key: cord-0760668-oitoxg0a
authors: Özdemir, Öner
title: Effects of COVID-19 in lymphoid malignancies
date: 2021-11-25
journal: World J Virol
DOI: 10.5501/wjv.v10.i6.329
sha: 980b02d084b51921fb9fb974b5d664dc0ebbab68
doc_id: 760668
cord_uid: oitoxg0a

I will have a couple of comments on the issues elaborated in the article titled as ‘Impact of COVID-19 in patients with lymphoid malignancies’. First, the author did not emphasize and overlook the prolonged persistence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA in coronavirus disease 2019 (COVID-19) patients with hematological malignancies. Second, the rise of a chronic lymphoid leukemia clone in COVID-19 was not mentioned by the authors. Third, achieving a complete remission in asymptomatic COVID-19 patients with follicular lymphoma in partial remission after bendamustine-based therapy is not specific to this lymphoma subtype. Fourth, follicular lymphoma does not always undergo complete remission with SARS-CoV-2 infection. Our aim is to help the authors to discuss and clarify these issues a little more in COVID-19 patients with hematological malignancies.

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I have read the original article by Riches[1] entitled 'Impact of COVID-19 in patients with lymphoid malignancies' with great interest [1] .

I will have a couple of comments on the issues elaborated in their article. First, the author did not emphasize and overlook the prolonged persistence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA in coronavirus disease 2019 (COVID-19) patients with hematological malignancies. The author just slightly touched upon within a sentence consisting of a couple of words (the persistence of a positive polymerase chain reaction for SARS-CoV-2) under the section of 'Impact of COVID-19 by Lymphoma Subtype'. However, I think that this is a huge and important problem itself and its management needs to be discussed especially in this kind of article. Here, I give some exemplary articles from the recent literature such as in King's College Hospital experience [2] , Karataş et al [3]'s, and Perini et al[4] 's studies.

Second, Largeaud et al [5] reported 'major rise of a chronic lymphoid leukemia clone during the course of COVID-19'. This aspect of CLL and COVID-19 disease should also be discussed by the author.

Third, the author discusses achieving a complete remission in asymptomatic COVID-19 patients with follicular lymphoma in partial remission after bendamustinebased therapy. When we look at the literature, this is not just specific to follicular lymphoma, but other hematological malignancies as well, such as in diffuse large Bcell lymphoma and Hodgkin lymphoma after concurrent other and SARS-CoV-2 infections, respectively [6] . Also, just a perfect article titled as 'complete remission of follicular lymphoma after SARS-CoV-2 infection: From the "flare phenomenon" to the "abscopal effect"' is reported by Sollini et al[7] . This issue should also further be elucidated.

Fourth, follicular lymphoma does not always undergo complete remission with SARS-CoV-2 infection, reported by Tafti et al [8] and Wright et al[9] . Indeed, in some malignancy patients, SARS-CoV-2 infection persisted, and COVID-19 pneumonia and the multimicrobial superinfection developed. Even, convalescent plasma needed to be utilized in the patient [9] .

The authors did not emphasize a couple of issues related to the effects of SARS-CoV-2 infection in various lymphoid malignancies. Our aim is to help to clarify these issues a little more in COVID-19 patients with hematological malignancies.

Impact of COVID-19 in patients with lymphoid malignancies

Poor outcome and prolonged persistence of SARS-CoV-2 RNA in COVID-19 patients with haematological malignancies; King's College Hospital experience

Prolonged viral shedding in a lymphoma patient with COVID-19 infection receiving convalescent plasma

How to manage lymphoid malignancies during novel 2019 coronavirus (CoVid-19) outbreak: a Brazilian task force recommendation

Major rise of a chronic lymphoid leukemia clone during the course of COVID-19

Complete spontaneous remission of diffuse large B-cell lymphoma of the maxillary sinus after concurrent infections

Complete remission of follicular lymphoma after SARS-CoV-2 infection: from the "flare phenomenon" to the "abscopal effect

COVID-19 in Patients With Hematologic-Oncologic Risk Factors: Complications in Three Patients

Successful Use of COVID-19 Convalescent Plasma in a Patient Recently Treated for Follicular Lymphoma