Positives

• Ocrelizumab depletes CD20 B cells and reduces autoantibody production, the same mechanism that drove rituximab's exploration in ME/CFS B-cell depletion studies PMC.
  
  

Negatives

• Patients on ocrelizumab have developed prolonged SARS-CoV-2 infections lasting more than three months with in-vivo viral mutation, raising concerns about persistent infection risk in already-immunocompromised Long COVID patients PMC.
  
  
• A reported case described severe persistent COVID with ocrelizumab-induced hypogammaglobulinemia requiring six months of IVIG to clear lung infiltrates Atsjournals.
  
  

Hurdles & Side Effects

• Ocrelizumab (Ocrevus) is FDA-approved only for multiple sclerosis, costs roughly $65,000 per year, and depletes B cells for six months or longer per infusion, making blunted vaccine responses a major practical concern Frontiers.