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Prolonged infective SARS-CoV-2 omicron variant shedding in a patient with diffuse large B cell lymphoma successfully cleared after three courses of remdesivir
We report a case of prolonged shedding of the infective SARS-CoV-2 omicron variant BA.1.1.2 in a 79-year-old male patient with diffuse large B-cell lymphoma, after receiving chemotherapy with rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone (R-CHOP). The patient was admitted t...
Autores principales: | , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Japanese Society of Chemotherapy, Japanese Association for Infectious Diseases, and Japanese Society for Infection Prevention and Control. Published by Elsevier Ltd.
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10176961/ https://www.ncbi.nlm.nih.gov/pubmed/37182841 http://dx.doi.org/10.1016/j.jiac.2023.05.003 |
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author | Nakamura, Kiwamu Sugiyama, Masahiro Ishizuka, Hikari Sasajima, Tomomi Minakawa, Yoko Sato, Hiroko Miyazawa, Masatsugu Kitakawa, Kazuhiro Fujita, Shohei Saito, Nozomi Kashiwabara, Naoko Kohata, Hironobu Hara, Yasuka Kanari, Yumiko Shinka, Toshikatsu Kanemitsu, Keiji |
author_facet | Nakamura, Kiwamu Sugiyama, Masahiro Ishizuka, Hikari Sasajima, Tomomi Minakawa, Yoko Sato, Hiroko Miyazawa, Masatsugu Kitakawa, Kazuhiro Fujita, Shohei Saito, Nozomi Kashiwabara, Naoko Kohata, Hironobu Hara, Yasuka Kanari, Yumiko Shinka, Toshikatsu Kanemitsu, Keiji |
author_sort | Nakamura, Kiwamu |
collection | PubMed |
description | We report a case of prolonged shedding of the infective SARS-CoV-2 omicron variant BA.1.1.2 in a 79-year-old male patient with diffuse large B-cell lymphoma, after receiving chemotherapy with rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone (R-CHOP). The patient was admitted to our hospital in late March 2022 for the sixth course of R-CHOP chemotherapy. Initially, the patient tested negative for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) using an in-hospital loop-mediated amplification assay with a nasopharyngeal swab, both on the day of admission and three days later. However, the patient developed fever and was diagnosed with coronavirus disease (COVID-19) six days after admission and was suspected to have contracted the infection in the ward. Viral shedding continued for more than three months, with confirmed viral infectivity. As compared to the original Wuhan-Hu-1/2019 strain, amino acid substitutions including S36 N in non-structural protein (NSP)2, S148P, S1265del and L1266I in NSP3, G105D in NSP4, G496S, A831V, or V987F in spike protein, and I45T in open-reading frame (ORF)9b were randomly detected in isolated viruses. Although the patient had received two doses of the BNT162b2 vaccine approximately six months earlier and the third dose on day 127 after the infection, both serum anti-spike and anti-nuclear protein IgG and IgM tests were negative at day 92, 114, and 149 after the infection. The patient finally cleared the virus after the third course of remdesivir and did not have further recurrence. |
format | Online Article Text |
id | pubmed-10176961 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Japanese Society of Chemotherapy, Japanese Association for Infectious Diseases, and Japanese Society for Infection Prevention and Control. Published by Elsevier Ltd. |
record_format | MEDLINE/PubMed |
spelling | pubmed-101769612023-05-12 Prolonged infective SARS-CoV-2 omicron variant shedding in a patient with diffuse large B cell lymphoma successfully cleared after three courses of remdesivir Nakamura, Kiwamu Sugiyama, Masahiro Ishizuka, Hikari Sasajima, Tomomi Minakawa, Yoko Sato, Hiroko Miyazawa, Masatsugu Kitakawa, Kazuhiro Fujita, Shohei Saito, Nozomi Kashiwabara, Naoko Kohata, Hironobu Hara, Yasuka Kanari, Yumiko Shinka, Toshikatsu Kanemitsu, Keiji J Infect Chemother Case Report We report a case of prolonged shedding of the infective SARS-CoV-2 omicron variant BA.1.1.2 in a 79-year-old male patient with diffuse large B-cell lymphoma, after receiving chemotherapy with rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone (R-CHOP). The patient was admitted to our hospital in late March 2022 for the sixth course of R-CHOP chemotherapy. Initially, the patient tested negative for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) using an in-hospital loop-mediated amplification assay with a nasopharyngeal swab, both on the day of admission and three days later. However, the patient developed fever and was diagnosed with coronavirus disease (COVID-19) six days after admission and was suspected to have contracted the infection in the ward. Viral shedding continued for more than three months, with confirmed viral infectivity. As compared to the original Wuhan-Hu-1/2019 strain, amino acid substitutions including S36 N in non-structural protein (NSP)2, S148P, S1265del and L1266I in NSP3, G105D in NSP4, G496S, A831V, or V987F in spike protein, and I45T in open-reading frame (ORF)9b were randomly detected in isolated viruses. Although the patient had received two doses of the BNT162b2 vaccine approximately six months earlier and the third dose on day 127 after the infection, both serum anti-spike and anti-nuclear protein IgG and IgM tests were negative at day 92, 114, and 149 after the infection. The patient finally cleared the virus after the third course of remdesivir and did not have further recurrence. Japanese Society of Chemotherapy, Japanese Association for Infectious Diseases, and Japanese Society for Infection Prevention and Control. Published by Elsevier Ltd. 2023-08 2023-05-12 /pmc/articles/PMC10176961/ /pubmed/37182841 http://dx.doi.org/10.1016/j.jiac.2023.05.003 Text en © 2023 Japanese Society of Chemotherapy, Japanese Association for Infectious Diseases, and Japanese Society for Infection Prevention and Control. Published by Elsevier Ltd. All rights reserved. Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active. |
spellingShingle | Case Report Nakamura, Kiwamu Sugiyama, Masahiro Ishizuka, Hikari Sasajima, Tomomi Minakawa, Yoko Sato, Hiroko Miyazawa, Masatsugu Kitakawa, Kazuhiro Fujita, Shohei Saito, Nozomi Kashiwabara, Naoko Kohata, Hironobu Hara, Yasuka Kanari, Yumiko Shinka, Toshikatsu Kanemitsu, Keiji Prolonged infective SARS-CoV-2 omicron variant shedding in a patient with diffuse large B cell lymphoma successfully cleared after three courses of remdesivir |
title | Prolonged infective SARS-CoV-2 omicron variant shedding in a patient with diffuse large B cell lymphoma successfully cleared after three courses of remdesivir |
title_full | Prolonged infective SARS-CoV-2 omicron variant shedding in a patient with diffuse large B cell lymphoma successfully cleared after three courses of remdesivir |
title_fullStr | Prolonged infective SARS-CoV-2 omicron variant shedding in a patient with diffuse large B cell lymphoma successfully cleared after three courses of remdesivir |
title_full_unstemmed | Prolonged infective SARS-CoV-2 omicron variant shedding in a patient with diffuse large B cell lymphoma successfully cleared after three courses of remdesivir |
title_short | Prolonged infective SARS-CoV-2 omicron variant shedding in a patient with diffuse large B cell lymphoma successfully cleared after three courses of remdesivir |
title_sort | prolonged infective sars-cov-2 omicron variant shedding in a patient with diffuse large b cell lymphoma successfully cleared after three courses of remdesivir |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10176961/ https://www.ncbi.nlm.nih.gov/pubmed/37182841 http://dx.doi.org/10.1016/j.jiac.2023.05.003 |
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