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. 2022;145(4):384-393.
doi: 10.1159/000521121. Epub 2021 Nov 26.

Management of Persistent SARS-CoV-2 Infection in Patients with Follicular Lymphoma

Pilar Martínez-Barranco  1 , María García-Roa  2 , Roberto Trelles-Martínez  1 , Karmele Arribalzaga  1 , María Velasco  3   4 , Carlos Guijarro  3 , Javier Marcos  3 , Carolina Campelo  5 , Juan Manuel Acedo-Sanz  6 , Lucía Villalón  1 , Pilar Ricard  1 , María José García-Bueno  1 , Elia Pérez-Fernández  4 , Gil Rodríguez-Caravaca  7 , Francisco-Javier Peñalver  1
Affiliations

Management of Persistent SARS-CoV-2 Infection in Patients with Follicular Lymphoma

Pilar Martínez-Barranco et al. Acta Haematol. 2022.

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.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Fig. 1
Fig. 1
Summary evolution of replicative capacity of COVID-19 (threshold cycle determined by RT-PCR) and treatments received.
See this image and copyright information in PMC

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