Usefulness of Plasma SARS-CoV-2 RNA Quantification by Droplet-based Digital PCR to Monitor Treatment Against COVID-19 in a B-cell Lymphoma Patient

Stem Cell Rev Rep. 2021 Feb;17(1):296-299. doi: 10.1007/s12015-020-10107-5. Epub 2021 Jan 5.

Abstract

We report the case of an HIV-1-infected patient, treated with anti-CD20 monoclonal antibody for a B-cell lymphoma previously treated by autologous stem cell transplant. He suffered from chronic COVID19 and we monitored by plasma SARS-CoV-2 RNA by highly sensitive droplet-based digital PCR technology (ddPCR). Under tocilizumab therapy and despite a first clinical improvement biologically associated with decreasing inflammatory markers, a slight increase of SARS-CoV-2 RNAaemia quantified by ddPCR was highlighted, confirming the absence of viral efficacy of this treatment and predicting the subsequent observed deterioration. As expected, his complete recovery, finally achieved after COVID-19 convalescent plasmatherapy, strictly paralleled plasma SARS-CoV-2 RNA clearance. With these results, we confirmed the interest of SARS-CoV-2 RNAaemia monitoring by ddPCR in COVID-19 patients, particularly during treatment, and firstly showed that this new and specific biomarker could be helpful to select eligible patient for anti-IL6 receptors therapy considering the variable levels of efficacy recently observed with such therapy.

Publication types

  • Case Reports
  • Letter
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Antibodies, Monoclonal, Humanized / therapeutic use
  • COVID-19 / blood*
  • COVID-19 / complications
  • COVID-19 / genetics
  • COVID-19 / virology
  • HIV Infections / blood*
  • HIV Infections / genetics
  • HIV Infections / therapy
  • HIV Infections / virology
  • HIV-1 / pathogenicity
  • Humans
  • Lymphocytes / virology
  • Lymphoma, B-Cell / complications
  • Lymphoma, B-Cell / drug therapy*
  • Lymphoma, B-Cell / genetics
  • Lymphoma, B-Cell / virology
  • RNA, Viral / blood*
  • RNA, Viral / drug effects
  • SARS-CoV-2 / genetics
  • SARS-CoV-2 / pathogenicity
  • Viral Load / drug effects

Substances

  • Antibodies, Monoclonal, Humanized
  • RNA, Viral
  • tocilizumab