Persistent SARS-CoV-2 infection with repeated clinical recurrence in a patient with common variable immunodeficiency

Abstract

A 22-year-old man with common variable immunodeficiency (CVID) complicated with granulomatous–lymphocytic interstitial lung disease (GLILD) previously treated with azathioprine and a 4-weekly course of rituximab 3 years before who was receiving subcutaneous (SC) immunoglobulin replacement therapy (IRT) was diagnosed of COVID-19 by SARS-CoV-2 reverse-transcriptase-polymerase-chain-reaction (RT-PCR) of a nasopharyngeal swab specimen after a 4-day history of fever. He quarantined at home but was later admitted to the hospital with COVID-19 bilateral pneumonia and hypoxemia on day 20. He was treated with ceftriaxone, dexamethasone, and an extra dose of SC-IRT, and was discharged on day 27 with positive RT-PCR assay of a nasopharyngeal swab (Ct value 30.1, Fig. 1B and 2B ). The patient did not develop serologic response at any time.