Curious cases that are the exception to the COVID-19 rule

COVID-19 has not ceased to surprise us, oftentimes for worse. However, from time to time exceptions do appear that can bring a glimmer of hope to our eyes even with a severe diagnosis in the worst circumstances! Consider the experience of a cancer patient, which has left the world's scientists in awe.

Since the pandemic began, cancer has been on the comorbid risk list as people who are stricken are also the most vulnerable to this respiratory infection due to their weakened immune system. Now, an elderly patient's own defense system is proving to be the real surprise.

The extraordinary patient

The case in question, a 61-year-old renal failure patient, was cited in the British Journal of Hematology in early January. Three years ago, the man underwent a kidney transplant that was unsuccessful. He was required to receive hemodialysis to stay alive. The patient began losing weight and suffering from progressive lymphadenopathy (enlarged lymph nodes), and his physicians decided to perform a biopsy. The results confirmed stage 3 Hodgkin's lymphoma, or cancer in the lymphatic system.

Shortly after receiving this dreadful diagnosis, the man became wheezy and began to have trouble breathing. Then came the final blow: a PCR test result that proved, in addition to the cancer, the patient was now infected with COVID-19. He spent eleven days in the hospital receiving unspecified, supportive care. What we do know is that he did not receive any corticosteroid or immunochemotherapy. The man was then instructed to continue recovery at home.

The big surprise for both patient and doctors arrived four months later. In addition to confirming the man was no longer infected with COVID-19, when comparing previous images of the cancer to current ones, they also found that his cancer had been impressively reduced.

How to explain that an immunosuppressed person not only managed to overcome the virus, but also shrink the cancer?

The answer to this question is not yet clear, but the experts in charge of this case postulate that the virus could have triggered an immune response that also helped fight the tumor. This is nothing new for science. In fact, stimulation of the immune system is the basis of immunotherapy. In other cases, especially related to HIV or specific types of cancer such as bladder cancer, patients have also shown similar instances where T cells, which fight pathogens, are helped by some inflammatory cells that are produced to fight infection. This activates the T cells to such an extent that they end up destroying tumors and other physical issues.

In short, the answer could lay in stimulating the immune system to an exact point where it responds by wiping out every threat attacking the body after making good use of the inseparable connection between the inflammatory response and the defenses.

Another encouraging case

A 63-year-old woman with an immunosuppressed system, due to a history of non-Hodgkin's lymphoma, was infected with COVID-19 for 12 weeks and managed to overcome it thanks to convalescent plasma (2[d]). Her case caught the attention of experts in Connecticut when she was in remission and receiving maintenance therapy with monoclonal antibodies, where she tested positive for COVID-19.

For three months she experienced symptoms including fever, body aches, and cough. The severity of her symptoms would wax and wane, although she never suffered from serious respiratory problems despite her frailty. Eighty-eight days after being diagnosed with the virus, which refused to leave her body, she was treated with convalescent plasma. This treatment finally yielded positive results for the patient.

How did the patient get better?

It is not yet completely clear, like the frequency of chronic infection and reinfections which are beginning to occur more often. Antibodies do appear to play an important role in protecting against more severe symptoms, especially in immunocompromised patients.

There are so many questions about this complex virus that remain unanswered. Yet cases like these give us hope that new discoveries will help fight it, even while supporting other diseases! These patients showed us once again that the human body can sometimes overcome its own weaknesses and that of various enemies at the same time, even in worst case scenarios. A bad diagnosis is never the end, so let's keep fighting the battle and be open to new surprises!

Let's keep believing, educating ourselves, and becoming healthier, together!

Your friends at Santo Remedio

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