Case Report: Stepwise Anti-Inflammatory and Anti-SARS-CoV-2 Effects Following Convalescent Plasma Therapy With Full Clinical Recovery.

Details

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State: Public
Version: Final published version
License: CC BY 4.0
Serval ID
serval:BIB_AE27E1EE2E3C
Type
Article: article from journal or magazin.
Publication sub-type
Case report (case report): feedback on an observation with a short commentary.
Collection
Publications
Institution
Title
Case Report: Stepwise Anti-Inflammatory and Anti-SARS-CoV-2 Effects Following Convalescent Plasma Therapy With Full Clinical Recovery.
Journal
Frontiers in immunology
Author(s)
Zimmerli A., Monti M., Fenwick C., Eckerle I., Beigelman-Aubry C., Pellaton C., Jaton K., Dumas D., Stamm G.M., Infanti L., Andreu-Ullrich H., Germann D., Mean M., Vollenweider P., Stadelmann R., Prella M., Comte D., Guery B., Gachoud D., Rufer N.
ISSN
1664-3224 (Electronic)
ISSN-L
1664-3224
Publication state
Published
Issued date
2021
Peer-reviewed
Oui
Volume
12
Pages
613502
Language
english
Notes
Publication types: Case Reports ; Research Support, Non-U.S. Gov't
Publication Status: epublish
Abstract
In these times of COVID-19 pandemic, concern has been raised about the potential effects of SARS-CoV-2 infection on immunocompromised patients, particularly on those receiving B-cell depleting agents and having therefore a severely depressed humoral response. Convalescent plasma can be a therapeutic option for these patients. Understanding the underlying mechanisms of convalescent plasma is crucial to optimize such therapeutic approach. Here, we describe a COVID-19 patient who was deeply immunosuppressed following rituximab (anti-CD20 monoclonal antibody) and concomitant chemotherapy for chronic lymphoid leukemia. His long-term severe T and B cell lymphopenia allowed to evaluate the treatment effects of convalescent plasma. Therapeutic outcome was monitored at the clinical, biological and radiological level. Moreover, anti-SARS-CoV-2 antibody titers (IgM, IgG and IgA) and neutralizing activity were assessed over time before and after plasma transfusions, alongside to SARS-CoV-2 RNA quantification and virus isolation from the upper respiratory tract. Already after the first cycle of plasma transfusion, the patient experienced rapid improvement of pneumonia, inflammation and blood cell counts, which may be related to the immunomodulatory properties of plasma. Subsequently, the cumulative increase in anti-SARS-CoV-2 neutralizing antibodies due to the three additional plasma transfusions was associated with progressive and finally complete viral clearance, resulting in full clinical recovery. In this case-report, administration of convalescent plasma revealed a stepwise effect with an initial and rapid anti-inflammatory activity followed by the progressive SARS-CoV-2 clearance. These data have potential implications for a more extended use of convalescent plasma and future monoclonal antibodies in the treatment of immunosuppressed COVID-19 patients.
Keywords
B-cell depletion, chronic SARS-CoV-2 infection, convalescent plasma therapy, neutralizing antibodies, severe immunosuppression, viral clearance
Pubmed
Web of science
Open Access
Yes
Create date
21/04/2021 17:14
Last modification date
21/11/2022 8:20
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