Persisting SARS-CoV-2 viremia after rituximab therapy: Two cases with fatal outcome and a review of literature

Abstract Background COVID-19 is an emerging infectious disease caused by SARS-CoV-2 The role of immunosuppression in disease course is not clear Here we describe the lethal disease course in two SARS-CoV-2 infected patients after rituximab therapy Methods Clinical data and laboratory findings of two SARS-CoV-2 infected rituximab treated patients were collected SARS-CoV-2 RNA was detected in blood Results Both patients developed severe respiratory failure SARS-CoV-2 viremia persisted in both patients until they died on day 22 and 26 after admission Conclusion Rituximab therapy leads to severe combined immunodeficiency and these two cases indicate a high risk for fatal outcome after SARS-CoV-2 infection