key: cord-0860609-lvga294e
authors: Lukaszewicz, Anne‐Claire; Venet, Fabienne; Faure, Alexandre; Vignot, Emmanuelle; Monneret, Guillaume
title: Immunostimulation with interferon‐γ in protracted SARS‐CoV‐2 pneumonia
date: 2021-07-08
journal: J Med Virol
DOI: 10.1002/jmv.27172
sha: 0435caf29bf128e45eb6e38609763a9916d907fc
doc_id: 860609
cord_uid: lvga294e

Deep immunosuppression is a major hallmark of COVID-19 patients with altered IFN-release, low monocyte HLA-DR expression (mHLA-DR), and profound lymphopenia accompanied by functional CD8+ T cell impairments. In this context, patients under chronic use of immunomodulatory therapeutics with pre-existent altered immune surveillance and defective anti-viral immunity may be at increased risk for protracted SARS-CoV-2 pneumonia. We report here COVID-19 pneumonia course in a 68-years-old female patient with rheumatoid arthritis chronically treated with rituximab (anti-CD20 monoclonal antibody). Due to rapid clinical deterioration and viral persistence despite convalescent plasma (CP) therapy, a treatment with IFN-γ was successfully instituted. This article is protected by copyright. All rights reserved.

Immunostimulation with interferon-γ in protracted SARS-CoV-2 pneumonia (Table S1 ), in association with severe lymphopenia with a complete lack of B cells, low mHLA-DR, and absence of anti-SARS-CoV-2 immunoglobulin G (IgG) despite normal total immunoglobulin levels (5.8 g/L, Table S2 ). Therefore, two infusions of two units of CP were performed at Days 22 and 23 after symptoms but did not elicit any improvement as shown by development of progressive pulmonary injury (bilateral ground-glass opacities 70%, compared to 30% 6 days before) and fibrosis ( Figure S1 

Protracted SARS-CoV-2 pneumonia with rituximab treatment: about two cases

RICO study group

Severe immunosuppression and not a cytokine storm characterizes COVID-19 infections

Monocyte HLA-DR measurement by flow cytometry in COVID-19 patients: an interim review

Multicentric experience with interferon gamma therapy in sepsis induced immunosuppression. A case series