tetano
Editor, Senior Moderator
Clin Infect Dis
. 2021 Jan 28;ciab072.
doi: 10.1093/cid/ciab072. Online ahead of print.
Intractable COVID-19 and Prolonged SARS-CoV-2 Replication in a CAR-T-cell Therapy Recipient: A Case Study
Matthew K Hensley[SUP] 1 [/SUP], William G Bain[SUP] 1 2 [/SUP], Jana Jacobs[SUP] 3 [/SUP], Sham Nambulli[SUP] 4 5 [/SUP], Urvi Parikh[SUP] 3 [/SUP], Anthony Cillo[SUP] 6 7 [/SUP], Brittany Staines[SUP] 3 [/SUP], Amy Heaps[SUP] 3 [/SUP], Michele D Sobolewski[SUP] 3 [/SUP], Linda J Rennick[SUP] 4 5 [/SUP], Bernard J C Macatangay[SUP] 3 [/SUP], Cynthia Klamar-Blain[SUP] 3 [/SUP], Georgios D Kitsios[SUP] 1 [/SUP], Barbara Meth?[SUP] 1 [/SUP], Ashwin Somasundaram[SUP] 6 8 [/SUP], Tullia Bruno[SUP] 6 [/SUP], Carly Cardello[SUP] 6 [/SUP], Feng Shan[SUP] 6 [/SUP], Creg Workman[SUP] 6 [/SUP], Prabir Ray[SUP] 1 6 [/SUP], Anuradha Ray[SUP] 1 6 [/SUP], Janet Lee[SUP] 1 9 [/SUP], Rahil Sethi[SUP] 10 [/SUP], William E Schwarzmann[SUP] 10 [/SUP], Mark S Ladinsky[SUP] 11 [/SUP], Pamela J Bjorkman[SUP] 11 [/SUP], Dario A Vignali[SUP] 6 [/SUP], W Paul Duprex[SUP] 4 5 [/SUP], Mounzer E Agha[SUP] 8 [/SUP], John W Mellors[SUP] 3 [/SUP], Kevin D McCormick[SUP] 3 [/SUP], Alison Morris[SUP] 1 [/SUP], Ghady Haidar[SUP] 3 [/SUP]
Affiliations
Abstract
A CAR-T-cell recipient developed severe COVID-19, intractable RNAemia, and viral replication lasting >2 months. Pre-mortem endotracheal aspirate contained 2x10 10 SARS-CoV-2 RNA copies/mL and infectious virus. Deep sequencing revealed multiple sequence variants consistent with intra-host virus evolution. SARS-CoV-2 humoral and cell-mediated immunity were minimal. Prolonged transmission from immunosuppressed patients is possible.
Keywords: COVID-19; SARS-CoV-2 RNAemia; SARS-CoV-2 immune responses; SARS-CoV-2 infectivity; SARS-CoV-2 intra-host variation; Severe Acute Respiratory Syndrome Coronavirus-2.
. 2021 Jan 28;ciab072.
doi: 10.1093/cid/ciab072. Online ahead of print.
Intractable COVID-19 and Prolonged SARS-CoV-2 Replication in a CAR-T-cell Therapy Recipient: A Case Study
Matthew K Hensley[SUP] 1 [/SUP], William G Bain[SUP] 1 2 [/SUP], Jana Jacobs[SUP] 3 [/SUP], Sham Nambulli[SUP] 4 5 [/SUP], Urvi Parikh[SUP] 3 [/SUP], Anthony Cillo[SUP] 6 7 [/SUP], Brittany Staines[SUP] 3 [/SUP], Amy Heaps[SUP] 3 [/SUP], Michele D Sobolewski[SUP] 3 [/SUP], Linda J Rennick[SUP] 4 5 [/SUP], Bernard J C Macatangay[SUP] 3 [/SUP], Cynthia Klamar-Blain[SUP] 3 [/SUP], Georgios D Kitsios[SUP] 1 [/SUP], Barbara Meth?[SUP] 1 [/SUP], Ashwin Somasundaram[SUP] 6 8 [/SUP], Tullia Bruno[SUP] 6 [/SUP], Carly Cardello[SUP] 6 [/SUP], Feng Shan[SUP] 6 [/SUP], Creg Workman[SUP] 6 [/SUP], Prabir Ray[SUP] 1 6 [/SUP], Anuradha Ray[SUP] 1 6 [/SUP], Janet Lee[SUP] 1 9 [/SUP], Rahil Sethi[SUP] 10 [/SUP], William E Schwarzmann[SUP] 10 [/SUP], Mark S Ladinsky[SUP] 11 [/SUP], Pamela J Bjorkman[SUP] 11 [/SUP], Dario A Vignali[SUP] 6 [/SUP], W Paul Duprex[SUP] 4 5 [/SUP], Mounzer E Agha[SUP] 8 [/SUP], John W Mellors[SUP] 3 [/SUP], Kevin D McCormick[SUP] 3 [/SUP], Alison Morris[SUP] 1 [/SUP], Ghady Haidar[SUP] 3 [/SUP]
Affiliations
- PMID: 33507235
- DOI: 10.1093/cid/ciab072
Abstract
A CAR-T-cell recipient developed severe COVID-19, intractable RNAemia, and viral replication lasting >2 months. Pre-mortem endotracheal aspirate contained 2x10 10 SARS-CoV-2 RNA copies/mL and infectious virus. Deep sequencing revealed multiple sequence variants consistent with intra-host virus evolution. SARS-CoV-2 humoral and cell-mediated immunity were minimal. Prolonged transmission from immunosuppressed patients is possible.
Keywords: COVID-19; SARS-CoV-2 RNAemia; SARS-CoV-2 immune responses; SARS-CoV-2 infectivity; SARS-CoV-2 intra-host variation; Severe Acute Respiratory Syndrome Coronavirus-2.