The evaluation of risk factors for prolonged viral shedding during anti-SARS-CoV-2 monoclonal antibodies and long-term administration of antivirals in COVID-19 patients with B-cell lymphoma treated by anti-CD20 antibody
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View abstract on PubMed
Summary
This summary is machine-generated.This study shows a novel treatment combining antivirals and antibodies effectively clears SARS-CoV-2 in immunocompromised B-cell lymphoma patients. Key factors prolonging viral shedding include bendamustine use and multiple prior lymphoma treatments.
Area Of Science
- Immunology
- Virology
- Oncology
Background
- The COVID-19 pandemic poses significant risks to immunocompromised individuals, especially those with B-cell lymphoma, who face higher rates of persistent SARS-CoV-2 infection, severe outcomes, and mortality.
- The emergence of multi-mutational SARS-CoV-2 variants in persistent infections complicates treatment strategies.
- Optimal management for sustained viral clearance, treatment cessation, and prevention of viral reactivation in these patients remains undefined.
Purpose Of The Study
- To evaluate the efficacy of a novel treatment strategy for immunocompromised B-cell lymphoma patients experiencing persistent COVID-19 infection.
- The strategy combines antivirals, neutralizing antibodies, genomic analysis, and frequent monitoring of viral load and spike-specific antibodies.
Main Methods
- A retrospective descriptive analysis of 44 immunocompromised B-cell lymphoma patients diagnosed with COVID-19 after January 2022.
- Treatment involved selecting anti-SARS-CoV-2 monoclonal antibodies based on subvariants, continuous antiviral therapy until viral shedding confirmation (tested every 5 days), and genomic analysis.
- Multivariate Cox regression identified predictors of prolonged viral shedding time.
Main Results
- All 44 patients survived, with a median viral shedding time of 28 days.
- Twenty-two patients received combination antiviral therapy, and 16 experienced severe COVID-19.
- Bendamustine use (especially within 1 year of treatment) and multiple prior lines of lymphoma therapy were independently associated with prolonged viral shedding.
Conclusions
- The novel treatment combining anti-SARS-CoV-2 monoclonal antibodies with extended antiviral therapy achieved virus elimination and 100% survival in this patient cohort.
- Identifying predictors of prolonged shedding, such as specific chemotherapy regimens, aids in tailoring treatment duration and management.
- This approach offers a promising strategy for managing persistent COVID-19 in immunocompromised B-cell lymphoma patients.
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