Prolonged SARS-CoV-2 Infection in Patients with Lymphoid Malignancies.
Prolonged SARS-CoV-2 Infection in Patients with Lymphoid Malignancies.
复制标题
DOI：
10.1158/2159-8290.cd-21-1033
复制
发表时间：
2022-01
期刊：
影响因子：
28.2
通讯作者：
Vardhana SA
中科院分区：
文献类型：
--
作者：
Lee CY;Shah MK;Hoyos D;Solovyov A;Douglas M;Taur Y;Maslak P;Babady NE;Greenbaum B;Kamboj M;Vardhana SA
2019年冠状病毒病（COVID-19）感染导致血液系统恶性肿瘤患者的急性死亡率和持续性和/或复发性疾病，但该人群中持续感染的驱动因素尚不清楚。我们发现B细胞淋巴瘤持续存在SARS-COV-2阳性的风险特别高。与疾病慢性相比，对这些患者的进一步分析确定了初始疾病严重程度的离散危险因素。活跃的治疗和T细胞计数减少是Covid-19感染淋巴瘤患者的急性死亡率的驱动因素。相反，占B细胞的疗法是Covid-19的重新住院的主要驱动力。在具有持续性SARS-COV-2阳性的患者中，我们观察到高水平的病毒熵与Host病毒进化一致，尤其是在CD8+ T细胞免疫受损的患者中。这些结果表明，持续的COVID-19感染可能仍然是适应性免疫受损的患者的风险，并且需要其他治疗策略来在此高风险人群中启用病毒清除。
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.
影响因子：
15.3
作者：
Miller, Carla;Stedra, Jaroslav;Kelsoe, Garnett;Cerny, Jan
通讯作者：
Cerny, Jan