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  • High-titre convalescent plasma therapy for an immunocompromised patient with systemic lupus erythematosus with protracted SARS-CoV-2 infection

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Case report
High-titre convalescent plasma therapy for an immunocompromised patient with systemic lupus erythematosus with protracted SARS-CoV-2 infection
  1. Sara Moutinho-Pereira1,
  2. Raquel Calisto1,
  3. Federico Sabio2 and
  4. Luísa Guerreiro1
  1. 1 Departmento de Medicina, Serviço de Medicina Interna, Unidade Local de Saúde de Matosinhos EPE, Senhora da Hora, Portugal
  2. 2 Departmento de Medicina, Serviço de Imunohemoterapia, Unidade Local de Saúde de Matosinhos EPE, Senhora da Hora, Portugal
  1. Correspondence to Dr Sara Moutinho-Pereira; sarasofia.pereira{at}ulsm.min-saude.pt

Abstract

A 39-year-old woman with systemic lupus erythematosus treated with anti-CD20 monoclonal antibody rituximab was admitted to our hospital with COVID-19 pneumonia. Despite receiving dexamethasone, she developed hypoxaemia and persistent lung opacities. As bronchoalveolar lavage was suggestive of cryptogenic organising pneumonia, high-dose corticosteroid was administered, and she received antimicrobial therapy for opportunistic infections without improvement. Reverse transcription PCR was repeatedly positive for SARS-CoV-2, and virus replication was confirmed in cell cultures. As no anti-SARS-CoV-2 antibodies were detected more than 100 days after symptom onset, she was treated with convalescent plasma with fast clinical improvement, returning home days later. Our case shows that persistent SARS-CoV-2 infection in an immunocompromised patient may be overturned with the appropriate treatment.

  • COVID-19
  • respiratory system
  • biological agents
  • systemic lupus erythematosus

This article is made freely available for use in accordance with BMJ’s website terms and conditions for the duration of the covid-19 pandemic or until otherwise determined by BMJ. You may use, download and print the article for any lawful, non-commercial purpose (including text and data mining) provided that all copyright notices and trade marks are retained.

https://bmj.com/coronavirus/usage

https://doi.org/10.1136/bcr-2021-244853

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    Footnotes

    • Contributors SM-P was the patient’s doctor and wrote the article as well as collected and treated the data and images. RC and LG were the patient's doctors, contributed to reach a diagnosis and helped to review the article. FS was also the patient’s doctor and helped in the therapeutic approach of using convalescent plasma.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.