Table 2 Assessment and screening of infection risk before CAR-T therapy

General laboratory tests

CBC, hepatic and renal function, coagulation function, etc.

Hb, WBC, PLT, ALT, AST, ALB, TBIL, LDH, UREA, CREA, BUN, PT, TT, APTT, etc.

For all patients.

Inflammatory indicators

D-dimer, CRP, procalcitonin, serum ferritin, erythrocyte sedimentation rate, etc.

Serum cytokines

IL-2, IL-4, IL-6, IL-10, IL-17, TNF-α, INF-γ, etc.

For SARS-CoV-2 confirmed patients to assess the degree of infection.

Immune indicators

Lymphocyte subsets

total T lymphocytes (CD3⁺), helper/inducer T lymphocytes (CD3⁺CD4⁺), suppressor/cytotoxic T lymphocytes (CD3⁺CD8⁺), B lymphocytes (CD3⁻CD19⁺), and natural killer cells (CD3⁻CD16⁺CD56⁺), etc.

For all patients to evaluate their immune status.

Etiological/serological detection

SARS-CoV-2

nucleic acid and/or antigen detection

For all patients and repeated if necessary.

HBV

HBV-DNA, HBsAg, HBsAb, etc.

For all patients.

Other respiratory viruses

nucleic acid, antigen, or antibody detection (including influenza A or B, RSV, parainfluenza viruses, adenovirus, enterovirus, rhinovirus, etc.)

When a respiratory tract co-infection is suspected.

Note: It is difficult to distinguish COVID-19 from other respiratory virus infections based on symptoms alone.

Sputum cultures

The presence of sputum expectoration.

G/GM test

For patients with high-risk factors for fungal infection.

mNGS

Optional. An unbiased technology to detect a variety of pathogenic microorganisms.

bronchoalveolar lavage fluid through a bronchoscope

SARS-CoV-2 nucleic acid

Advisable if chest CT imaging suggests residual shadow.

Imaging

Chest CT scans

For SARS-CoV-2 confirmed patients with pneumonia.

Others

If other infection or organ dysfunction is suspected, the appropriate examinations can be performed.