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Case report: Long-lasting SARS-CoV-2 infection with post-COVID-19 condition in two patients with chronic lymphocytic leukemia: The emerging therapeutic role of casirivimab/imdevimab

Post-coronavirus disease 2019 (post-COVID-19) condition, previously referred to as long COVID, includes a post-acute syndrome defined by the presence of non-specific symptoms occurring usually 3 months from the onset of the acute phase and lasting at least 2 months. Patients with chronic lymphocytic...

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Autores principales: Ballotta, Laura, Simonetti, Omar, D’Agaro, Pierlanfranco, Segat, Ludovica, Koncan, Raffaella, Martinez-Orellana, Pamela, Dattola, Federica, Orsini, Emanuele, Marcello, Alessandro, Dal Monego, Simeone, Licastro, Danilo, Misin, Andrea, Mohamed, Sara, Sbisà, Eugenio, Lucchini, Elisa, De Sabbata, Giovanni Maria, Zaja, Francesco, Luzzati, Roberto
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9561900/
https://www.ncbi.nlm.nih.gov/pubmed/36249044
http://dx.doi.org/10.3389/fonc.2022.945060
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author Ballotta, Laura
Simonetti, Omar
D’Agaro, Pierlanfranco
Segat, Ludovica
Koncan, Raffaella
Martinez-Orellana, Pamela
Dattola, Federica
Orsini, Emanuele
Marcello, Alessandro
Dal Monego, Simeone
Licastro, Danilo
Misin, Andrea
Mohamed, Sara
Sbisà, Eugenio
Lucchini, Elisa
De Sabbata, Giovanni Maria
Zaja, Francesco
Luzzati, Roberto
author_facet Ballotta, Laura
Simonetti, Omar
D’Agaro, Pierlanfranco
Segat, Ludovica
Koncan, Raffaella
Martinez-Orellana, Pamela
Dattola, Federica
Orsini, Emanuele
Marcello, Alessandro
Dal Monego, Simeone
Licastro, Danilo
Misin, Andrea
Mohamed, Sara
Sbisà, Eugenio
Lucchini, Elisa
De Sabbata, Giovanni Maria
Zaja, Francesco
Luzzati, Roberto
author_sort Ballotta, Laura
collection PubMed
description Post-coronavirus disease 2019 (post-COVID-19) condition, previously referred to as long COVID, includes a post-acute syndrome defined by the presence of non-specific symptoms occurring usually 3 months from the onset of the acute phase and lasting at least 2 months. Patients with chronic lymphocytic leukemia (CLL) represent a high-risk population for COVID-19. Moreover, the response to SARS-CoV-2 vaccination is often absent or inadequate. The introduction of monoclonal antibodies (mAbs) in the treatment landscape of COVID-19 allowed to reduce hospitalization and mortality in mild–moderate SARS-CoV-2 infection, but limited data are available in hematological patients. We here report the effective use of casirivimab/imdevimab (CI) in the treatment of two CLL patients with persistent infection and post-COVID-19 condition. Full genome sequencing of viral RNA from nasopharyngeal swabs was performed at the time of COVID-19 diagnosis and before the administration of CI. Both patients experienced persistent SARS-CoV-2 infection with no seroconversion for 8 and 7 months, respectively, associated with COVID symptoms. In both cases after the infusion of CI, we observed a rapid negativization of the nasal swabs, the resolution of post-COVID-19 condition, and the development of both the IgG against the trimeric spike protein and the receptor-binding domain (RBD) of the spike protein. The analysis of the viral genome in the period elapsed from the time of COVID-19 diagnosis and the administration of mAbs showed the development of new mutations, especially in the S gene. The genome variations observed during the time suggest a role of persistent SARS-CoV-2 infection as a possible source for the development of viral variants. The effects observed in these two patients appeared strongly related to passive immunity conferred by CI treatment permitting SARS-CoV-2 clearance and resolution of post-COVID-19 condition. On these grounds, passive anti-SARS-CoV-2 antibody treatment may represent as a possible therapeutic option in some patients with persistent SARS-CoV-2 infection.
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spelling pubmed-95619002022-10-15 Case report: Long-lasting SARS-CoV-2 infection with post-COVID-19 condition in two patients with chronic lymphocytic leukemia: The emerging therapeutic role of casirivimab/imdevimab Ballotta, Laura Simonetti, Omar D’Agaro, Pierlanfranco Segat, Ludovica Koncan, Raffaella Martinez-Orellana, Pamela Dattola, Federica Orsini, Emanuele Marcello, Alessandro Dal Monego, Simeone Licastro, Danilo Misin, Andrea Mohamed, Sara Sbisà, Eugenio Lucchini, Elisa De Sabbata, Giovanni Maria Zaja, Francesco Luzzati, Roberto Front Oncol Oncology Post-coronavirus disease 2019 (post-COVID-19) condition, previously referred to as long COVID, includes a post-acute syndrome defined by the presence of non-specific symptoms occurring usually 3 months from the onset of the acute phase and lasting at least 2 months. Patients with chronic lymphocytic leukemia (CLL) represent a high-risk population for COVID-19. Moreover, the response to SARS-CoV-2 vaccination is often absent or inadequate. The introduction of monoclonal antibodies (mAbs) in the treatment landscape of COVID-19 allowed to reduce hospitalization and mortality in mild–moderate SARS-CoV-2 infection, but limited data are available in hematological patients. We here report the effective use of casirivimab/imdevimab (CI) in the treatment of two CLL patients with persistent infection and post-COVID-19 condition. Full genome sequencing of viral RNA from nasopharyngeal swabs was performed at the time of COVID-19 diagnosis and before the administration of CI. Both patients experienced persistent SARS-CoV-2 infection with no seroconversion for 8 and 7 months, respectively, associated with COVID symptoms. In both cases after the infusion of CI, we observed a rapid negativization of the nasal swabs, the resolution of post-COVID-19 condition, and the development of both the IgG against the trimeric spike protein and the receptor-binding domain (RBD) of the spike protein. The analysis of the viral genome in the period elapsed from the time of COVID-19 diagnosis and the administration of mAbs showed the development of new mutations, especially in the S gene. The genome variations observed during the time suggest a role of persistent SARS-CoV-2 infection as a possible source for the development of viral variants. The effects observed in these two patients appeared strongly related to passive immunity conferred by CI treatment permitting SARS-CoV-2 clearance and resolution of post-COVID-19 condition. On these grounds, passive anti-SARS-CoV-2 antibody treatment may represent as a possible therapeutic option in some patients with persistent SARS-CoV-2 infection. Frontiers Media S.A. 2022-09-30 /pmc/articles/PMC9561900/ /pubmed/36249044 http://dx.doi.org/10.3389/fonc.2022.945060 Text en Copyright © 2022 Ballotta, Simonetti, D’Agaro, Segat, Koncan, Martinez-Orellana, Dattola, Orsini, Marcello, Dal Monego, Licastro, Misin, Mohamed, Sbisà, Lucchini, De Sabbata, Zaja and Luzzati https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Oncology
Ballotta, Laura
Simonetti, Omar
D’Agaro, Pierlanfranco
Segat, Ludovica
Koncan, Raffaella
Martinez-Orellana, Pamela
Dattola, Federica
Orsini, Emanuele
Marcello, Alessandro
Dal Monego, Simeone
Licastro, Danilo
Misin, Andrea
Mohamed, Sara
Sbisà, Eugenio
Lucchini, Elisa
De Sabbata, Giovanni Maria
Zaja, Francesco
Luzzati, Roberto
Case report: Long-lasting SARS-CoV-2 infection with post-COVID-19 condition in two patients with chronic lymphocytic leukemia: The emerging therapeutic role of casirivimab/imdevimab
title Case report: Long-lasting SARS-CoV-2 infection with post-COVID-19 condition in two patients with chronic lymphocytic leukemia: The emerging therapeutic role of casirivimab/imdevimab
title_full Case report: Long-lasting SARS-CoV-2 infection with post-COVID-19 condition in two patients with chronic lymphocytic leukemia: The emerging therapeutic role of casirivimab/imdevimab
title_fullStr Case report: Long-lasting SARS-CoV-2 infection with post-COVID-19 condition in two patients with chronic lymphocytic leukemia: The emerging therapeutic role of casirivimab/imdevimab
title_full_unstemmed Case report: Long-lasting SARS-CoV-2 infection with post-COVID-19 condition in two patients with chronic lymphocytic leukemia: The emerging therapeutic role of casirivimab/imdevimab
title_short Case report: Long-lasting SARS-CoV-2 infection with post-COVID-19 condition in two patients with chronic lymphocytic leukemia: The emerging therapeutic role of casirivimab/imdevimab
title_sort case report: long-lasting sars-cov-2 infection with post-covid-19 condition in two patients with chronic lymphocytic leukemia: the emerging therapeutic role of casirivimab/imdevimab
topic Oncology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9561900/
https://www.ncbi.nlm.nih.gov/pubmed/36249044
http://dx.doi.org/10.3389/fonc.2022.945060
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