Taliani Gloria, Follini Elena, Guglielmetti Lorenzo, Bernuzzi Patrizia, Faggi Alberto, Ferrante Patrizia, Fronti Elisa, Gerna Laura, Leoni Maria Cristina, Paolillo Franco, Ratti Giovanna, Ruggieri Alessandro, Valdatta Caterina, Donisi Alessandra, Zangrandi Adriano, Pochintesta Lara, Moroni Carlo, Sacchini Daria, Vallisa Daniele, Codeluppi Mauro
Infectious Diseases Unit, "Guglielmo da Saliceto" Piacenza Hospital, Piacenza, Italy.
Anti-COVID-19 Task Force of the Italian Civil Protection, Rome, Italy.
Front Oncol. 2021 Jan 25;10:582901. doi: 10.3389/fonc.2020.582901. eCollection 2020.
Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infects humans through the angiotensin converting enzyme-2 (ACE-2) receptor expressed on many cells, including lymphocytes. In Covid-19 patients IL-6 is overexpressed, and hyperactivated plasmacytoid lymphocytes are detected in peripheral blood film. We hypothesize that, due to the unpredictable interaction between the new virus and the B cell lineage of infected patients, a cascade of out of control events can ensue, capable of determining unexpected pathologic disorders involving such lineage. Here we report two cases of autoimmune hemolytic anemia (AIHA) and two cases of B-cell hematological malignancies developed or reactivated during acute SARS-CoV-2 infection. The temporal relationship of the events may suggest a potential causal relationship between SARS-CoV-2 infection and the hematopoietic disorders. We suggest that special attention should be paid to COVID-19 patients with underlining B cell lineage disorders.
严重急性呼吸综合征冠状病毒2（SARS-CoV-2）通过包括淋巴细胞在内的许多细胞上表达的血管紧张素转换酶2（ACE-2）受体感染人类。在新冠肺炎患者中，白细胞介素-6（IL-6）过度表达，并且在外周血涂片上检测到过度活化的浆细胞样淋巴细胞。我们推测，由于新病毒与受感染患者的B细胞谱系之间存在不可预测的相互作用，可能会引发一系列失控事件，从而导致涉及该谱系的意外病理紊乱。在此，我们报告了两例自身免疫性溶血性贫血（AIHA）以及两例在急性SARS-CoV-2感染期间发生或复发的B细胞血液系统恶性肿瘤病例。这些事件的时间关系可能提示SARS-CoV-2感染与血液系统疾病之间存在潜在因果关系。我们建议，对于患有潜在B细胞谱系疾病的新冠肺炎患者应给予特别关注。
