AUTHOR=Furlan Anna , Forner Gabriella , Cipriani Ludovica , Vian Elisa , Rigoli Roberto , Gherlinzoni Filippo , Scotton Piergiorgio TITLE=COVID-19 in B Cell-Depleted Patients After Rituximab: A Diagnostic and Therapeutic Challenge JOURNAL=Frontiers in Immunology VOLUME=12 YEAR=2021 URL=https://www.frontiersin.org/journals/immunology/articles/10.3389/fimmu.2021.763412 DOI=10.3389/fimmu.2021.763412 ISSN=1664-3224 ABSTRACT=

B cell-targeting strategies such as rituximab are widely used in B cell hematologic malignancies, rheumatologic and musculoskeletal diseases and a variety of autoimmune disorders. The purpose of this paper is to illustrate how exposure to anti-CD20 treatment profoundly affects B cell functions involved in anti-SARS-CoV-2 immunity and significantly impacts on the clinical and serological course of SARS-CoV-2 infection, long term immunity and vaccine responses. The data presented here suggest that the effects of B cell-depleting agents on adaptive immunity should be taken into account for the proper selection and interpretation of SARS-CoV-2 diagnostics and to guide appropriate therapeutic approaches and protective measures. Combination therapeutic strategies including immunotherapy in association with prolonged antiviral treatment may play a decisive role in the setting of B cell immune deficiencies.