Severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) seroconversion in hematology–oncology patients

Abstract

Since the emergence of SARS‐CoV‐2 in China at the end of 2019, the virus has spread rapidly across the globe leading to millions of infections and subsequent deaths. Although the virus infects those exposed indiscriminately, there are groups in society at an increased risk of severe infection, leading to increased morbidity. Patients suffering from haematological cancers, particularly leukaemia, lymphoma and myeloma, may be one such group and previous studies have suggested that they may be at a 3‐4 times greater risk of severe COVID‐19 after SARS‐CoV‐2 infection, leading to admissions to ICU, mechanical ventilation, and death compared to those without such malignancies. Serological testing for IgG seroconversion has been extensively studied in the immunocompetent, but fewer publications have characterised this process in large series of immunocompromised patients. This study described 20 patients with haematological cancers who tested positive for SARS‐CoV‐2 via PCR with 12 of the patients receiving further serological testing. We found that of the 12 patients screened for SARS‐CoV‐2 IgG antibodies, only 2 (16.6%) were able to generate an immune response to the infection. Yet despite this low seroconversion rate in this cohort, none of these patients died or became particularly unwell with COVID‐19 or its related complications. This article is protected by copyright. All rights reserved.

COVID‐19 elicits an impaired antibody response against SARS‐CoV‐2 in patients with haematological malignancies

“…This suggests that measuring serological response too soon after SARS‐CoV‐2 infection in HM might lead to an incorrect evaluation of immune response. This probably explains the very low rate of seroconversion reported in 20 HMs (16·6%), tested after 12 days from COVID‐19 15 …”

“…This probably explains the very low rate of seroconversion reported in 20 HMs (16Á6%), tested after 12 days from COVID-19. 15 Figure 1B shows the rate of seroconversion per HM type and specific treatments (more details in Figure S2). We found that serological non-responders were spread evenly across patients with lymphomas, MM and myeloid neoplasms.…”

Production and persistence of specific antibodies in COVID-19 patients with hematologic malignancies: role of rituximab

“…On the other hand, in a series of 21 CLL patients, a seroconversion rate of 67% and a delay in the time of Ab responses were reported [16]. In another study, among 12 patients with HM whose Ab responses to SARS-CoV-2 were measured on average 13 days after symptom onset, only two showed evidence of seroconversion [27]. We have previously reported blunted SARS-CoV-2-specific Ab responses in three immunocompromised individuals, including one with CLL [17].…”

COVID-19 in patients with hematologic malignancy

“…Smaller case series confirmed the impaired immune response to SARS-CoV-2 in patients with HM and reported a range of seroconversion of 16.6% to 84%. 53,55 Evaluating cellular immune response, Bilich et al 56 Lacking T-cell immunity even in the setting of humoral response was demonstrated in the prospective monocentric study of specific viral immune responses induced by SARS-CoV-2 (COV-CREM) evaluating 39 SARS-CoV-2-infected patients with cancer, including 11 patients with HM. 57 Only 36.4% of patients with HM exhibited T-cell responses against at least 1 of the SARS-CoV-2 proteins (S, M, or N).…”