# Long-Lasting SARS-CoV-2 Infection With Post-COVID-19 Chronic Interstitial Pneumonia in a Patient With Chronic Lymphocytic Leukemia Treated Successfully With Intravenous Immunoglobulin

## TL;DR

A patient with chronic lymphocytic leukemia experienced long-term SARS-CoV-2 infection and chronic lung issues, which improved with intravenous immunoglobulin therapy.

## Contribution

Highlights IVIG as a potential treatment for long-COVID in immunocompromised CLL patients with hypogammaglobulinemia.

## Key findings

- A 77-year-old CLL patient with hypogammaglobulinemia had prolonged SARS-CoV-2 infection and chronic pneumonia.
- Intravenous immunoglobulin therapy successfully managed the persistent infection and lung complications.
- Early detection of hypogammaglobulinemia in CLL patients may improve outcomes in long-COVID cases.

## Abstract

Post-coronavirus disease 2019 (post-COVID-19) condition is a post-acute syndrome characterized by non-specific symptoms that remain for at least two months and typically appear three months after the start of the acute phase. Individuals with chronic lymphocytic leukemia (CLL) are considered to be at high risk of contracting COVID-19. It is also becoming increasingly evident that the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccine response is frequently lacking or insufficient. We present a 77-year-old male patient with CLL who had multiple hospitalizations for the management of pneumonia related to persistent COVID-19 infection due to hypogammaglobulinemia. He was subsequently treated with intravenous immunoglobulin (IVIG). This case emphasizes the importance of the early detection of hypogammaglobulinemia in patients with CLL and long COVID because of the potential therapeutic benefit of IVIG therapy. We also provide a literature review on COVID-19 infection in CLL patients, focusing mainly on the subset population of patients with hypergammaglobulinemia.