Abstract
We studied clinical and immunological outcome of Covid-19 in consecutive CLL patients from a well-defined area during month 1-13 of the pandemic. Sixty patients (median age 71 y, range 43-97) were identified. Median CIRS was eight (4-20). Patients had indolent CLL (n = 38), had completed (n = 12) or ongoing therapy (n = 10). Forty-six patients (77%) were hospitalized due to severe Covid-19 and 11 were admitted to ICU. Severe Covid-19 was equally distributed across subgroups irrespective of age, gender, BMI, CLL status except CIRS (p < 0.05). Fourteen patients (23%) died; age ≥75 y was the only significant risk factor (p < 0.05, multivariate analysis with limited power). Comparing month 1-6 vs 7-13 of the pandemic, deaths were numerically reduced from 32% to 18%, ICU admission from 37% to 15% whereas hospitalizations remained frequent (86% vs 71%). Seroconversion occurred in 33/40 patients (82%) and anti-SARS-CoV-2 antibodies were detectable at six and 12 months in 17/22 and 8/11 patients, respectively. Most (13/17) had neutralizing antibodies and 19/28 had antibodies in saliva. SARS-CoV-2-specific T-cells (ELISpot) were detected in 14/17 patients. Covid-19 continued to result in high admission even among consecutive and young early- stage CLL patients. A robust and durable B and/or T cell immunity was observed in most convalescents.
【초록키워드】 neutralizing antibody, Saliva, pandemic, therapy, Hospitalized, severe COVID-19, Immunity, Hospitalization, Neutralizing antibodies, antibody, T-cells, Gender, outcome, risk factor, anti-SARS-CoV-2 antibodies, T cell, Seroconversion, anti-SARS-CoV-2 antibody, hospitalizations, Patient, ICU admission, death, age, CLL, ELISPOT, T-cell, BMI, Admission, patients, Multivariate analysis, Analysis, subgroup, subgroups, median age, MOST, CLL patients, immunological, indolent, robust, occurred, remained, detectable, eight, reduced, admitted to ICU, CLL patient, 【제목키워드】 Clinical outcome, Patient, T-cell immunity, consecutive patient,