renate Haberl  3 , Christoph Wenisch  1 , Arschang Valipour  2
Affiliations
Case Reports

Treatment of persistent COVID-19 in two B-cell-depleted patients with the monoclonal antibody Sotrovimab

David Totschnig et al. IDCases. 2022.

Abstract

Background: Patients having undergone B-cell-depletion with anti-CD20-antibodies have a higher risk of mortality, delayed viral clearance and prolonged infection due to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). We report two cases of patients with persistent coronavirus disease 2019 (COVID-19) in association with B-cell-depletion that were treated with the monoclonal antibody Sotrovimab.

Case presentation: Both patients presented with chronic symptoms of COVID-19 such as dyspnea, fatigue, and chest pain. Nasopharyngeal swabs remained positive months after the initial infection with fluctuating cycle threshold (Ct) values around 30. Both patients received a single infusion with the monoclonal SARS-CoV-2 antibody Sotrovimab, which resulted in a rapid improvement of symptoms and inflammation markers as well as negative SARS-CoV-2 swabs. A follow-up after a month showed ongoing improvement of symptoms, persistent negative SARS-CoV-2 swabs, and positive serum antibodies.

Conclusion: Infusion with the monoclonal SARS-CoV-2 antibody led to rapid improvement in two patients with persistent COVID-19 after B-cell depletion.

Keywords: Anti-CD20-antibody; B-cell depletion; COVID-19; COVID-19, Coronavirus disease 2019; CoV-2-S-AB, SARS-CoV-2 S protein antibodies; Ct, Cycle threshold; LTOT, Long term oxygen therapy; Monoclonal antibody; PCR, polymerase chain reaction; Persistent COVID-19; SARS-CoV-2; SARS-CoV-2, Severe acute respiratory syndrome coronavirus type2; Sotrovimab; mABs, monoclonal antibodies.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Graph 1&2
Graph 1&2
Changes in SARS-CoV-2 PCR Ct-Value and serum antibody levels of both patients, measured at admission, 5 days after Sotrovimab infusion and at a follow-up 1 month later. Negative SARS-CoV-2 PCRs were represented with a Ct-value of > 40.
Graph 3&4
Graph 3&4
All recorded SARS-CoV-2 PCR Ct-Values of both patients since their initial infection. Undocumented Ct-values between hospitalizations: Both patients report fluctuating Ct-Values around 30.
See this image and copyright information in PMC

References

    1. Weston S., Frieman M.B. COVID-19: knowns, unknowns, and questions. mSphere. 2020;5(2):e00203–e00220. - PMC - PubMed
    1. COVID-19 Dashboard by the Center for Systems Science and Engineering (CSSE) at Johns Hopkins University (JHU) [Internet]. 2021 [cited 4 July 2021].
    1. Plosker G.L., Figgitt D.P. Rituximab: a review of its use in non-Hodgkin’s lymphoma and chronic lymphocytic leukaemia. Drugs. 2003;63(8):803–843. - PubMed
    1. Berghen N., Vulsteke J.B., Westhovens R., Lenaerts J., De Langhe E. Rituximab in systemic autoimmune rheumatic diseases: indications and practical use. Acta Clin Belg. 2019;74(4):272–279. - PubMed
    1. Strangfeld A., Schäfer M., Gianfrancesco M.A., Lawson-Tovey S., Liew J.W., Ljung L., et al. Factors associated with COVID-19-related death in people with rheumatic diseases: results from the COVID-19 Global Rheumatology Alliance physician-reported registry. Ann Rheum Dis. 2021;80(7):930–942. - PMC - PubMed

Publication types

LinkOut - more resources