Safety of Using Rituximab Therapy During COVID-19 Pandemic

Introduction: Our modern world is facing extraordinary circumstances while passing through a serious pandemic caused by the novel coronavirus (COVID-19) which may lead to multi-organ system failure & death. B cell depletion could compromise antiviral immunity, which makes the safety of rituximab use in the COVID 19 era unclear. Methods: All patients who had renal transplant from the 1st of March 2020 till 30th of July 2020 and registered in the OPTN were retrospectively reviewed. Patients were followed up to September 2020. We included patients who received rituximab induction therapy during this period. Exclusion criteria were patients who did not receive rituximab induction therapy, and patients with missing data about rituximab induction therapy. Measured outcome centered on patient survival until the end of the follow-up period. Results: During the first wave of COVID-19 pandemic from the 1st of March 2020 till 31st of July 2020, 9,095 patients had renal transplant and were registered in OPTN database. 8,770 patients had single organ transplant (kidney transplant) and 325 patients had dual organ transplant (kidney and pancreas). Out of this cohort, 114 patients received rituximab induction therapy. The total number of deaths was 127 patients (1.39%). Among those who received rituximab induction agent, only one patient died during the follow-up period. The cause of death for this patient was unknown. Conclusion: Our study showed that it is safe to use Rituximab as an important therapeutic agent during COVID-19 pandemic. However, special precautions and shielding are needed.