In the global context of the Sars-Cov2 pandemia, there is a great need to understand the course of the Covid-19 disease in immunocompromised patients. We report the case of a 68 years-old patient who was diagnosed with chronic lymphocytic leukemia 4 years ago and was now on a third-line therapy with ibrutinib. The patient was admitted to the emergency department of a public health care service in Brazil reporting a 5-days history of fever, malaise, diarrhea and cough. Physical exam revealed tachypnea, desaturation and pulmonary crackles. Covid-19 was confirmed with a nasal swab. Ibrutinib was discontinued due to neutropenia and was re-started one week later as the patient improved with resolution of fever and desaturation. There was no need for mechanical ventilation or admission to an intensive care unit. As evidence grows worldwide, we find it important to rapidly access the gravity of respiratory symptoms in the immunocompromised patient to determine whether admission to healthcare unit is necessary. Withdrawing immunotherapy might be a reasonable alternative for the first few days during the critical period of the Covid-19 disease.
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