Mark Ehioghae, Harini Shah, Anu Taylor, Brian Buggy, Gabriel Mikhael
{"title":"一名曾患弥漫性大 B 细胞淋巴瘤的患者在接受 CAR-T 疗法后出现长期 COVID-19 肺炎和严重肺损伤:强调皮质类固醇的作用。","authors":"Mark Ehioghae, Harini Shah, Anu Taylor, Brian Buggy, Gabriel Mikhael","doi":"","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>COVID-19 can have severe consequences for immunocompromised individuals, including those with hematological malignancies. Prolonged infections causing pneumonia and lung injury are rare in patients with diffuse large B-cell lymphoma (DLBCL) treated with chimeric antigen receptor T-cell (CAR-T).</p><p><strong>Case presentation: </strong>A 43-year-old male with a history of DLBCL, in remission for 2 years after CAR-T therapy, developed a persistent COVID infection, as confirmed via positive polymerase chain reaction. This slowly progressed to symptomatic hypoxemic pneumonitis and biopsy-proven diffuse alveolar damage, which responded to corticosteroid treatment.</p><p><strong>Discussion: </strong>COVID-19 poses increased risks to patients with a history of hematologic malignancies and can lead to severe respiratory distress and mortality. Studies have shown prolonged pneumonitis may require corticosteroids for improvement. However, data on appropriate regimen for managing prolonged COVID-19 pneumonitis are lacking.</p><p><strong>Conclusions: </strong>This case highlights challenges of the treatment of COVID-19 infections in immunocompromised individuals with hematological malignancies. Corticosteroid treatment shows benefits, but dosing and duration should be based on individual patient response. Extended monitoring, individualized treatment plans, and research are crucial for optimizing outcomes in this vulnerable population.</p>","PeriodicalId":94268,"journal":{"name":"WMJ : official publication of the State Medical Society of Wisconsin","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Prolonged COVID-19 Pneumonitis and Severe Lung Injury in a Patient with a History of Diffuse Large B-cell Lymphoma after CAR-T Therapy: Highlighting the Role of Corticosteroids.\",\"authors\":\"Mark Ehioghae, Harini Shah, Anu Taylor, Brian Buggy, Gabriel Mikhael\",\"doi\":\"\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong>COVID-19 can have severe consequences for immunocompromised individuals, including those with hematological malignancies. Prolonged infections causing pneumonia and lung injury are rare in patients with diffuse large B-cell lymphoma (DLBCL) treated with chimeric antigen receptor T-cell (CAR-T).</p><p><strong>Case presentation: </strong>A 43-year-old male with a history of DLBCL, in remission for 2 years after CAR-T therapy, developed a persistent COVID infection, as confirmed via positive polymerase chain reaction. This slowly progressed to symptomatic hypoxemic pneumonitis and biopsy-proven diffuse alveolar damage, which responded to corticosteroid treatment.</p><p><strong>Discussion: </strong>COVID-19 poses increased risks to patients with a history of hematologic malignancies and can lead to severe respiratory distress and mortality. Studies have shown prolonged pneumonitis may require corticosteroids for improvement. However, data on appropriate regimen for managing prolonged COVID-19 pneumonitis are lacking.</p><p><strong>Conclusions: </strong>This case highlights challenges of the treatment of COVID-19 infections in immunocompromised individuals with hematological malignancies. Corticosteroid treatment shows benefits, but dosing and duration should be based on individual patient response. Extended monitoring, individualized treatment plans, and research are crucial for optimizing outcomes in this vulnerable population.</p>\",\"PeriodicalId\":94268,\"journal\":{\"name\":\"WMJ : official publication of the State Medical Society of Wisconsin\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2024-09-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"WMJ : official publication of the State Medical Society of Wisconsin\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"WMJ : official publication of the State Medical Society of Wisconsin","FirstCategoryId":"1085","ListUrlMain":"","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
Prolonged COVID-19 Pneumonitis and Severe Lung Injury in a Patient with a History of Diffuse Large B-cell Lymphoma after CAR-T Therapy: Highlighting the Role of Corticosteroids.
Introduction: COVID-19 can have severe consequences for immunocompromised individuals, including those with hematological malignancies. Prolonged infections causing pneumonia and lung injury are rare in patients with diffuse large B-cell lymphoma (DLBCL) treated with chimeric antigen receptor T-cell (CAR-T).
Case presentation: A 43-year-old male with a history of DLBCL, in remission for 2 years after CAR-T therapy, developed a persistent COVID infection, as confirmed via positive polymerase chain reaction. This slowly progressed to symptomatic hypoxemic pneumonitis and biopsy-proven diffuse alveolar damage, which responded to corticosteroid treatment.
Discussion: COVID-19 poses increased risks to patients with a history of hematologic malignancies and can lead to severe respiratory distress and mortality. Studies have shown prolonged pneumonitis may require corticosteroids for improvement. However, data on appropriate regimen for managing prolonged COVID-19 pneumonitis are lacking.
Conclusions: This case highlights challenges of the treatment of COVID-19 infections in immunocompromised individuals with hematological malignancies. Corticosteroid treatment shows benefits, but dosing and duration should be based on individual patient response. Extended monitoring, individualized treatment plans, and research are crucial for optimizing outcomes in this vulnerable population.