ReviewJournal of clinical laboratory analysis2025
COVID-19 Infection Confirmed by Bronchoalveolar Lavage Fluid Metagenomics -Next-Generation Sequencing Instead of Pharyngeal Swabs in Follicular Lymphoma: Three-Case Report and Literature Review.
Review in Journal of clinical laboratory analysis, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundHematologic malignancy patients with B lymphocytopenia after anti-CD20 monoclonal antibody or anti-CD19 chimeric antigen receptor (CAR) T cell therapy often face prolonged SARS-CoV-2 positivity on pharyngeal swabs and persistent or recurrent COVID-19 infection, resulting in high mortality.
methodsHere, we describe three follicular lymphoma (FL) patients with persistent fever, cough, and hypoxemia, but they were ruled out for bacterial, viral, fungal, and other pathogen infections, and the throat swabs were consistently SARS-CoV-2 negative. These FL patients with B lymphocyte deficiency who were diagnosed with COVID-19 infection confirmed by bronchoalveolar lavage fluid (BALF) metagenomics next-generation sequencing (mNGS). Their COVID-19 infection was characterized by differences in viral load in the upper and lower respiratory tracts. When this particular COVID-19 infection occurred, although their percentages and absolute values of CD8
resultsThe patients received a combination therapy of molnupiravir and methylprednisolone; then their symptoms were relieved over the next 2 weeks-2 months.
conclusionTherefore, for immunocompromised patients, especially those with B lymphocyte deficiency, hypogammaglobulinemia, and low expression of IL-6 in peripheral blood inconsistent with clinical infection symptoms, mNGS for BALF should be performed as soon as possible in this particular condition to confirm the diagnosis of COVID-19 infection.
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