Abstract
Introduction: There is no consensus on the management of the coronavirus disease (COVID-19) in patients with secondary immunosuppression due to either an underlying hematological disease or to the effects of immunochemotherapy (ICT). Some of them may present persistent infection with multiple relapses of COVID-19, requiring several admissions. This study evaluated the clinical characteristics and outcomes after treatment of 5 patients with follicular lymphoma (FL), previously treated with ICT, who developed several episodes of COVID-19.
Methods: We analyzed the clinical evolution and response to treatment with antiviral agent, steroids, and convalescent plasma in 5 patients with FL and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) persistent infection. Reverse transcriptase polymerase chain reaction tests and peripheral blood immunophenotype were performed for all patients.
Results: All patients required hospitalization due to pneumonia with severity criteria and were re-admitted after a median of 22 days (13-42) from the previous discharge. They all showed B-cell depletion by immunophenotyping, and no traces of immunoglobulin antibodies against SARS-CoV-2 were detected in any of the cases. The survival rate was 80%.
Conclusion: The combination therapy evidenced clinical benefits, demonstrating its capacity to control infection in immunosuppressed FL patients treated with ICT.
Keywords: COVID-19; Follicular lymphoma; Immunocompromised patients; Persistent infection; SARS-CoV-2.
【저자키워드】 COVID-19, Immunocompromised patients, SARS-CoV-2., persistent infection, Follicular lymphoma, 【초록키워드】 Treatment, coronavirus disease, convalescent plasma, SARS-CoV-2, coronavirus, Antiviral, Clinical characteristics, Pneumonia, antibody, severity, Infection, Immunosuppression, combination therapy, outcome, Steroids, discharge, Peripheral blood, Immunoglobulin, lymphoma, management, Patient, survival rate, persistent, disease, patients, B-cell, Immunosuppressed, criteria, reverse transcriptase, Admissions, Consensus, acute respiratory syndrome, clinical benefits, hematological, clinical evolution, Effect, polymerase chain, analyzed, performed, evaluated, median, treated, evidenced, follicular, patients required hospitalization, patients treated, 【제목키워드】 SARS-CoV-2, persistent,