Rare Case of Persistently Depressed T Lymphocyte Subsets After SARS-CoV-2 Infection.
Am J Case Rep
; 23: e937760, 2022 Nov 01.
Article
in English
| MEDLINE | ID: covidwho-2100412
ABSTRACT
BACKGROUND On rare occasions, viral infections are known to also depress immune cell lines, further worsening clinical outcomes. We describe a patient who presented 3 weeks after recovery from mild COVID-19 disease with clinical features of an atypical pneumonia and was found to have a low CD4+ T-cell count. CASE REPORT An 82-year-old man with a past medical history of coronary artery disease, rheumatoid arthritis, gout, hypertension, and atrial fibrillation presented with a 1-week history of progressively worsening shortness of breath and cough. He was noted to have recovered from mild SARS-CoV-2 infection 3 weeks prior to his current presentation and had been at his baseline level of health following infection. A T cell subset panel was obtained, which revealed an absolute CD3 count of 92 (reference range 840-3060), absolute CD4 count of 52 (reference range 500-1400), absolute CD8 count of 37 (reference range 180-1170), and a normal CD4 CD8 ratio. He was subsequently started on atovaquone for pneumocystis jiroveci pneumonia prophylaxis. CONCLUSIONS This case highlights the need for a high index of suspicion for lymphocyte depletion in older patients with multiple comorbidities who present during or after SARS-CoV-2 infection with atypical symptoms that are suggestive of immunosuppression. In such instances, there should be a low threshold to start prophylactic therapy for possible opportunistic infections.
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Pneumonia, Pneumocystis
/
COVID-19
Type of study:
Case report
/
Prognostic study
Topics:
Long Covid
Limits:
Aged
/
Humans
/
Male
Language:
English
Journal:
Am J Case Rep
Year:
2022
Document Type:
Article
Affiliation country:
AJCR.937760
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