Clinical and radiological improvement of protracted COVID-19 and Good syndrome secondary to advanced thymoma

Cerezoli, Milena Tenorio; Prats, João Antônio Gonçalves Garreta; Medeiros, Augusto Kreling; Santana, Diego Vinícius Gonçalves; Costa, F.; Torres, Ulysses S.; William, William Nassib

doi:10.1016/j.pulmoe.2022.04.011

Cited by 9 publications

(4 citation statements)

References 9 publications

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“…At least in 2 cases with relapsing nature of disease has been reported (8). Despite antimicrobial treatment and immunoglobulin replacement mortality remain high (13)(14)(15).…”

Section: Discussionmentioning

confidence: 99%

Clinical and Genomic Evaluations of a persistent fatal SARS-CoV-2 infection in a Goods syndrome patient: A case report

Tabarsi

Maleki

Abtahian

et al. 2023

Preprint

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COVID-19 resulted from an infection by SARS-Cov-2 which is the main cause of ADRS in global population from 2019 on. It may contribute to higher rate of death among the patients with immunodeficiency based on recent reports. In addition, Good syndrome (GS) as a result of thymoma removal might cause in some long-lasting microbial infections. We described clinical aspects and viral mutations on a case of GS suffering from COVID-19. A 46-year-old man with fever, general respiratory signs and positive COVID-19 PCR test, with the history of thymoma removal surgery was admitted to Masih Daneshvari Hospital, Tehran, Iran. Lung radiographs and Oxygen saturation measurement disclosed considerable implication resulted in application of several anti-microbial medication. The delta variant (B.1.617.2 (21J Clade)) was the strain isolated from the patient by sequencing methods done by CNRL while the dominant strain circulated mostly among population was Omicron (B.1.1.529) at the time of sampling. Unfortunately, the patient had passed away a month later by sudden respiratory failure progressed in refractory septic shock. Despite the fact that opportunistic infections may lead the GS patients to a major health problematic condition, unusual persistent of infections such as non-dominant variant of SARS-Cov-2 could be observed through the disease timeline. Therefore, a fully screening of thymoma plus intra-host evolution monitoring of SARS-CoV-2 is highly recommended in immunocompromised patients.

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“…At least in 2 cases with relapsing nature of disease has been reported (8). Despite antimicrobial treatment and immunoglobulin replacement mortality remain high (13)(14)(15).…”

Section: Discussionmentioning

confidence: 99%

Clinical and Genomic Evaluations of a persistent fatal SARS-CoV-2 infection in a Goods syndrome patient: A case report

Tabarsi

Maleki

Abtahian

et al. 2023

Preprint

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“…Patients with thymoma, a thymic epithelial tumor, 156 frequently develop T‐cell or Ab‐mediated autoimmune disease (including late‐onset myasthenia gravis, 157 and tissue‐specific auto‐Abs of the APS‐1 spectrum 158–160 ). They harbor auto‐Abs against IL‐17A/F, which are associated with the occurrence of the CMC, 38,158,159,161 and about ∼70% of patients have auto‐Abs against type I IFNs, 87,158,162 leading to a particularly high fatality rate for COVID‐19, especially in patients with Good syndrome (the association of thymoma and immunodeficiency) 163–173 . Interestingly, neoplastic mTECs do not express AIRE, 174,175 suggesting that the breakdown of T‐cell tolerance is a consequence of impaired central tolerance linked to impaired AIRE expression in the neoplastic tissue.…”

Section: Genetic Causes Of Auto‐abs Against Type I Ifnsmentioning

confidence: 99%

“…They harbor auto-Abs against IL-17A/F, which are associated with the occurrence of the CMC, 38,158,159,161 and about ∼70% of patients have auto-Abs against type I IFNs, 87,158,162 leading to a particularly high fatality rate for COVID-19, especially in patients with Good syndrome (the association of thymoma and immunodeficiency). [163][164][165][166][167][168][169][170][171][172][173] Interestingly, neoplastic mTECs do not express AIRE, 174,175 suggesting that the breakdown of T-cell tolerance is a consequence of impaired central tolerance linked to impaired AIRE expression in the neoplastic tissue.…”

Section: G Ene Ti CC Aus E Sofauto -Abs Ag Ain S T T Ype I Ifn Smentioning

confidence: 99%

Human autoantibodies neutralizing type I IFNs: From 1981 to 2023

Bastard,

Gervais,

Le Voyer

et al. 2024

Immunological Reviews

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SummaryHuman autoantibodies (auto‐Abs) neutralizing type I IFNs were first discovered in a woman with disseminated shingles and were described by Ion Gresser from 1981 to 1984. They have since been found in patients with diverse conditions and are even used as a diagnostic criterion in patients with autoimmune polyendocrinopathy syndrome type 1 (APS‐1). However, their apparent lack of association with viral diseases, including shingles, led to wide acceptance of the conclusion that they had no pathological consequences. This perception began to change in 2020, when they were found to underlie about 15% of cases of critical COVID‐19 pneumonia. They have since been shown to underlie other severe viral diseases, including 5%, 20%, and 40% of cases of critical influenza pneumonia, critical MERS pneumonia, and West Nile virus encephalitis, respectively. They also seem to be associated with shingles in various settings. These auto‐Abs are present in all age groups of the general population, but their frequency increases with age to reach at least 5% in the elderly. We estimate that at least 100 million people worldwide carry auto‐Abs neutralizing type I IFNs. Here, we briefly review the history of the study of these auto‐Abs, focusing particularly on their known causes and consequences.

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“…Additional methodological details are provided in Figure 1 and in the Supplementary Methods and Supplementary Tables 1, 2 . This review included 19 studies that reported on a total of 24 patients (median age, 54.5 years [interquartile range (IQR) 44–64 years]; 15 male) [ 7 8 9 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 ].…”

Section: Systematic Search and Analysis Of Literaturementioning

confidence: 99%

Radiologic Abnormalities in Prolonged SARS-CoV-2 Infection: A Systematic Review

Beck,

Yoon,

Yoon

2024

Korean J Radiol

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We systematically reviewed radiological abnormalities in patients with prolonged SARS-CoV-2 infection, defined as persistently positive polymerase chain reaction (PCR) results for SARS-CoV-2 for > 21 days, with either persistent or relapsed symptoms. We extracted data from 24 patients (median age, 54.5 [interquartile range, 44–64 years]) reported in the literature and analyzed their representative CT images based on the timing of the CT scan relative to the initial PCR positivity. Our analysis focused on the patterns and distribution of CT findings, severity scores of lung involvement on a scale of 0–4, and the presence of migration. All patients were immunocompromised, including 62.5% (15/24) with underlying lymphoma and 83.3% (20/24) who had received anti-CD20 therapy within one year. Median duration of infection was 90 days. Most patients exhibited typical CT appearance of coronavirus disease 19 (COVID-19), including ground-glass opacities with or without consolidation, throughout the follow-up period. Notably, CT severity scores were significantly lower during ≤ 21 days than during > 21 days ( P < 0.001). Migration was observed on CT in 22.7% (5/22) of patients at ≤ 21 days and in 68.2% (15/22) to 87.5% (14/16) of patients at > 21 days, with rare instances of parenchymal bands in previously affected areas. Prolonged SARS-CoV-2 infection usually presents as migrating typical COVID-19 pneumonia in immunocompromised patients, especially those with impaired B-cell immunity.

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Clinical and radiological improvement of protracted COVID-19 and Good syndrome secondary to advanced thymoma

Cited by 9 publications

References 9 publications

Clinical and Genomic Evaluations of a persistent fatal SARS-CoV-2 infection in a Goods syndrome patient: A case report

Clinical and Genomic Evaluations of a persistent fatal SARS-CoV-2 infection in a Goods syndrome patient: A case report

Human autoantibodies neutralizing type I IFNs: From 1981 to 2023

Radiologic Abnormalities in Prolonged SARS-CoV-2 Infection: A Systematic Review

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