Management of Persistent SARS-CoV-2 Infection in Patients with Follicular Lymphoma
Introduction: There is no consensus on the management of the coronavirus disease (COVID-19) in patients with secondary immunosuppression due to either an underlying haematological disease or to the effects of immunochemotherapy (ICT). Some of them may present persistent infection with multiple relapses of the COVID-19, requiring several admissions. This study evaluated the clinical characteristics and outcomes after treatment of five patients with follicular lymphoma (FL), previously treated with ICT, who developed several episodes of COVID-19. Methods: We analyzed the clinical evolution and response to treatment with antiviral agent, steroids and convalescent plasma in five patients with FL and SARS-CoV-2 persistent infection. Reverse-transcriptase-polymerase-chain-reaction (RT-PCR) tests and peripheral blood immunophenotype were performed for all patients. Results: All patients required hospitalization due to pneumonia with severity criteria and were re-admitted after a median of 22 days (13-42) from the previous discharge. They all showed B-cell depletion by immunophenotyping and no traces of immunoglobulin (IgG) antibodies against SARS-CoV-2 were detected in any of the cases. The survival rate was 80%. Conclusion: The combination therapy evidenced clinical benefits, demonstrating its capacity to control infection in immunosuppressed follicular lymphoma patients treated with ICT.