Low-dose rituximab regimen does not increase severe COVID-19 risk in patients with neuroimmune diseases during the pandemic: a cross-sectional study

A retrospective study was conducted to evaluate the impact of low-dose rituximab (RTX) regimen on the severity of coronavirus disease 2019 (Covid-19) in patients with neuroimmune diseases (PwNIDs) at Tangdu Hospital, Fourth Military Medical University from July 2017 to December 2022. A total of 70 PwNIDs were enrolled, of which 39 contracted COVID-19. The co-residents of these PwNIDs, serving as the control group, comprised 94 individuals, among whom 56 contracted COVID-19. However, there was no significant difference in the severity of COVID-19, including severe cases or death, between the two groups. Among PwNIDs, there were no notable differences observed in age, sex, underlying conditions, comorbidities, cumulative RTX dosages, or the duration since the last RTX infusion between the infected and uninfected groups. Among the PwNIDs who contracted COVID-19, 89.7% (35/39) stated that the virus had no influence on their existing conditions. Only 10.3% (4/39) reported worsened previous symptoms without requirement of hospitalization, and none developed new-onset neurological symptoms requiring acute-phase treatment. The administration of a low-dose RTX regimen does not increase the risk of COVID-19 or severe illness in PwNIDs, irrespective of the cumulative RTX dosages or the duration since the last RTX infusion. Moreover, COVID-19 does not seem to significantly exacerbate underlying neuroimmune disorders in these individuals.