Case Report of COVID-19 Infection Unmasking CLL
Posted: Monday, November 30, 2020
Generally, individuals infected with COVID-19, a newly emerging disease characterized by acute respiratory symptoms, have low lymphocyte counts. Mohamed A. Yassin, FACP, MSc, and colleagues, of Hamad Medical Corporation, Doha, Qatar, explored a rare case of a patient who presented with COVID-19 and absolute lymphocytosis. After more extensive testing, the patient was also diagnosed with chronic lymphocytic leukemia (CLL). The results were published in the American Journal of Case Reports.
“To the best of our knowledge, this is the first case of a patient with no significant medical history who presented with typical COVID-19 symptoms and had concomitant CLL,” the researchers stated.
The man, aged 49, presented to the hospital with shortness of breath, fever, and body aches. Other than a high fever, his physical examination was unremarkable. He reported no weight loss, changes in appetite, or night sweating. He had no significant medical history, family history, or previous laboratory or medical records. The research team reported abnormally high lymphocyte counts, and he tested positive for COVID-19.
Patients with CLL tend to be at an increased risk of infections, mainly because of low humoral immunity and sometimes due to low cellular immunity. Patients with low immunity are especially vulnerable to infections such as COVID-19. However, the patient developed moderate disease, not severe, as was expected. Of note, he did not require mechanical ventilation of oxygen and was discharged after 6 days. The researchers suggested the less severe disease may be explained by the fact that COVID-19 infection is primarily cellular, whereas immunity defects in CLL are mainly humoral.
The patient returned for a follow-up 1 month after discharge, with no remaining symptoms of fever, fatigue, or shortness of breath. He is currently under observation due to the early stages of CLL, and no medication has been started.
Disclosure: The study authors reported no conflicts of interest.