tetano
Editor, Senior Moderator
Cancer Discov
. 2021 Nov 9;candisc.1033.2021.
doi: 10.1158/2159-8290.CD-21-1033. Online ahead of print.
Prolonged SARS-CoV-2 infection in patients with lymphoid malignancies
Christina Y Lee[SUP] 1 [/SUP], Monika K Shah[SUP] 1 [/SUP], David Hoyos[SUP] 2 [/SUP], Alexander Solovyov[SUP] 3 [/SUP], Melanie Douglas[SUP] 1 [/SUP], Ying Taur[SUP] 4 [/SUP], Peter Maslak[SUP] 5 [/SUP], N Esther Babady[SUP] 6 [/SUP], Benjamin Greenbaum, Mini Kamboj[SUP] 7 [/SUP], Santosha A Vardhana[SUP] 8 [/SUP]
Affiliations
Abstract
Coronavirus disease 2019 (COVID-19) infection results in both acute mortality and persistent and/or recurrent disease in patients with hematologic malignancies, but the drivers of persistent infection in this population are unknown. We found that B-cell lymphomas were at particularly high risk for persistent SARS-CoV-2 positivity. Further analysis of these patients identified discrete risk factors for initial disease severity as compared to disease chronicity. Active therapy and diminished T-cell counts were drivers of acute mortality in COVID-19 infected lymphoma patients. Conversely, B-cell-depleting therapy was the primary driver of re-hospitalization for COVID-19. In patients with persistent SARS-CoV-2 positivity, we observed high levels of viral entropy consistent with intrahost viral evolution, particularly in patients with impaired CD8+ T-cell immunity. These results suggest that persistent COVID-19 infection is likely to remain a risk in patients with impaired adaptive immunity and that additional therapeutic strategies are needed to enable viral clearance in this high-risk population.
. 2021 Nov 9;candisc.1033.2021.
doi: 10.1158/2159-8290.CD-21-1033. Online ahead of print.
Prolonged SARS-CoV-2 infection in patients with lymphoid malignancies
Christina Y Lee[SUP] 1 [/SUP], Monika K Shah[SUP] 1 [/SUP], David Hoyos[SUP] 2 [/SUP], Alexander Solovyov[SUP] 3 [/SUP], Melanie Douglas[SUP] 1 [/SUP], Ying Taur[SUP] 4 [/SUP], Peter Maslak[SUP] 5 [/SUP], N Esther Babady[SUP] 6 [/SUP], Benjamin Greenbaum, Mini Kamboj[SUP] 7 [/SUP], Santosha A Vardhana[SUP] 8 [/SUP]
Affiliations
- PMID: 34753749
- DOI: 10.1158/2159-8290.CD-21-1033
Abstract
Coronavirus disease 2019 (COVID-19) infection results in both acute mortality and persistent and/or recurrent disease in patients with hematologic malignancies, but the drivers of persistent infection in this population are unknown. We found that B-cell lymphomas were at particularly high risk for persistent SARS-CoV-2 positivity. Further analysis of these patients identified discrete risk factors for initial disease severity as compared to disease chronicity. Active therapy and diminished T-cell counts were drivers of acute mortality in COVID-19 infected lymphoma patients. Conversely, B-cell-depleting therapy was the primary driver of re-hospitalization for COVID-19. In patients with persistent SARS-CoV-2 positivity, we observed high levels of viral entropy consistent with intrahost viral evolution, particularly in patients with impaired CD8+ T-cell immunity. These results suggest that persistent COVID-19 infection is likely to remain a risk in patients with impaired adaptive immunity and that additional therapeutic strategies are needed to enable viral clearance in this high-risk population.