the outcome of covid-19 in patients with a history of taking rituximab: a narrative review

coronavirus disease 2019 (covid-19) is a recently emerging disease caused by severe acute respiratory syndrome coronavirus 2 (sars-cov-2). notably, the safety of immunosuppressive medications is a major concern during an infectious disease pandemic. rituximab (rtx), as a monoclonal antibody against cd20 molecule, is widely used for the treatment of various diseases, mostly autoimmune diseases and some malignancies. previous studies indicated that rtx, as an immunosuppressive medication, may be associated with the increased risk of infections. moreover, given the wide use of rtx, a necessity of determining the different aspects of rtx use in the covid-19 era is strongly felt. we reviewed current studies on the clinical courses of patients with sars- cov-2 infection. it appears that the use of rtx does not increase morbidity and mortality in most patients. however, underlying diseases and other concomitant medications may play a role in the disease course, while the concerns of vaccine efficacy in patients receiving rtx still need to be addressed. therefore, more controlled studies are needed for a better conclusion.