Case Report: Successful treatment of recurrent COVID-19 with intravenous immunoglobulin in a patient with rituximab-induced B-cell depletion and restoration of Fc-mediated effector functions - Summary - MDSpire
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Case Report: Successful treatment of recurrent COVID-19 with intravenous immunoglobulin in a patient with rituximab-induced B-cell depletion and restoration of Fc-mediated effector functions
To evaluate the clinical and immunological impact of intravenous immunoglobulin (IVIG) in a patient with rituximab-induced B-cell depletion experiencing persistent COVID-19.
Key Findings:
Before IVIG, SARS-CoV-2-specific IgG was undetectable, and ADCC and ADCP activities were minimal.
Post-IVIG, IgG titers against both wild-type and Omicron variants increased.
Fc-mediated effector functions, including ADCC and ADCP, were restored and peaked one week after IVIG treatment.
Interpretation:
The findings indicate that IVIG may restore critical immune effector functions in individuals with B-cell depletion, in addition to providing passive antibody transfer.
Limitations:
The study is based on a single case report, limiting generalizability.
Long-term outcomes and potential side effects of IVIG treatment were not assessed.
Conclusion:
The case suggests that IVIG may be a therapeutic adjunct for managing persistent COVID-19 in patients following B-cell–depleting therapy.
Invited narrative review supports early, interprofessional rehabilitation across the ICU recovery continuum while emphasizing heterogeneous evidence and inconsistent implementation worldwide.
