Open Forum Infect Dis
. 2021 Aug 2;8(9):ofab359.
doi: 10.1093/ofid/ofab359. eCollection 2021 Sep.
Defective Severe Acute Respiratory Syndrome Coronavirus 2 Immune Responses in an Immunocompromised Individual With Prolonged Viral Replication
Claire L Gordon 1 2 , Olivia C Smibert 1 3 4 , Natasha E Holmes 1 5 , Kyra Y L Chua 1 , Morgan Rose 1 , George Drewett 1 , Fiona James 1 , Effie Mouhtouris 1 , Thi H O Nguyen 2 , Wuji Zhang 2 , Lukasz Kedzierski 2 6 , Louise C Rowntree 2 , Brendon Y Chua 2 , Leon Caly 7 , Mike G Catton 7 , Julian Druce 7 , Michelle Sait 8 , Torsten Seemann 8 , Norelle L Sherry 1 8 , Benjamin P Howden 1 8 , Katherine Kedzierska 2 , Jason C Kwong 1 2 , Jason A Trubiano 1 3 4 9 10
Affiliations
- PMID: 34514016
- PMCID: PMC8419740
- DOI: 10.1093/ofid/ofab359
Abstract
We describe severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-specific immune responses in a patient with lymphoma and recent programmed death 1 (PD-1) inhibitor therapy with late onset of severe coronavirus disease 2019 disease and prolonged SARS-CoV-2 replication, in comparison to age-matched and immunocompromised controls. High levels of HLA-DR+/CD38+ activation, interleukin 6, and interleukin 18 in the absence of B cells and PD-1 expression was observed. SARS-CoV-2-specific antibody responses were absent and SARS-CoV-2-specific T cells were minimally detected. This case highlights challenges in managing immunocompromised hosts who may fail to mount effective virus-specific immune responses.
Keywords: COVID-19; SARS-CoV-2; cellular immunity; humoral immunity; immunocompromise; lymphoma.