SARS-CoV-2 infection in patients with primary central nervous system lymphoma.


Journal

Journal of neurology
ISSN: 1432-1459
Titre abrégé: J Neurol
Pays: Germany
ID NLM: 0423161

Informations de publication

Date de publication:
Sep 2021
Historique:
received: 17 09 2020
accepted: 08 11 2020
revised: 26 10 2020
pubmed: 3 1 2021
medline: 14 8 2021
entrez: 2 1 2021
Statut: ppublish

Résumé

Cancer patients may be at higher risk for severe coronavirus infectious disease-19 (COVID-19); however, the outcome of Primary Central Nervous System Lymphoma (PCNSL) patients with SARS-CoV-2 infection has not been described yet. We conducted a retrospective study within the Lymphomes Oculo-Cérébraux national network (LOC) to assess the clinical characteristics and outcome of SARS-CoV-2 infection in PCNSL patients (positive real-time polymerase chain reaction of nasopharyngeal swab or evocative lung computed tomography scan). We compared clinical characteristics between patients with severe (death and/or intensive care unit admission) and mild disease. Between March and May 2020, 13 PCNSL patients were diagnosed with SARS-CoV-2 infection, 11 (85%) of whom were undergoing chemotherapy at the time of infection. The mortality rate was 23% (3/13), and two additional patients (15%) required mechanical ventilation. Two patients (15%) had no COVID-19 symptoms. History of diabetes mellitus was more common in severe patients (3/5 vs 0/8, p = 0.03). Two patients recovered from COVID-19 after mechanical ventilation during more than two weeks and resumed chemotherapy. In all, chemotherapy was resumed after COVID-19 recovery in nine patients (69%) after a median delay of 16 days (range 3-32), none of whom developed unusual chemotherapy complication nor SARS-Cov2 reactivation. This preliminary analysis suggests that, while being at higher risk be for severe illness, PCNSL patients with COVID-19 might be treated maximally especially if they achieved oncological response at the time of SARS-CoV-2 infection. Chemotherapy might be resumed without prolonged delay in PCNSL patients with COVID-19.

Sections du résumé

BACKGROUND BACKGROUND
Cancer patients may be at higher risk for severe coronavirus infectious disease-19 (COVID-19); however, the outcome of Primary Central Nervous System Lymphoma (PCNSL) patients with SARS-CoV-2 infection has not been described yet.
METHODS METHODS
We conducted a retrospective study within the Lymphomes Oculo-Cérébraux national network (LOC) to assess the clinical characteristics and outcome of SARS-CoV-2 infection in PCNSL patients (positive real-time polymerase chain reaction of nasopharyngeal swab or evocative lung computed tomography scan). We compared clinical characteristics between patients with severe (death and/or intensive care unit admission) and mild disease.
RESULTS RESULTS
Between March and May 2020, 13 PCNSL patients were diagnosed with SARS-CoV-2 infection, 11 (85%) of whom were undergoing chemotherapy at the time of infection. The mortality rate was 23% (3/13), and two additional patients (15%) required mechanical ventilation. Two patients (15%) had no COVID-19 symptoms. History of diabetes mellitus was more common in severe patients (3/5 vs 0/8, p = 0.03). Two patients recovered from COVID-19 after mechanical ventilation during more than two weeks and resumed chemotherapy. In all, chemotherapy was resumed after COVID-19 recovery in nine patients (69%) after a median delay of 16 days (range 3-32), none of whom developed unusual chemotherapy complication nor SARS-Cov2 reactivation.
CONCLUSION CONCLUSIONS
This preliminary analysis suggests that, while being at higher risk be for severe illness, PCNSL patients with COVID-19 might be treated maximally especially if they achieved oncological response at the time of SARS-CoV-2 infection. Chemotherapy might be resumed without prolonged delay in PCNSL patients with COVID-19.

Identifiants

pubmed: 33387015
doi: 10.1007/s00415-020-10311-w
pii: 10.1007/s00415-020-10311-w
pmc: PMC7776286
doi:

Substances chimiques

RNA, Viral 0

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

3072-3080

Subventions

Organisme : SiRIC CURAMUS Institut National du Cancer
ID : INCa-DGOS-Inserm_12560

Informations de copyright

© 2021. Springer-Verlag GmbH Germany, part of Springer Nature.

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Auteurs

Alice Laurenge (A)

Service de Neurologie 2-Mazarin, Sorbonne Université, Inserm, CNRS, UMR S 1127, Institut du Cerveau Et de La Moelle Épinière, ICM, AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, 47-83 boulevard de l'Hôpital, 75013, Paris, France.

Renata Ursu (R)

Service de Neurologie, Université de Paris, AP-HP, Hôpital Saint Louis, 75010, Paris, France.

Caroline Houillier (C)

Service de Neurologie 2-Mazarin, Sorbonne Université, Inserm, CNRS, UMR S 1127, Institut du Cerveau Et de La Moelle Épinière, ICM, AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, 47-83 boulevard de l'Hôpital, 75013, Paris, France.

Basma Abdi (B)

Laboratoire de virologie, AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, 75013, Paris, France.
Sorbonne Université, INSERM 1136, Institut Pierre Louis D'Epidémiologie Et de Santé Publique, 75013, Paris, France.

Gianpiero Tebano (G)

Service de Maladies infectieuses et Tropicales, AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, 75013, Paris, France.

Cyril Quemeneur (C)

Département d'anesthésie et réanimation, AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Groupe Hospitalier Pitié-Salpêtrière, 75013, Paris, France.

Sylvain Choquet (S)

Service d'hématologie clinique, AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Groupe Hospitalier Pitié-Salpêtrière, 75013, Paris, France.

Roberta Di Blasi (R)

Service d'Hématologie, Université de Paris, AP-HP, Hôpital Saint Louis, 75010, Paris, France.

Fernando Lozano (F)

Service de Neurologie 2-Mazarin, Sorbonne Université, Inserm, CNRS, UMR S 1127, Institut du Cerveau Et de La Moelle Épinière, ICM, AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, 47-83 boulevard de l'Hôpital, 75013, Paris, France.

Andrea Morales (A)

Service de Neurologie 2-Mazarin, Sorbonne Université, Inserm, CNRS, UMR S 1127, Institut du Cerveau Et de La Moelle Épinière, ICM, AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, 47-83 boulevard de l'Hôpital, 75013, Paris, France.

Alberto Durán-Peña (A)

Service de Neurologie 2-Mazarin, Sorbonne Université, Inserm, CNRS, UMR S 1127, Institut du Cerveau Et de La Moelle Épinière, ICM, AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, 47-83 boulevard de l'Hôpital, 75013, Paris, France.

Lila Sirven-Villaros (L)

Service de Neurologie, Université de Paris, AP-HP, Hôpital Saint Louis, 75010, Paris, France.

Bertrand Mathon (B)

Service de neurochirurgie, AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Groupe Hospitalier Pitié-Salpêtrière, 75013, Paris, France.

Karima Mokhtari (K)

Service de Neuropathologie Laboratoire Escourolle, Sorbonne Université, Inserm, CNRS, UMR S 1127, Institut du Cerveau Et de La Moelle Épinière, ICM, AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, 75013, Paris, France.

Franck Bielle (F)

Service de Neuropathologie Laboratoire Escourolle, Sorbonne Université, Inserm, CNRS, UMR S 1127, Institut du Cerveau Et de La Moelle Épinière, ICM, AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, 75013, Paris, France.

Nadine Martin-Duverneuil (N)

Service de neuroradiologie, AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, 75013, Paris, France.

Jean-Yves Delattre (JY)

Service de Neurologie 2-Mazarin, Sorbonne Université, Inserm, CNRS, UMR S 1127, Institut du Cerveau Et de La Moelle Épinière, ICM, AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, 47-83 boulevard de l'Hôpital, 75013, Paris, France.

Anne-Geneviève Marcelin (AG)

Laboratoire de virologie, AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, 75013, Paris, France.
Sorbonne Université, INSERM 1136, Institut Pierre Louis D'Epidémiologie Et de Santé Publique, 75013, Paris, France.

Valérie Pourcher (V)

Sorbonne Université, INSERM 1136, Institut Pierre Louis D'Epidémiologie Et de Santé Publique, 75013, Paris, France.
Service de Maladies infectieuses et Tropicales, AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, 75013, Paris, France.

Agusti Alentorn (A)

Service de Neurologie 2-Mazarin, Sorbonne Université, Inserm, CNRS, UMR S 1127, Institut du Cerveau Et de La Moelle Épinière, ICM, AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, 47-83 boulevard de l'Hôpital, 75013, Paris, France.

Ahmed Idbaih (A)

Service de Neurologie 2-Mazarin, Sorbonne Université, Inserm, CNRS, UMR S 1127, Institut du Cerveau Et de La Moelle Épinière, ICM, AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, 47-83 boulevard de l'Hôpital, 75013, Paris, France.

Antoine F Carpentier (AF)

Service de Neurologie, Université de Paris, AP-HP, Hôpital Saint Louis, 75010, Paris, France.

Véronique Leblond (V)

Service d'hématologie clinique, AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Groupe Hospitalier Pitié-Salpêtrière, 75013, Paris, France.

Khê Hoang-Xuan (K)

Service de Neurologie 2-Mazarin, Sorbonne Université, Inserm, CNRS, UMR S 1127, Institut du Cerveau Et de La Moelle Épinière, ICM, AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, 47-83 boulevard de l'Hôpital, 75013, Paris, France.

Mehdi Touat (M)

Service de Neurologie 2-Mazarin, Sorbonne Université, Inserm, CNRS, UMR S 1127, Institut du Cerveau Et de La Moelle Épinière, ICM, AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, 47-83 boulevard de l'Hôpital, 75013, Paris, France. mehdi.touat@gmail.com.

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