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Abstract：
Despite the potential of neutralizing antibodies in the management of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), clinical research on its efficacy in Chinese patients remains limited. This study is aimed at investigating the therapeutic effect of combination of antiviral therapy with neutralizing monoclonal antibodies for recurrent persistent SARS-CoV-2 pneumonia in patients with lymphoma complicated by B cell depletion. A prospective study was conducted on Chinese patients who were treated with antiviral nirmatrelvir/ritonavir therapy and the neutralizing antibody tixagevimab-cilgavimab (tix-cil). The primary outcome was the rate of recurrent SARS-CoV-2 infection. Five patients with lymphoma experienced recurrent SARS-CoV-2 pneumonia and received tix-cil treatment. All patients had a history of CD20 monoclonal antibody use within the year preceding SARS-CoV-2 infection, and two patients also had a history of Bruton\'s tyrosine kinase (BTK) inhibitor use. These patients had notably low lymphocyte counts and exhibited near depletion of B cells. All five patients tested negative for serum SARS-CoV-2 IgG and IgM antibodies. None of the patients developed reinfection with SARS-CoV-2 pneumonia after antiviral and tix-cil treatment during the 6-month follow-up period. In conclusion, the administration of antiviral and SARS-CoV-2-neutralizing antibodies showed encouraging therapeutic efficacy against SARS-CoV-2 pneumonia in patients with lymphoma complicated by B cell depletion, along with the potential preventive effect of neutralizing antibodies for up to 6 months.
摘要：
尽管中和抗体在严重急性呼吸综合征冠状病毒-2（SARS-CoV-2）的治疗中具有潜力，其在中国患者中的疗效的临床研究仍然有限。这项研究旨在研究抗病毒治疗与中和单克隆抗体联合治疗对淋巴瘤合并B细胞耗竭的患者复发性持续性SARS-CoV-2肺炎的治疗效果。对接受抗病毒尼马特雷韦/利托那韦治疗和中和抗体替沙格维单抗-西加维单抗（tix-cil）治疗的中国患者进行了前瞻性研究。主要结果是SARS-CoV-2感染的复发率。5例淋巴瘤患者反复出现SARS-CoV-2肺炎，并接受了tix-cil治疗。所有患者在SARS-CoV-2感染前一年内都有CD20单克隆抗体使用史，两名患者也有布鲁顿酪氨酸激酶（BTK）抑制剂使用史。这些患者的淋巴细胞计数明显较低，并且几乎耗尽了B细胞。所有五名患者的血清SARS-CoV-2IgG和IgM抗体检测均为阴性。在6个月的随访期内，抗病毒和tix-cil治疗后，没有患者出现SARS-CoV-2肺炎的再感染。总之,抗病毒和SARS-CoV-2中和抗体的给药显示出令人鼓舞的治疗SARS-CoV-2肺炎的淋巴瘤并发B细胞耗竭，以及中和抗体的潜在预防作用长达6个月。
