Monoclonal Gammopathy in Korean COVID-19 Patients.
Abstract
Introduction COVID-19 is known to induce plasma cell
differentiation by elevating interleukin-6 level. Proliferation of
dyscrasic plasma cells lead to production of monoclonal immunoglobulins.
Cases with monoclonal gammopathy in COVID-19 have been reported in
various countries. In this study, we present nine cases of Korean
patients diagnosed with COVID-19 infection, and their consecutive
electrophoresis results of monoclonal gammopathies. Material &
Methods A total of 34 serial serum samples from 9 patients diagnosed
with COVID-19 infection were analyzed for the protein electrophoresis,
immunofixation, immunoglobulin quantification, SARS-CoV-2 antibody
titers and interleukin-6 level assessments. Cases were classified into
four groups based on the disease severity. Results Six cases
revealed the presence of monoclonal paraprotein in serum electrophoresis
results. Both two expired cases showed monoclonal bands, with one case
of notable correlation with the increase of virus activity. Types of
immunoglobulins were variable among six cases. Most of the cases showed
high interleukin-6 levels and COVID-19 antibody titers, but their
fluctuations did not correlate with monoclonal paraprotein patterns.
Conclusions In conclusion, monoclonal paraproteins were
observed with relatively higher frequency in the severe cases rather
than mild cases. Longitudinal monitoring on monoclonal paraproteins
associated with COVID-19 infection were proved to be transient in mild
cases.