We studied clinical and immunological outcome of Covid-19 in consecutive CLL patients from a well-defined area during month 1–13 of the pandemic. Sixty patients (median age 71 y, range 43–97) were identified. Median CIRS was eight (4–20). Patients had indolent CLL (n = 38), had completed (n = 12) or ongoing therapy (n = 10). Forty-six patients (77%) were hospitalized due to severe Covid-19 and 11 were admitted to ICU. Severe Covid-19 was equally distributed across subgroups irrespective of age, gender, BMI, CLL status except CIRS (p < 0.05). Fourteen patients (23%) died; age ≥75 y was the only significant risk factor (p < 0.05, multivariate analysis with limited power). Comparing month 1–6 vs 7–13 of the pandemic, deaths were numerically reduced from 32% to 18%, ICU admission from 37% to 15% whereas hospitalizations remained frequent (86% vs 71%). Seroconversion occurred in 33/40 patients (82%) and anti-SARS-CoV-2 antibodies were detectable at six and 12 months in 17/22 and 8/11 patients, respectively. Most (13/17) had neutralizing antibodies and 19/28 had antibodies in saliva. SARS-CoV-2-specific T-cells (ELISpot) were detected in 14/17 patients. Covid-19 continued to result in high admission even among consecutive and young early- stage CLL patients. A robust and durable B and/or T cell immunity was observed in most convalescents.

我们在大流行的第 1-13 个月研究了来自明确区域的连续 CLL 患者中 Covid-19 的临床和免疫学结果。确定了 60 名患者（中位年龄 71 岁，范围 43-97）。CIRS 中位数为 8 (4-20)。患者患有惰性 CLL ( n  = 38)、已完成 ( n  = 12) 或正在进行治疗 ( n  = 10)。46 名患者 (77%) 因严重的 Covid-19 住院，11 名患者入住 ICU。除 CIRS 外，无论年龄、性别、BMI、CLL 状态如何，严重的 Covid-19 在各亚组中均等分布（p < 0.05)。14 名患者 (23%) 死亡；年龄≥75 岁是唯一显着的危险因素（p < 0.05，有限功效的多变量分析）。比较大流行的第 1-6 个月和第 7-13 个月，死亡人数从 32% 减少到 18%，ICU 入院率从 37% 减少到 15%，而住院率仍然频繁（86% 对 71%）。33/40 名患者 (82%) 发生了血清转换，分别有 17/22 和 8/11 名患者在 6 个月和 12 个月时检测到了抗 SARS-CoV-2 抗体。大多数（13/17）有中和抗体，19/28 有唾液中的抗体。在 14/17 名患者中检测到 SARS-CoV-2 特异性 T 细胞 (ELISpot)。即使在连续和年轻的早期 CLL 患者中，Covid-19 也继续导致高入院率。在大多数康复者中观察到强大而持久的 B 和/或 T 细胞免疫。