Intractable COVID-19 and Prolonged SARS-CoV-2 Replication in a CAR-T-cell Therapy Recipient: A Case Study

Publication: Clinical Infectious Diseases


A chimeric antigen receptor-modified T-cell therapy recipient developed severe coronavirus disease 2019, intractable RNAemia, and viral replication lasting >2 months. Premortem endotracheal aspirate contained >2 × 1010 severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA copies/mL and infectious virus. Deep sequencing revealed multiple sequence variants consistent with intrahost virus evolution. SARS-CoV-2 humoral and cell-mediated immunity were minimal. Prolonged transmission from immunosuppressed patients is possible.

By Matthew K Hensley, William Bain, Jana Jacobs, Sham Nambulli, Urvi Parikh, Anthony Cillo, Brittany Staines, Amy Heaps, Michele D Sobolewski, Linda J Rennick, Bernard JC Macatangay, Cynthia Klamar-Blain, Georgios D Kitsios, Barbara Methé, Ashwin Somasundaram, Tullia C Bruno, Carly Cardello, Feng Shan, Creg Workman, Prabir Ray, Anuradha Ray, Janet S Lee, Rahil Sethi, William E Schwarzmann, Mark S Ladinsky, Pamela J Bjorkman, Dario A Vignali, W Paul Duprex, Mounzer E Agha, John W Mellors, Kevin Dylan McCormick
Alison Morris
Ghady Haidar