We discuss a case of a 53-year-old woman with multiple sclerosis on monthly ofatumumab injections, who was infected with SARS-CoV-2 with persistent fevers for seven weeks. She was hospitalized for fever with diagnostic workup being unremarkable with negative SARS-CoV-2 IgM and undetectable nucleocapsid IgG antibodies four weeks out from the initial infection, indicating she may not have mounted an appropriate immune response to the infection. Patients on immunosuppression therapy may have a prolonged course of disease given that medications such as ofatumumab can take up to 24 weeks of B-cell recovery post-treatment discontinuation and a longer road to recovery.
Keywords: anti-cd20 monoclonal antibodies; coronavirus disease 2019 (covid-19); high fever; immunocompromised patient; kesimpta; ofatumumab; paxlovid; relapsing-remitting multiple sclerosis (rrms); sars-cov-2; sars-cov-2 infection.
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