COVID-19 in a Patient with Chronic Lymphocytic Leukaemia with Pseudohypoxemia

Barbosa, Orivaldo Alves; Andrade, Talita Guimarães; Sousa, Maria Danielly de Almeida; Correia, José Walter

doi:10.12890/2020_001763

Cited by 2 publications

(2 citation statements)

References 7 publications

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“…Patients with CLL with very high leukocyte counts may, extremely rarely, experience spurious hypoxemia or pseudohypoxemia, which may create diagnostic and therapeutic difficulties ( 24 ).…”

Section: Distinct Characteristics Of Sars-cov-2 Infection In Patients With Cllmentioning

confidence: 99%

“…It was also higher than the mortality rate due to SARS-CoV-2 infection in Spain in May 2020, in the general population. Age, lymphocytosis, and D-dimers were associated with overall survival in patients with CLL infected with SARS-CoV-2 ( 24 ). Therefore, a more active CLL disease, which manifests as a higher number of lymphocytes, may contribute to a greater vulnerability in these patients during this infection ( 31 ).…”

Section: Clinical Experience Of Patients With Cll During the Sars-cov-2 Pandemicmentioning

confidence: 99%

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Management of patients with chronic lymphocytic leukemia during the SARS‑CoV‑2 pandemic (Review)

Mihăilă

2021

Oncol Lett

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Oncohematological patients are prone to develop infections due to immunosuppression caused by the disease and chemo-immunotherapy. The aim of this review was to outline the details of the management of patients with chronic lymphocytic leukemia (CLL) during the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic. Patients with CLL often exhibit inadequate humoral and cellular immune responses to various infections and vaccinations. Patients under the 'watch and wait' strategy have a lower risk of infections, including with SARS-CoV-2, compared with those undergoing therapeutic interventions, but they still have a higher risk than age-matched controls. Patients with CLL have a high risk of developing severe forms of coronavirus disease-2019 (COVID-19), particularly if they are undergoing chemo-immunotherapy. The total anti-SARS-CoV-2 antibody titer demonstrates a slower increase in patients with CLL infected with the virus, and the antibody levels tend to decrease after reaching a maximum level sooner than in healthy individuals. This leads to a late negativation of the PCR tests and a longer duration of hospitalization. In total, ~1/3 of patients with CLL do not develop a persistent titer of antiviral antibodies, and this is associated with the presence of hypogammaglobulinemia. It appears that patients with CLL have the worst outcomes amongst patients with malignant hemopathies and SARS-CoV-2 infection. Bruton tyrosine kinase inhibitors reduce the hyperinflammatory status of patients with CLL with COVID-19, which is accompanied by decreased levels of serum inflammatory markers, ferritin and D-dimer, and serum levels of pro-inflammatory cytokines, but they increase the risk of infections and impaired humoral immunity. An abrupt discontinuation of these may promote the rapid decompensation of CLL, which may even mimic the clinical manifestations of COVID-I9, including a significant increase in cytokine release. In conclusion, therapeutic decisions must be personalized to each patient with CLL and each at risk patient must be quarantined during the SARS-CoV-2 pandemic to reduce their risk of contraction. Contents

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“…Patients with CLL with very high leukocyte counts may, extremely rarely, experience spurious hypoxemia or pseudohypoxemia, which may create diagnostic and therapeutic difficulties ( 24 ).…”

Section: Distinct Characteristics Of Sars-cov-2 Infection In Patients With Cllmentioning

confidence: 99%

Section: Clinical Experience Of Patients With Cll During the Sars-cov-2 Pandemicmentioning

confidence: 99%

Management of patients with chronic lymphocytic leukemia during the SARS‑CoV‑2 pandemic (Review)

Mihăilă

2021

Oncol Lett

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COVID-19-Induced Hyperleucocytosis in Chronic Lymphocytic Leukaemia

Singh

Ayad

Kaur

et al. 2021

European Journal of Case Reports in Internal Medicine

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Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a novel coronavirus responsible for the current global pandemic, coronavirus disease 2019 (COVID-19). COVID-19 usually presents with respiratory symptoms but can affect multiple organ systems. A wide spectrum of complications can occur depending upon the comorbidities of patients. There is limited literature available regarding the presentation and outcome of COVID-19 in chronic lymphocytic leukaemia (CLL) patients. We report 2 cases of COVID-19-induced hyperleucocytosis (WBC count >100,000/?l) in CLL patients.

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COVID-19 in a Patient with Chronic Lymphocytic Leukaemia with Pseudohypoxemia

Cited by 2 publications

References 7 publications

Management of patients with chronic lymphocytic leukemia during the SARS‑CoV‑2 pandemic (Review)

Management of patients with chronic lymphocytic leukemia during the SARS‑CoV‑2 pandemic (Review)

COVID-19-Induced Hyperleucocytosis in Chronic Lymphocytic Leukaemia

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