Persistent-relapsing SARS-CoV-2 infection following rituximab treatment for autoimmune rheumatic diseases: diagnosis and outcomes
Authors' conclusion
AIRD patients treated with RTX are at risk for prCOVID-19. In such patients, the diagnostic accuracy of NPS PCR is suboptimal, necessitating PCR testing in BAL when prCOVID-19 is highly suspected.
Study context
- Population
- Patients with autoimmune rheumatic diseases (AIRD) treated with rituximab (RTX), diagnosed with prCOVID-19 (June 2021 to January 2025)27 prCOVID-19 events
- Participants
- 225 vs 661
- Exposure
- RTX vs other b/ts/csDMARDs
- RTXn = 225
- Controln = 661reference
- Outcome
- Rate and outcome of persistent-relapsing COVID-19 (symptoms and lung imaging >30 days with persistently positive or PCR-based conversion in respiratory samples)
Methodological detailssingle-centre
- Single-centre
Main finding
As reported in the abstract
prCOVID-19 among AIRD patients with COVID-19 during RTX treatment
RTX
11.6%
26 of 225
Observational data: associations, not effects.
Further findings
Duration of prCOVID-19 infection
- Median duration of prCOVID-19 infection, days (IQR 74)
- 65
Duration of hospitalisation
- Median duration of hospitalisation, days (IQR 14)
- 10.5
≥2 hospitalisations
- Patients with ≥2 hospitalisations, 11
- 42.3%
IgG below 700 mg/L
- prCOVID-19 events with IgG below 700 mg/L, 17
- 68%
Positive PCR samples during prCOVID-19
- Nasopharyngeal PCR samples (NPS) positive, 59 of 113
- 52.2%
- Bronchoalveolar lavage (BAL) PCR samples positive, 12/17
- 70.6%
- Diagnosis established by bronchoscopy, events
- 33%
Original publication
Persistent-relapsing SARS-CoV-2 infection following rituximab treatment for autoimmune rheumatic diseases: diagnosis and outcomes. RMD Open. Published 21 July 2025. doi:10.
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