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...
| Main Authors: | , , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2022-09-01
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| Series: | Frontiers in Oncology |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fonc.2022.945060/full |
| _version_ | 1828386596909481984 |
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| author | Laura Ballotta Laura Ballotta Omar Simonetti Pierlanfranco D’Agaro Pierlanfranco D’Agaro Ludovica Segat Raffaella Koncan Raffaella Koncan Pamela Martinez-Orellana Federica Dattola Federica Dattola Emanuele Orsini Alessandro Marcello Simeone Dal Monego Danilo Licastro Andrea Misin Sara Mohamed Eugenio Sbisà Elisa Lucchini Giovanni Maria De Sabbata Francesco Zaja Francesco Zaja Roberto Luzzati Roberto Luzzati |
| author_facet | Laura Ballotta Laura Ballotta Omar Simonetti Pierlanfranco D’Agaro Pierlanfranco D’Agaro Ludovica Segat Raffaella Koncan Raffaella Koncan Pamela Martinez-Orellana Federica Dattola Federica Dattola Emanuele Orsini Alessandro Marcello Simeone Dal Monego Danilo Licastro Andrea Misin Sara Mohamed Eugenio Sbisà Elisa Lucchini Giovanni Maria De Sabbata Francesco Zaja Francesco Zaja Roberto Luzzati Roberto Luzzati |
| author_sort | Laura Ballotta |
| collection | DOAJ |
| 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. |
| first_indexed | 2024-12-10T05:39:54Z |
| format | Article |
| id | doaj.art-536c0ab5cb9149988f1bd8145ebe5619 |
| institution | Directory Open Access Journal |
| issn | 2234-943X |
| language | English |
| last_indexed | 2024-12-10T05:39:54Z |
| publishDate | 2022-09-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Oncology |
| spelling | doaj.art-536c0ab5cb9149988f1bd8145ebe56192022-12-22T02:00:18ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2022-09-011210.3389/fonc.2022.945060945060Case 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/imdevimabLaura Ballotta0Laura Ballotta1Omar Simonetti2Pierlanfranco D’Agaro3Pierlanfranco D’Agaro4Ludovica Segat5Raffaella Koncan6Raffaella Koncan7Pamela Martinez-Orellana8Federica Dattola9Federica Dattola10Emanuele Orsini11Alessandro Marcello12Simeone Dal Monego13Danilo Licastro14Andrea Misin15Sara Mohamed16Eugenio Sbisà17Elisa Lucchini18Giovanni Maria De Sabbata19Francesco Zaja20Francesco Zaja21Roberto Luzzati22Roberto Luzzati23Dipartimento Clinico di Scienze Mediche, Chirurgiche e della Salute, Università degli Studi di Trieste, Trieste, ItalyUnità Complessa Operativa (UCO) Ematologia, Azienda Sanitaria Universitaria Giuliano Isontina, Trieste, ItalyStruttura Complessa (SC) Malattie Infettive, Azienda Sanitaria Universitaria Giuliano Isontina, Trieste, ItalyDipartimento Clinico di Scienze Mediche, Chirurgiche e della Salute, Università degli Studi di Trieste, Trieste, ItalyUnità Complessa Operativa (UCO) Igiene e Sanità Pubblica, Azienda Sanitaria Universitaria Integrata Giuliano Isontina, Trieste, ItalyUnità Complessa Operativa (UCO) Igiene e Sanità Pubblica, Azienda Sanitaria Universitaria Integrata Giuliano Isontina, Trieste, ItalyDipartimento Clinico di Scienze Mediche, Chirurgiche e della Salute, Università degli Studi di Trieste, Trieste, ItalyUnità Complessa Operativa (UCO) Igiene e Sanità Pubblica, Azienda Sanitaria Universitaria Integrata Giuliano Isontina, Trieste, ItalyLaboratory of Molecular Virology, International Centre for Genetic Engineering and Biotechnology (ICGEB), AREA Science Park, Trieste, ItalyLaboratory of Molecular Virology, International Centre for Genetic Engineering and Biotechnology (ICGEB), AREA Science Park, Trieste, ItalyDepartment of Life Sciences, Università degli Studi di Trieste, Trieste, ItalyLaboratory of Molecular Virology, International Centre for Genetic Engineering and Biotechnology (ICGEB), AREA Science Park, Trieste, ItalyLaboratory of Molecular Virology, International Centre for Genetic Engineering and Biotechnology (ICGEB), AREA Science Park, Trieste, ItalyBiomedicine, AREA Science Park, Trieste, ItalyBiomedicine, AREA Science Park, Trieste, ItalyStruttura Complessa (SC) Malattie Infettive, Azienda Sanitaria Universitaria Giuliano Isontina, Trieste, ItalyUnità Complessa Operativa (UCO) Ematologia, Azienda Sanitaria Universitaria Giuliano Isontina, Trieste, ItalyUnità Complessa Operativa (UCO) Ematologia, Azienda Sanitaria Universitaria Giuliano Isontina, Trieste, ItalyUnità Complessa Operativa (UCO) Ematologia, Azienda Sanitaria Universitaria Giuliano Isontina, Trieste, ItalyUnità Complessa Operativa (UCO) Ematologia, Azienda Sanitaria Universitaria Giuliano Isontina, Trieste, ItalyDipartimento Clinico di Scienze Mediche, Chirurgiche e della Salute, Università degli Studi di Trieste, Trieste, ItalyUnità Complessa Operativa (UCO) Ematologia, Azienda Sanitaria Universitaria Giuliano Isontina, Trieste, ItalyDipartimento Clinico di Scienze Mediche, Chirurgiche e della Salute, Università degli Studi di Trieste, Trieste, ItalyStruttura Complessa (SC) Malattie Infettive, Azienda Sanitaria Universitaria Giuliano Isontina, Trieste, ItalyPost-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.https://www.frontiersin.org/articles/10.3389/fonc.2022.945060/fullchronic lymphocyte leukemiaCOVID - 19monoclonal antibodiescasirivimab/imdevimabpost COVID-19 condition |
| spellingShingle | Laura Ballotta Laura Ballotta Omar Simonetti Pierlanfranco D’Agaro Pierlanfranco D’Agaro Ludovica Segat Raffaella Koncan Raffaella Koncan Pamela Martinez-Orellana Federica Dattola Federica Dattola Emanuele Orsini Alessandro Marcello Simeone Dal Monego Danilo Licastro Andrea Misin Sara Mohamed Eugenio Sbisà Elisa Lucchini Giovanni Maria De Sabbata Francesco Zaja Francesco Zaja Roberto Luzzati Roberto Luzzati 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 Frontiers in Oncology chronic lymphocyte leukemia COVID - 19 monoclonal antibodies casirivimab/imdevimab post COVID-19 condition |
| 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 | chronic lymphocyte leukemia COVID - 19 monoclonal antibodies casirivimab/imdevimab post COVID-19 condition |
| url | https://www.frontiersin.org/articles/10.3389/fonc.2022.945060/full |
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