Abstract：
Among immunocompromised hosts, leukemia patients, and hematopoietic cell transplant recipients are particularly vulnerable, facing challenges in balancing coronavirus disease 2019 (COVID-19) management with their underlying conditions. In this How I Treat article, we discuss how we approach severe acute respiratory syndrome coronavirus 2 infections in daily clinical practice, considering the existing body of literature and for topics where the available data are not sufficient to provide adequate guidance, we provide our opinion based on our clinical expertise and experience. Diagnostic approaches include nasopharyngeal swabs for polymerase chain reaction testing and chest computed tomography scans for symptomatic patients at risk of disease progression. Preventive measures involve strict infection control protocols and prioritizing vaccination for both patients and their families. Decisions regarding chemotherapy or hematopoietic cell transplantation in leukemia patients with COVID-19 require careful consideration of factors such as COVID-19 severity and treatment urgency. Treatment protocols include early initiation of antiviral therapy, with nirmatrelvir/ritonavir or remdesivir. For cases of prolonged viral shedding, distinguishing between viable and non-viable viruses remains challenging but is crucial for determining contagiousness and guiding management decisions. Overall, individualized approaches considering immune status, clinical presentation, and viral kinetics are essential for effectively managing COVID-19 in leukemia patients.
摘要：
在免疫受损的宿主中，白血病患者,造血细胞移植受者特别脆弱，在平衡2019年冠状病毒病(COVID-19)管理与基本条件方面面临挑战。在这篇我如何对待的文章中，我们讨论如何在日常临床实践中处理严重急性呼吸综合征冠状病毒2感染，考虑到现有的文献和现有数据不足以提供足够指导的主题，我们根据我们的临床专业知识和经验提供我们的意见。诊断方法包括鼻咽拭子进行聚合酶链反应测试和胸部计算机断层扫描，用于有疾病进展风险的症状患者。预防措施包括严格的感染控制方案，并优先为患者及其家人接种疫苗。对于患有COVID-19的白血病患者，关于化疗或造血细胞移植的决定需要仔细考虑因素，如COVID-19的严重程度和治疗紧迫性。治疗方案包括早期开始抗病毒治疗，用尼马特雷韦/利托那韦或雷姆德西韦。对于病毒长时间脱落的病例，区分可行病毒和不可行病毒仍然具有挑战性,但对于确定传染性和指导管理决策至关重要.总的来说,考虑免疫状态的个性化方法，临床表现,和病毒动力学对于有效管理白血病患者的COVID-19至关重要。
