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. 2021 Sep;268(9):3072-3080.
doi: 10.1007/s00415-020-10311-w. Epub 2021 Jan 2.

SARS-CoV-2 infection in patients with primary central nervous system lymphoma

Alice Laurenge  1 , Renata Ursu  2 , Caroline Houillier  1 , Basma Abdi  3   4 , Gianpiero Tebano  5 , Cyril Quemeneur  6 , Sylvain Choquet  7 , Roberta Di Blasi  8 , Fernando Lozano  1 , Andrea Morales  1 , Alberto Durán-Peña  1 , Lila Sirven-Villaros  2 , Bertrand Mathon  9 , Karima Mokhtari  10 , Franck Bielle  10 , Nadine Martin-Duverneuil  11 , Jean-Yves Delattre  1 , Anne-Geneviève Marcelin  3   4 , Valérie Pourcher  4   5 , Agusti Alentorn  1 , Ahmed Idbaih  1 , Antoine F Carpentier  2 , Véronique Leblond  7 , Khê Hoang-Xuan  1 , Mehdi Touat  12
Affiliations

SARS-CoV-2 infection in patients with primary central nervous system lymphoma

Alice Laurenge et al. J Neurol. 2021 Sep.

Abstract

Background: Cancer patients may be at higher risk for severe coronavirus infectious disease-19 (COVID-19); however, the outcome of Primary Central Nervous System Lymphoma (PCNSL) patients with SARS-CoV-2 infection has not been described yet.

Methods: We conducted a retrospective study within the Lymphomes Oculo-Cérébraux national network (LOC) to assess the clinical characteristics and outcome of SARS-CoV-2 infection in PCNSL patients (positive real-time polymerase chain reaction of nasopharyngeal swab or evocative lung computed tomography scan). We compared clinical characteristics between patients with severe (death and/or intensive care unit admission) and mild disease.

Results: Between March and May 2020, 13 PCNSL patients were diagnosed with SARS-CoV-2 infection, 11 (85%) of whom were undergoing chemotherapy at the time of infection. The mortality rate was 23% (3/13), and two additional patients (15%) required mechanical ventilation. Two patients (15%) had no COVID-19 symptoms. History of diabetes mellitus was more common in severe patients (3/5 vs 0/8, p = 0.03). Two patients recovered from COVID-19 after mechanical ventilation during more than two weeks and resumed chemotherapy. In all, chemotherapy was resumed after COVID-19 recovery in nine patients (69%) after a median delay of 16 days (range 3-32), none of whom developed unusual chemotherapy complication nor SARS-Cov2 reactivation.

Conclusion: This preliminary analysis suggests that, while being at higher risk be for severe illness, PCNSL patients with COVID-19 might be treated maximally especially if they achieved oncological response at the time of SARS-CoV-2 infection. Chemotherapy might be resumed without prolonged delay in PCNSL patients with COVID-19.

Keywords: COVID-19; PCNSL.

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Conflict of interest statement

MT reports consulting or advisory role from Agios Pharmaceutical, Integragen, and Taiho Oncology, outside the submitted work; travel, accommodations, expenses from Merck Sharp & Dome, outside the submitted work. All authors report no disclosures relevant to the manuscript.

Figures

Fig. 1
Fig. 1
Timeline of illness onset, SARS-CoV-2 RNA detection, admission, oxygen therapy, symptom resolution and chemotherapy resumption among the cohort
Fig. 2
Fig. 2
Severe COVID-19 Infection in a 65-year-old patient with PCNSL. a Clinical Timeline. Top, timeline; bottom, brain MRI (left, T1-Gad; right, FLAIR) and lung CT-scan images during initial PCNSL diagnosis (left), SARS-Cov2 infection, and the recovery phase. b–e Evolution of gas exchange parameters during SARS-Cov2 infection
See this image and copyright information in PMC

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