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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...
Autores principales: | , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Frontiers Media S.A.
2022
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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. |
format | Online Article Text |
id | pubmed-9561900 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
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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