Resolution of One-Year Persisting COVID-19 Pneumonia and Development of Immune Thrombocytopenia in a Follicular Lymphoma Patient With Preceding Rituximab Maintenance Therapy: A follow-up Report and Literature Review of Cases With Prolonged Infections

Clin Lymphoma Myeloma Leuk. 2021 Oct;21(10):e810-e816. doi: 10.1016/j.clml.2021.07.004. Epub 2021 Jul 18.

Abstract

Background: We previously reported elsewhere of a follicular lymphoma patient suffering from persistent COVID-19 pneumonia that was still ongoing at 2 months after onset.

Materials and methods: We provide a follow-up report of the case along with a literature review of immunocompromised lymphoma patients experiencing prolonged COVID-19 infections.

Results: Although requiring a full 1 year, the presented case eventually achieved spontaneous resolution of COVID-19 pneumonia. Anti-SARS-CoV-2 antibodies could not be detected throughout the disease course, but COVID-19-directed T-cell response was found to be intact. The patient also developed secondary immune thrombocytopenia subsequent to COVID-19 pneumonia. We found 19 case reports of immunocompromised lymphoma patients with prolonged COVID-19 infections in the literature. All 5 patients who died did not receive convalescent plasma therapy, whereas resolution of COVID-19 infection was achieved in 8 out of 9 patients who received convalescent plasma therapy.

Conclusions: We demonstrate through the presented case that while time-consuming, resolution of COVID-19 infections may be achieved without aid from humoral immunity if cellular immunity is intact. Immunocompromised lymphoma patients are at risk of a prolonged disease course of COVID-19, and convalescent plasma therapy may be a promising approach in such patients.

Keywords: Anti-sars-cov-2 antibodies; Chemotherapy; Convalescent plasma; Coronavirus; Itp.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Antineoplastic Agents, Immunological / therapeutic use
  • COVID-19 / immunology*
  • COVID-19 / virology
  • Female
  • Follow-Up Studies
  • Humans
  • Immunocompromised Host / immunology
  • Lymphoma, Follicular / complications
  • Lymphoma, Follicular / drug therapy*
  • Lymphoma, Follicular / immunology
  • Maintenance Chemotherapy / methods
  • Middle Aged
  • Pneumonia / complications
  • Pneumonia / immunology*
  • Pneumonia / virology
  • Remission, Spontaneous
  • Rituximab / therapeutic use*
  • SARS-CoV-2 / immunology*
  • SARS-CoV-2 / physiology
  • T-Lymphocytes / immunology
  • T-Lymphocytes / virology
  • Thrombocytopenia / complications
  • Thrombocytopenia / immunology*

Substances

  • Antineoplastic Agents, Immunological
  • Rituximab