Prolonged viral shedding in a lymphoma patient with COVID-19 infection receiving convalescent plasma

Abstract

Acute respiratory syndrome coronavirus 2 (SARS-CoV-2) first identified in Wuhan, China; and spread all over the world. Reverse-transcription polymerase chain reaction (RT-PCR) test for SARS-CoV-2 usually returns to negative in 20 days post-infection, but prolonged positivity has been reported up to 63 days. A case whose viral shedding lasted 60 days is reported from China. Herein we report a patient with a history of autologous stem cell transplantation (ASCT) for lymphoma whose RT-PCR test remained positive for SARS-CoV-2 for 74 days. The prolonged RT-PCR positivity, despite convalescent plasma infusion, may suggest that the given antibodies may be ineffective in terms of viral clearance. In patients with hematological malignancies or immunosuppression, such as ASCT, may lead to prolonged viral shedding, and strict isolation is warranted for long-term SARS-CoV-2 infection control.

Convalescent plasma may be a possible treatment for COVID-19: A systematic review

“…Following removing duplicates and screening of titles and abstracts, we evaluated 153 articles in full text. Among these, we found 45 relevant articles (4RCTs, 11 controlled NRSIs, 7 non-controlled NRSIs and 23 case reports) [21] , [22] , [23] , [24] , [25] , [26] , [27] , [28] , [29] , [30] , [31] , [32] , [33] , [34] , [35] , [36] , [37] , [38] , [39] , [40] , [41] , [42] , [43] , [44] , [45] , [46] , [47] , [48] , [49] , [50] , [51] , [52] , [53] , [54] , [55] , [56] , [57] , [58] , [59] , [60] , [61] , [62] , [63] , [64] , [65] . Extracted details are presented in Table 1 (RCTs, controlled NRSIs, and non-controlled NRSIs) and table 2 (case report(series)).…”

“…The arterial oxyhemoglobin saturation decreased to 86%, and mv was administered. No AEs Karataş A et al [58] Turkey Case report 61y/M – 13.3 (≥1.1 positive) – Mixed cellularity classical Hodgkin lymphoma, autologous stem cell transplantation (ASCT, 6 months ago) After the CPT, his fever resolved after 3 days.He was discharged from the hospital on the 78th day of hospitalization. No AEs Naeem S et al [59] USA Case series(n = 3) 65y/F;35y/F;36y/F Case1: 1 unit case2: 2 units case3: 3 unit Case1:antibody Levels in plasma (index):8.68. case2:antibody index:5.70,8.15 case3:antibody index:5.67.…”

“…Naeem S et al and Jiang J et al reported 4 cases of renal transplantation patients undergoing immunotherapy, two of them were 65 and 70 years old, they were discharged and the use of plasma was helpful for SARS-CoV-2 clearance and her recovery [59] , [63] . Karataş A et al reported a 61-year-old man with a history of mixed cellularity classical Hodgkin lymphoma, autologous stem cell transplantation (6 months ago) [58] . On After the CP transfusion, his fever resolved after 3 days and he was discharged from the hospital on the 78th day of hospitalization.…”

“…But unfortunately, a week later, his sensor released and follow-up RT-PCR test was found to be positive. In patients with hematological malignancies or immunosuppression such as ASCT may lead to prolonged viral shedding [58] .…”

A patient affected by critical COVID-19 pneumonia, successfully treated with convalescent plasma

“…There are still no antiviral drugs for COVID-19 and the efficacy of currently available therapeutic remedies is limited [1,2]. Under the Blood Regulators Network, the World Health Organization recommends passive immunotherapy by administration of convalescent plasma (CP) or serum when vaccines and antiviral drugs are unavailable for emerging infection-related diseases [3][4][5].…”