E. Malek1*, Cristina Gutierrez2*,
Victor E. Mulanovich1, Joshua Botdorf2,
Roy F. Chemaly1, Shivan Shah1,
Brandi M. McCall2, Judd T. Melancon2,
Kelly K. McConn1, Jovan Borjan3,
Issam I. Raad1, Jan A. Burger4,
Guillermo Garcia-Manero4 and Javier A. Adachi1..
of Infectious Diseases, Infection Control and Employee Health. The
University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd.,
Houston, TX 77030, USA.
2 Department of Critical Care Department; The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd., Houston, TX 77030, USA.
3 Division of Pharmacy; The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd., Houston, TX 77030, USA.
4 Department of Leukemia; The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd., Houston, TX 77030, USA.
* Alexandre E. Malek and Cristina Gutierrez are first Co-authors.
| This is an Open Access article distributed
under the terms of the Creative Commons Attribution License
(https://creativecommons.org/licenses/by-nc/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
emergence and spread of 2019 novel coronavirus have led to an
unprecedented public health crisis around the globe, threatening the
lives of millions of people. We report a severe case of COVID-19 in a
patient with chronic lymphocytic leukemia and describe primarily the
clinical presentation and the challenges encountered in the COVID-19
diagnosis, treatment, and specimens sampling pitfalls. This case
highlights the importance of a comprehensive diagnostic approach of
pneumonia in immunocompromised hosts, including timely and safe
bronchoscopy, because of the broad differential diagnosis, more
challenging with the current outbreak of COVID-19.
|Figure 1. Symptoms, signs, PCR testing, chest computed tomography scan imaging according to day of Illness and day of hospitalization. Abbreviation: BAL: bronchoalveolar lavage; CT: computed tomography; Pos: positive; NP: nasopharyngeal; Neg: negative; RT-PCR: reverse transcriptase-polymerase chain reaction. aTypical features of COVID-19, including peripheral, bilateral ground-glass opacities with visible intralobular lines (crazy-paving), and consolidation.|
|Figure 2. Panel a: Posteroanterior chest radiograph, (illness day 10, hospital day 1), showing bilateral lungs opacities and infiltrates. Panel b: A chest computed tomography scan, (illness day 11, hospital day 2), revealing a bilateral multi-segmental ground glass and consolidative opacities (centrally and mainly peripherally).|
|Table 1. Clinical Laboratory Results.|