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A 63-Year-Old Woman with a History of Non-Hodgkin Lymphoma with Persistent SARS-CoV-2 Infection Who Was Seronegative and Treated with Convalescent Plasma.
Moore, Joanna L; Ganapathiraju, Pavan V; Kurtz, Caroline P; Wainscoat, Booth.
  • Moore JL; Department of Medicine, Norwalk Hospital, Norwalk, CT, USA.
  • Ganapathiraju PV; Department of Internal Medicine, Yale School of Medicine, New Haven, CT, USA.
  • Kurtz CP; Department of Pulmonary and Critical Care Medicine, Norwalk Hospital, Yale School of Medicine, University of Vermont School of Medicine, Norwalk, CT, USA.
  • Wainscoat B; Department of Pulmonary and Critical Care Medicine, Norwalk Hospital, Norwalk, CT, USA.
Am J Case Rep ; 21: e927812, 2020 Oct 03.
Article in English | MEDLINE | ID: covidwho-854653
ABSTRACT
BACKGROUND This is a case report of an immunocompromised patient with a history of non-Hodgkin lymphoma and persistent severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection who was seronegative and successfully treated with convalescent plasma. CASE REPORT A 63-year-old woman with a past medical history of non-Hodgkin lymphoma in remission while on maintenance therapy with the anti-CD20 monoclonal antibody, obinutuzumab, tested positive for SARS-CoV-2 via nasopharyngeal reverse transcription polymerase chain reaction (RT-PCR) testing over 12 weeks and persistently tested seronegative for immunoglobulin G (IgG) antibodies using SARS-CoV-2 IgG chemiluminescent microparticle immunoassay technology. During this time, the patient experienced waxing and waning of symptoms, which included fever, myalgia, and non-productive cough, but never acquired severe respiratory distress. She was admitted to our hospital on illness day 88, and her symptoms resolved after the administration of convalescent plasma. CONCLUSIONS As the understanding of the pathogenesis of SARS-CoV-2 continues to evolve, we can currently only speculate about the occurrence of chronic infection vs. reinfection. The protective role of antibodies and their longevity against SARS-CoV-2 remain unclear. Since humoral immunity has an integral role in SARS-CoV-2 infection, various phase 3 vaccine trials are underway. In the context of this pandemic, the present case demonstrates the challenges in our understanding of testing and treating immunocompromised patients.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pneumonia, Viral / Lymphoma, Non-Hodgkin / Immunocompromised Host / Coronavirus Infections / Antibodies, Monoclonal, Humanized Type of study: Case report / Cohort study / Diagnostic study / Prognostic study Topics: Long Covid / Vaccines Limits: Female / Humans / Middle aged Language: English Journal: Am J Case Rep Year: 2020 Document Type: Article Affiliation country: AJCR.927812

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pneumonia, Viral / Lymphoma, Non-Hodgkin / Immunocompromised Host / Coronavirus Infections / Antibodies, Monoclonal, Humanized Type of study: Case report / Cohort study / Diagnostic study / Prognostic study Topics: Long Covid / Vaccines Limits: Female / Humans / Middle aged Language: English Journal: Am J Case Rep Year: 2020 Document Type: Article Affiliation country: AJCR.927812