Intractable Coronavirus Disease 2019 (COVID-19) and Prolonged Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Replication in a Chimeric Antigen Receptor-Modified T-Cell Therapy Recipient: A Case Study

Clin Infect Dis. 2021 Aug 2;73(3):e815-e821. doi: 10.1093/cid/ciab072.

Abstract

A chimeric antigen receptor-modified T-cell therapy recipient developed severe coronavirus disease 2019, intractable RNAemia, and viral replication lasting >2 months. Premortem endotracheal aspirate contained >2 × 1010 severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA copies/mL and infectious virus. Deep sequencing revealed multiple sequence variants consistent with intrahost 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 intrahost variation; severe acute respiratory syndrome coronavirus 2.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • COVID-19*
  • Cell- and Tissue-Based Therapy
  • Humans
  • Receptors, Chimeric Antigen*
  • SARS-CoV-2
  • Virus Replication

Substances

  • Receptors, Chimeric Antigen