Case | 1 | 2 |
Sex/age | M/in his early 30s | M/52 |
Primary disease | Multiple myeloma | Chronic kidney disease |
Prior treatment/date | Anti-BCMA-CAR T 2019/10 | Kidney transplantation 2013/06 |
Symptoms onset time | January 26 | January 20 |
Main symptoms | Fever, dry cough | Fever, sore throat, and dry cough |
First swab time/results* | January 30 (+) | January 27 (+) |
CRP at disease onset (mg/L) | 11 | – |
WBC/LYM at disease onset (×109/L) | 3.14/1.42 | 4.67/0.38 |
COVID-19 clinical classification† | Moderate to severe to critical | Moderate to severe |
Cytokine profiles and lymphocyte subsets in severe status | ||
IL-1β (range: <5.0 pg/mL) | <5.0 | <5.0 |
IL-2R (range: 223–710 U/mL) | 903 ↑ | 670 |
IL-6 (range: <7.0 pg/mL) | 87.51 ↑ | 2.82 |
IL-8 (range: <62 pg/mL) | <5.0 | 12.4 |
IL-10 (range: <9.1 pg/mL) | <5.0 | <5.0 |
TNF-α (range: <8.1 pg/mL) | 17.6 ↑ | 6.7 |
Ferritin (range: 30–400 µg/L) | 10308 ↑ | 2534 ↑ |
Lymphocyte subsets‡ | ||
T Lymphocytes (CD3 +CD19−) (range: 27%–51%) | 84.43% ↑ | 65.6% ↑ |
Helper T cell: CD3 +CD4+ (%) (range: 27%–51%) | 7.74% | 47.37% |
Cytotoxic T cell: CD3 +CD8+ (%) (range: 15%–44%) | 76.56% ↑ | 16.40% |
B Lymphocytes (CD3−CD19+) (range: 5%–18%) | 0% ↓ | 24.5% ↑ |
Anti-SARS-CoV-2-IgG (AU/mL)§ | (−) 0.48 | (+) 41.51 |
Anti-SARS-CoV-2-IgM (AU/mL)§ | (−) 2.97 | (−) 7.54 |
*RNA was extracted from oropharyngeal swabs of patients using the respiratory sample RNA isolation kit (Xi’an Tianlong Science and Technology Co., China). The reverse-transcription PCR assay (Shanghai Huirui Biotechnology Co., China) of SARS-CoV-2 RNA was conducted to amplify and test two target genes including open reading frame 1ab and nucleocapsid protein. Patients with the cycle threshold value greater than 40 were categorized as positive for the virus.
†Clinical classification is re-defined according to the seventh version of New Coronavirus Pneumonia Prevention and Control Program issued by the Chinese National Health Commission.
‡Lymphocyte subsets in peripheral blood were assessed by flow cytometry.
§Serological detection of anti-SARS-CoV-2-IgG/IgM was performed by chemiluminescence immunoassay kit (YHLO BIOTECH, China); <10.00 AU/mL was categorized as negative results; ≥10.00 AU/mL was categorized as positive results.
BCMA, B-cell maturation antigen; CAR T, chimeric antigen receptor T cells; COVID-19, coronavirus disease 2019; CRP, C-reactive protein; Ig, immunoglobulin; IL, interleukin; LYM, lymphocyte; SARS-CoV-2, severe acute respiratory syndrome coronavirus 2 ; TNF-α, tumor necrosis factor α; WBC, white blood cell.