Efficacy of antiviral therapy and disease outcomes in COVID-19 patients previously treated with obinutuzumab for follicular lymphoma

Abstract

Background: Obinutuzumab, an anti-CD20 monoclonal antibody, is associated with poorer outcomes in treating COVID-19 infections than rituximab. In this study, we investigated the treatments and outcomes of COVID-19 patients with a history of obinutuzumab therapy.

Methods: We retrospectively evaluated patients diagnosed with COVID-19 between January 1, 2022, and July 31, 2023 (Omicron outbreak period) who had previously received obinutuzumab for follicular lymphoma (until March 31, 2023) at Tenri Hospital.

Results: Of 56 patients previously treated with obinutuzumab, 23 (41.1%) were diagnosed with COVID-19. Of the 20 patients whose severity of disease at diagnosis and treatment were known, 13 had mild disease (0 deaths) and seven had moderate disease (including three deaths). Among COVID-19 patients who were symptomatic at diagnosis, those who received remdesivir or nirmatrelvir/ritonavir had significantly lower COVID-19 relapses (33.3% vs. 90.0%, P = 0.02) and relapses requiring hospitalization (22.2% vs. 80.0%, P = 0.02).

Conclusion: Administering remdesivir or nirmatrelvir/ritonavir as initial therapy for COVID-19 patients with a history of obinutuzumab treatment may help prevent relapse and reduce the need for hospitalization due to relapse.