Relapsing COVID-19 in a Patient With Non-Hodgkin Lymphoma on Chemotherapy

Detalhes bibliográficos
Autor(a) principal: Carujo, A
Data de Publicação: 2023
Outros Autores: Ferreira, L, Bergantim, R, Santos Silva, A, Vasconcelos, AL
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
Texto Completo: http://hdl.handle.net/10400.26/48902
Resumo: Hematologic malignancies and chemotherapy are risk factors for COVID-19 progression and mortality. Immunocompromised hosts, particularly those with severe B-cell depletion, can shed viable viruses for extended periods, which can lead to persistent infection. We present the case of a 73-year-old male with diffuse large B-cell lymphoma (stage IV-B) under curative immunochemotherapy with rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP). After the first episode of mild COVID-19, he developed two severe relapses following the third and fourth cycles of R-CHOP. Lung CT scans performed in both episodes showed new-onset ground-glass infiltrates and fibrosis of previously affected pulmonary segments. In light of similar semiquantitative SARS-CoV-2 viral loads between episodes, without further risk exposure or microbiological findings, persistent COVID-19 with severe clinical relapses was assumed and successfully treated with polyclonal immunoglobulin and remdesivir. Whole-genome sequencing was performed in all samples, confirming the same specimen, which belonged to the B.1.177 lineage. This case stands out for the unusually long viral persistence and the various relapses of severe COVID-19 related to the worsening immune status with each immunochemotherapy cycle.
id RCAP_f5ad5be836e777a3ed631b5c3290671d
oai_identifier_str oai:comum.rcaap.pt:10400.26/48902
network_acronym_str RCAP
network_name_str Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
repository_id_str 7160
spelling Relapsing COVID-19 in a Patient With Non-Hodgkin Lymphoma on ChemotherapyCOVID-19Linfoma Não- Hodgkin/tratamentoLymphoma, Non-Hodgkin/therapyHematologic malignancies and chemotherapy are risk factors for COVID-19 progression and mortality. Immunocompromised hosts, particularly those with severe B-cell depletion, can shed viable viruses for extended periods, which can lead to persistent infection. We present the case of a 73-year-old male with diffuse large B-cell lymphoma (stage IV-B) under curative immunochemotherapy with rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP). After the first episode of mild COVID-19, he developed two severe relapses following the third and fourth cycles of R-CHOP. Lung CT scans performed in both episodes showed new-onset ground-glass infiltrates and fibrosis of previously affected pulmonary segments. In light of similar semiquantitative SARS-CoV-2 viral loads between episodes, without further risk exposure or microbiological findings, persistent COVID-19 with severe clinical relapses was assumed and successfully treated with polyclonal immunoglobulin and remdesivir. Whole-genome sequencing was performed in all samples, confirming the same specimen, which belonged to the B.1.177 lineage. This case stands out for the unusually long viral persistence and the various relapses of severe COVID-19 related to the worsening immune status with each immunochemotherapy cycle.Repositório ComumCarujo, AFerreira, LBergantim, RSantos Silva, AVasconcelos, AL2024-01-14T17:47:40Z20232023-01-01T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttp://hdl.handle.net/10400.26/48902engCureus . 2023 Dec 5;15(12):e49974.10.7759/cureus.49974info:eu-repo/semantics/openAccessreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAP2024-01-16T04:45:19Zoai:comum.rcaap.pt:10400.26/48902Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-20T01:44:49.094175Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse
dc.title.none.fl_str_mv Relapsing COVID-19 in a Patient With Non-Hodgkin Lymphoma on Chemotherapy
title Relapsing COVID-19 in a Patient With Non-Hodgkin Lymphoma on Chemotherapy
spellingShingle Relapsing COVID-19 in a Patient With Non-Hodgkin Lymphoma on Chemotherapy
Carujo, A
COVID-19
Linfoma Não- Hodgkin/tratamento
Lymphoma, Non-Hodgkin/therapy
title_short Relapsing COVID-19 in a Patient With Non-Hodgkin Lymphoma on Chemotherapy
title_full Relapsing COVID-19 in a Patient With Non-Hodgkin Lymphoma on Chemotherapy
title_fullStr Relapsing COVID-19 in a Patient With Non-Hodgkin Lymphoma on Chemotherapy
title_full_unstemmed Relapsing COVID-19 in a Patient With Non-Hodgkin Lymphoma on Chemotherapy
title_sort Relapsing COVID-19 in a Patient With Non-Hodgkin Lymphoma on Chemotherapy
author Carujo, A
author_facet Carujo, A
Ferreira, L
Bergantim, R
Santos Silva, A
Vasconcelos, AL
author_role author
author2 Ferreira, L
Bergantim, R
Santos Silva, A
Vasconcelos, AL
author2_role author
author
author
author
dc.contributor.none.fl_str_mv Repositório Comum
dc.contributor.author.fl_str_mv Carujo, A
Ferreira, L
Bergantim, R
Santos Silva, A
Vasconcelos, AL
dc.subject.por.fl_str_mv COVID-19
Linfoma Não- Hodgkin/tratamento
Lymphoma, Non-Hodgkin/therapy
topic COVID-19
Linfoma Não- Hodgkin/tratamento
Lymphoma, Non-Hodgkin/therapy
description Hematologic malignancies and chemotherapy are risk factors for COVID-19 progression and mortality. Immunocompromised hosts, particularly those with severe B-cell depletion, can shed viable viruses for extended periods, which can lead to persistent infection. We present the case of a 73-year-old male with diffuse large B-cell lymphoma (stage IV-B) under curative immunochemotherapy with rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP). After the first episode of mild COVID-19, he developed two severe relapses following the third and fourth cycles of R-CHOP. Lung CT scans performed in both episodes showed new-onset ground-glass infiltrates and fibrosis of previously affected pulmonary segments. In light of similar semiquantitative SARS-CoV-2 viral loads between episodes, without further risk exposure or microbiological findings, persistent COVID-19 with severe clinical relapses was assumed and successfully treated with polyclonal immunoglobulin and remdesivir. Whole-genome sequencing was performed in all samples, confirming the same specimen, which belonged to the B.1.177 lineage. This case stands out for the unusually long viral persistence and the various relapses of severe COVID-19 related to the worsening immune status with each immunochemotherapy cycle.
publishDate 2023
dc.date.none.fl_str_mv 2023
2023-01-01T00:00:00Z
2024-01-14T17:47:40Z
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
format article
status_str publishedVersion
dc.identifier.uri.fl_str_mv http://hdl.handle.net/10400.26/48902
url http://hdl.handle.net/10400.26/48902
dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv Cureus . 2023 Dec 5;15(12):e49974.
10.7759/cureus.49974
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.source.none.fl_str_mv reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
instacron:RCAAP
instname_str Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
instacron_str RCAAP
institution RCAAP
reponame_str Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
collection Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
repository.name.fl_str_mv Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
repository.mail.fl_str_mv
_version_ 1799136944249110528