Han Dae Hee, Lee Raeseok, Min Gi June, Lee Jongmin, Sohn Yejin, Min Eun Jeong, Lee Jinyoung, Jung Jung Im, Beck Kyongmin Sarah
Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul 06591, Republic of Korea.
Division of Infectious Diseases, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul 06591, Republic of Korea.
J Clin Med. 2025 Apr 15;14(8):2701. doi: 10.3390/jcm14082701.
Hematologic malignancy patients have a heightened risk for prolonged COVID-19 pneumonia. We retrospectively investigated the clinical significance and serial CT findings of prolonged COVID-19 pneumonia in hematologic malignancy patients. Hematologic malignancy patients with persistent SARS-CoV-2 polymerase chain reaction (PCR) positivity >30 days and more than one chest CT after initial positivity were reviewed. Serial CT images were analyzed for the presence of COVID-19 pneumonia, patterns and distribution of CT findings, and severity scores of lung involvement. Clinical characteristics of the patients, including treatments for underlying hematologic malignancy prior to and after COVID-19 and COVID-19-related factors, were compared according to the presence of COVID-19 pneumonia. A total of 55 patients (36 male, median age 60 years) were included in the study. A total of 56.4% had received B-cell-directed therapies, such as rituximab or teclistamab, within one year of COVID-19 diagnosis. A total of 76.4% of patients had the presence of COVID-19 pneumonia on CT, with a median CT duration of pneumonia of 35.5 days, and they experienced more frequent ( = 0.005) and longer ( = 0.002) hospital stays and longer delays in treatment for underlying malignancy ( = 0.03), compared to those without evidence of COVID-19 pneumonia on CT. The development of COVID-19 pneumonia was significantly related to B-cell-directed antibody therapies ( = 0.02). Median CT severity scores during <30 days, 30-59 days, 60-89 days, and ≥90 days from initial diagnosis were 2.0, 2.0, 2.0, and 1.0, respectively. Patients with hematologic malignancies may experience prolonged COVID-19 pneumonia, which is associated with the use of B-cell-directed antibody-based drugs and can result in longer hospital stays and delays in treatments for underlying malignancy.
血液系统恶性肿瘤患者发生新冠病毒肺炎病程延长的风险更高。我们回顾性研究了血液系统恶性肿瘤患者新冠病毒肺炎病程延长的临床意义及系列CT表现。对严重急性呼吸综合征冠状病毒2（SARS-CoV-2）聚合酶链反应（PCR）持续阳性>30天且首次阳性后进行了不止一次胸部CT检查的血液系统恶性肿瘤患者进行了回顾。分析系列CT图像，以确定是否存在新冠病毒肺炎、CT表现的模式和分布以及肺部受累的严重程度评分。根据是否存在新冠病毒肺炎，比较患者的临床特征，包括新冠病毒感染之前和之后针对潜在血液系统恶性肿瘤的治疗以及与新冠病毒相关的因素。共有55例患者（36例男性，中位年龄60岁）纳入研究。共有56.4%的患者在新冠病毒诊断后一年内接受了如利妥昔单抗或替西他单抗等B细胞定向疗法。共有76.4%的患者CT显示存在新冠病毒肺炎，肺炎的中位CT病程为35.5天，与CT未显示新冠病毒肺炎证据的患者相比，他们住院时间更频繁（P = 0.005）、更长（P = 0.002），且潜在恶性肿瘤治疗延迟更长（P = 0.03）。新冠病毒肺炎的发生与B细胞定向抗体疗法显著相关（P = 0.02）。从初始诊断起<30天、30 - 59天、60 - 89天和≥90天期间的中位CT严重程度评分分别为2.0、2.0、2.0和1.0。血液系统恶性肿瘤患者可能会出现新冠病毒肺炎病程延长，这与使用B细胞定向抗体类药物有关，并可能导致住院时间延长和潜在恶性肿瘤治疗延迟。
