[Outcomes of COVID-19 due to omicron variant infection complicated with hematological disorders].

Masao Hagihara, Hiroyasu Hayashi, Shiori Nakajima, Yui Imai, Hirofumi Nakano, Tomoyuki Uchida, Morihiro Inoue, Masayoshi Miyawaki, Nobuhiro Ikeda, Ryosuke Konuma, Yuya Atsuta, Masaru Tanaka, Akifumi Imamura
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Abstract

When the omicron variant became the most dominant severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2) variant causing coronavirus disease 2019 (COVID-19) in Japan, 11 patients with hematological diseases infected with this new variant were treated at our institution. Among them, four of the five patients who had been treated with chemotherapy progressed to moderate-II COVID-19, and two of them died. In contrast, five of the six patients who did not receive the treatment remained at mild to moderate-I stage of COVID-19, except for a single case progressing to moderate-II COVID-19. While all four patients infused with anti-coronavirus monoclonal antibodies within 8 days after the onset survived, the other two patients, being withheld from treatment or treated later, died. In these two cases, anti-SARS-Cov-2 immunoglobulin G antibodies remained at low titers. Although the omicron variant is considered a less harmful SARS-Cov-2 variant, patients with hematological disorders, particularly those who are immunosuppressed caused by chemotherapy, should be continuously cared for as they remain at a higher risk of severe COVID-19 due to insufficient or delayed anti-viral humoral immunity development. Thus, the rapid introduction of antiviral monoclonal antibodies together with anti-viral reagents may rescue these patients.

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[组粒变异感染合并血液系统疾病的COVID-19结局]。
当组粒变异成为日本导致2019冠状病毒病(COVID-19)的最主要的严重急性呼吸综合征冠状病毒2 (SARS-Cov-2)变异时,11名感染该新变异的血液病患者在我所接受治疗。其中,接受化疗的5例患者中有4例进展为中ii型,其中2例死亡。相比之下,6例未接受治疗的患者中有5例仍处于COVID-19轻至中i期,只有1例进展为COVID-19中ii期。在发病后8天内注射抗冠状病毒单克隆抗体的4名患者全部存活,但另外2名患者因未接受治疗或治疗后死亡。在这两例中,抗sars - cov -2免疫球蛋白G抗体保持在低滴度。虽然组粒变异被认为是一种危害较小的SARS-Cov-2变异,但血液病患者,特别是那些因化疗引起免疫抑制的患者,应继续得到护理,因为由于抗病毒体液免疫发育不足或延迟,他们患严重COVID-19的风险仍然较高。因此,快速引入抗病毒单克隆抗体和抗病毒试剂可能挽救这些患者。
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