Two cases of nasopharyngeal negative COVID-19 infections in patients with demyelinating diseases on anti-CD20 treatments

Abstract

We report two cases of nasopharyngeal negative COVID-19 infections in patients with demyelinating diseases on anti-CD20 treatments. Despite negative nasopharyngeal polymerase chain reaction (PCR) tests, both patients exhibited radiological features consistent with SARS-CoV-2 infection, with one confirmed in bronchoalveolar lavage fluid. Immunocompromised patients may have limited immune responses, possibly contributing to persistent COVID-19 infections despite vaccination history. These findings underscore the need for increased vigilance and consideration of lower respiratory tract infections in immunocompromised patients on anti-CD20 therapies.