Covid-19 in patients with chronic lymphocytic leukemia : clinical outcome and B- and T-cell immunity during 13 months in consecutive patients

• We studied clinical and immunological outcome of Covid-19 in consecutive CLL patients from a well-defined area during month 1–13 of the pandemic. Sixty patients (median age 71 y, range 43–97) were identified. Median CIRS was eight (4–20). Patients had indolent CLL (n = 38), had completed (n = 12) or ongoing therapy (n = 10). Forty-six patients (77%) were hospitalized due to severe Covid-19 and 11 were admitted to ICU. Severe Covid-19 was equally distributed across subgroups irrespective of age, gender, BMI, CLL status except CIRS (p < 0.05). Fourteen patients (23%) died; age ≥75 y was the only significant risk factor (p < 0.05, multivariate analysis with limited power). Comparing month 1–6 vs 7–13 of the pandemic, deaths were numerically reduced from 32% to 18%, ICU admission from 37% to 15% whereas hospitalizations remained frequent (86% vs 71%). Seroconversion occurred in 33/40 patients (82%) and anti-SARS-CoV-2 antibodies were detectable at six and 12 months in 17/22 and 8/11 patients, respectively. Most (13/17) had neutralizing antibodies and 19/28 had antibodies in saliva. SARS-CoV-2-specific T-cells (ELISpot) were detected in 14/17 patients. Covid-19 continued to result in high admission even among consecutive and young early- stage CLL patients. A robust and durable B and/or T cell immunity was observed in most convalescents.

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Infektionsmedicin (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Infectious Medicine (hsv//eng)

MEDICIN OCH HÄLSOVETENSKAP  -- Medicinska och farmaceutiska grundvetenskaper -- Immunologi inom det medicinska området (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Basic Medicine -- Immunology in the medical area (hsv//eng)

Nyckelord

anticoagulant agent

antineoplastic monoclonal antibody

bendamustine

Bruton tyrosine kinase inhibitor

corticosteroid

gamma interferon

hydroxychloroquine

hypertensive agent

immunoglobulin

immunoglobulin G antibody

neutralizing antibody

remdesivir

rituximab

SARS-CoV-2 antibody

SARS-CoV-2 convalescent plasma

tocilizumab

venetoclax

virus antibody

adult

aged

antibody response

Article

body mass

cellular immunity

chronic lymphatic leukemia

controlled study

coronavirus disease 2019

Cumulative Illness Rating Scale

enzyme linked immunospot assay

female

hospitalization

human

humoral immunity

intensive care

major clinical study

male

mortality rate

seroconversion

Sweden

B lymphocyte

blood

complication

follow up

immunology

isolation and purification

middle aged

multimodality cancer therapy

prognosis

T lymphocyte

very elderly

virology

Aged

80 and over

Antibodies

Neutralizing

Antibodies

Viral

B-Lymphocytes

Combined Modality Therapy

COVID-19

Follow-Up Studies

Humans

Leukemia

Lymphocytic

Chronic

B-Cell

SARS-CoV-2

T-Lymphocytes

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