Successful Treatment of Persistent SARS-CoV-2 Infection in a B-Cell Depleted Patient with Activated Cytotoxic T and NK Cells: A Case Report

Int J Mol Sci. 2021 Oct 10;22(20):10934. doi: 10.3390/ijms222010934.

Abstract

We report a lymphoma patient with profound B-cell deficiency after chemotherapy combined with anti-CD20 antibody successfully treated with remdesivir and convalescent plasma for prolonged SARS-CoV-2 infection. Viral clearance was likely attributed to the robust expansion and activation of TCR Vβ2 CD8+ cytotoxic T cells and CD16 + CD56- NK cells. This is the first presentation of TCR-specific T cell oligoclonal response in COVID-19. Our study suggests that B-cell depleted patients may effectively respond to anti-SARS-CoV-2 treatment when NK and antigen-specific Tc cell response is induced.

Keywords: CD8+ cytotoxic T cells; COVID-19; TCR Vβ repertoire; natural killer cells (NK cells); oligoclonal T cell response.

Publication types

  • Case Reports

MeSH terms

  • Adenosine Monophosphate / analogs & derivatives
  • Adenosine Monophosphate / therapeutic use
  • Aged
  • Alanine / analogs & derivatives
  • Alanine / therapeutic use
  • Antibodies, Monoclonal, Humanized / therapeutic use
  • B-Lymphocytes / metabolism
  • COVID-19 / therapy*
  • COVID-19 / virology
  • COVID-19 Serotherapy
  • Humans
  • Immunization, Passive
  • Killer Cells, Natural / immunology*
  • SARS-CoV-2 / isolation & purification
  • T-Lymphocytes, Cytotoxic / immunology*

Substances

  • Antibodies, Monoclonal, Humanized
  • remdesivir
  • Adenosine Monophosphate
  • obinutuzumab
  • Alanine