Case Report: Persistent COVID-19 in a fully vaccinated Japanese man being treated with rituximab and epcoritamab for diffuse large B-cell lymphoma

The management of persistent coronavirus disease 2019 (COVID-19) in patients with hematological malignancies who are immunocompromised because of underlying disease or iatrogenic immunosuppression remains clinically challenging. Herein, we report an 84-year-old man with stage 3 diffuse large B-cell...

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Main Authors: Masaki Suzuki, Isao Fujioka, Takamitsu Matsushima
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-04-01
Series:Frontiers in Medicine
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Online Access:https://www.frontiersin.org/articles/10.3389/fmed.2025.1554100/full
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author Masaki Suzuki
Isao Fujioka
Takamitsu Matsushima
author_facet Masaki Suzuki
Isao Fujioka
Takamitsu Matsushima
author_sort Masaki Suzuki
collection DOAJ
description The management of persistent coronavirus disease 2019 (COVID-19) in patients with hematological malignancies who are immunocompromised because of underlying disease or iatrogenic immunosuppression remains clinically challenging. Herein, we report an 84-year-old man with stage 3 diffuse large B-cell lymphoma treated with rituximab and epcoritamab who subsequently developed persistent severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, despite having received seven doses of COVID-19 mRNA vaccine and remdesivir. The patient was treated with a combination of remdesivir, sotrovimab, and nirmatrelvir/ritonavir, and recovered clinically. SARS-CoV-2 polymerase chain reaction and antigen tests eventually turned negative, and he was discharged after 28 days of hospitalization. This case highlights the challenges associated with managing persistent SARS-CoV-2 infection in immunocompromised patients with hematological malignancies. Combined treatment with antivirals and monoclonal antibodies may be an effective strategy.
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spelling doaj-art-a23c62fda39b49cdba24867238931bc42025-08-20T02:20:16ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2025-04-011210.3389/fmed.2025.15541001554100Case Report: Persistent COVID-19 in a fully vaccinated Japanese man being treated with rituximab and epcoritamab for diffuse large B-cell lymphomaMasaki Suzuki0Isao Fujioka1Takamitsu Matsushima2Department of Respirology, Kashiwa Kousei General Hospital, Kashiwa, JapanDepartment of Hematology, Kashiwa Kousei General Hospital, Kashiwa, JapanDepartment of Hematology, Kashiwa Kousei General Hospital, Kashiwa, JapanThe management of persistent coronavirus disease 2019 (COVID-19) in patients with hematological malignancies who are immunocompromised because of underlying disease or iatrogenic immunosuppression remains clinically challenging. Herein, we report an 84-year-old man with stage 3 diffuse large B-cell lymphoma treated with rituximab and epcoritamab who subsequently developed persistent severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, despite having received seven doses of COVID-19 mRNA vaccine and remdesivir. The patient was treated with a combination of remdesivir, sotrovimab, and nirmatrelvir/ritonavir, and recovered clinically. SARS-CoV-2 polymerase chain reaction and antigen tests eventually turned negative, and he was discharged after 28 days of hospitalization. This case highlights the challenges associated with managing persistent SARS-CoV-2 infection in immunocompromised patients with hematological malignancies. Combined treatment with antivirals and monoclonal antibodies may be an effective strategy.https://www.frontiersin.org/articles/10.3389/fmed.2025.1554100/fullpersistent COVID-19diffuse large B-cell lymphomarituximabepcoritamabSARS-CoV-2
spellingShingle Masaki Suzuki
Isao Fujioka
Takamitsu Matsushima
Case Report: Persistent COVID-19 in a fully vaccinated Japanese man being treated with rituximab and epcoritamab for diffuse large B-cell lymphoma
Frontiers in Medicine
persistent COVID-19
diffuse large B-cell lymphoma
rituximab
epcoritamab
SARS-CoV-2
title Case Report: Persistent COVID-19 in a fully vaccinated Japanese man being treated with rituximab and epcoritamab for diffuse large B-cell lymphoma
title_full Case Report: Persistent COVID-19 in a fully vaccinated Japanese man being treated with rituximab and epcoritamab for diffuse large B-cell lymphoma
title_fullStr Case Report: Persistent COVID-19 in a fully vaccinated Japanese man being treated with rituximab and epcoritamab for diffuse large B-cell lymphoma
title_full_unstemmed Case Report: Persistent COVID-19 in a fully vaccinated Japanese man being treated with rituximab and epcoritamab for diffuse large B-cell lymphoma
title_short Case Report: Persistent COVID-19 in a fully vaccinated Japanese man being treated with rituximab and epcoritamab for diffuse large B-cell lymphoma
title_sort case report persistent covid 19 in a fully vaccinated japanese man being treated with rituximab and epcoritamab for diffuse large b cell lymphoma
topic persistent COVID-19
diffuse large B-cell lymphoma
rituximab
epcoritamab
SARS-CoV-2
url https://www.frontiersin.org/articles/10.3389/fmed.2025.1554100/full
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