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Case report
Complicated and persistent severe COVID-19 pneumonia in a recipient of allogeneic haematopoietic stem cell transplant
  1. Lorenzo Lazzari1,
  2. Chiara Oltolini2,
  3. Fabio Ciceri1 and
  4. Fabio Giglio1
  1. 1Hematology and Bone Marrow Transplantation Unit, IRCCS Ospedale San Raffaele, Milano, Italy
  2. 2Department of Infectious Diseases, IRCCS Ospedale San Raffaele, Milano, Italy
  1. Correspondence to Dr Lorenzo Lazzari; lazzari.lorenzo{at}hsr.it

Abstract

We describe the case of a 45-year-old man affected by T-cell acute lymphoblastic leukaemia and diagnosed with COVID-19 early after an allogeneic haematopoietic stem cell transplant. The infectious disease was characterised by a severe and prolonged course, further complicated by a spontaneous pneumomediastinum and pneumopericardium. We successfully treated this patient with the antiviral drug remdesivir associated with two courses of COVID-19 convalescent plasma. This case report represents a good example of the typical clinical course of COVID-19 in severely immunosuppressed patients and gives evidence that in this population only a prompt treatment directed towards viral clearance can face the absence of a valid immune reactivity.

  • COVID-19
  • haematology (incl blood transfusion)

This article is made freely available for use in accordance with BMJ’s website terms and conditions for the duration of the covid-19 pandemic or until otherwise determined by BMJ. You may use, download and print the article for any lawful, non-commercial purpose (including text and data mining) provided that all copyright notices and trade marks are retained.

https://bmj.com/coronavirus/usage

https://doi.org/10.1136/bcr-2021-245992

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    Footnotes

    • Contributors LL, CO, FC and FG cared for the patient, interpreted the clinical and laboratory data, and wrote the manuscript. All the authors critically revised the article and approved the final version.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.