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

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...

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Autores principales: Zimmerli, Aurelia, Monti, Matteo, Fenwick, Craig, Eckerle, Isabella, Beigelman-Aubry, Catherine, Pellaton, Céline, Jaton, Katia, Dumas, Dominique, Stamm, Gian-Marco, Infanti, Laura, Andreu-Ullrich, Heidrun, Germann, Daphné, Mean, Marie, Vollenweider, Peter, Stadelmann, Raphael, Prella, Maura, Comte, Denis, Guery, Benoit, Gachoud, David, Rufer, Nathalie
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8097002/
https://www.ncbi.nlm.nih.gov/pubmed/33968017
http://dx.doi.org/10.3389/fimmu.2021.613502
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author Zimmerli, Aurelia
Monti, Matteo
Fenwick, Craig
Eckerle, Isabella
Beigelman-Aubry, Catherine
Pellaton, Céline
Jaton, Katia
Dumas, Dominique
Stamm, Gian-Marco
Infanti, Laura
Andreu-Ullrich, Heidrun
Germann, Daphné
Mean, Marie
Vollenweider, Peter
Stadelmann, Raphael
Prella, Maura
Comte, Denis
Guery, Benoit
Gachoud, David
Rufer, Nathalie
author_facet Zimmerli, Aurelia
Monti, Matteo
Fenwick, Craig
Eckerle, Isabella
Beigelman-Aubry, Catherine
Pellaton, Céline
Jaton, Katia
Dumas, Dominique
Stamm, Gian-Marco
Infanti, Laura
Andreu-Ullrich, Heidrun
Germann, Daphné
Mean, Marie
Vollenweider, Peter
Stadelmann, Raphael
Prella, Maura
Comte, Denis
Guery, Benoit
Gachoud, David
Rufer, Nathalie
author_sort Zimmerli, Aurelia
collection PubMed
description 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.
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spelling pubmed-80970022021-05-06 Case Report: Stepwise Anti-Inflammatory and Anti-SARS-CoV-2 Effects Following Convalescent Plasma Therapy With Full Clinical Recovery Zimmerli, Aurelia Monti, Matteo Fenwick, Craig Eckerle, Isabella Beigelman-Aubry, Catherine Pellaton, Céline Jaton, Katia Dumas, Dominique Stamm, Gian-Marco Infanti, Laura Andreu-Ullrich, Heidrun Germann, Daphné Mean, Marie Vollenweider, Peter Stadelmann, Raphael Prella, Maura Comte, Denis Guery, Benoit Gachoud, David Rufer, Nathalie Front Immunol Immunology 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. Frontiers Media S.A. 2021-04-21 /pmc/articles/PMC8097002/ /pubmed/33968017 http://dx.doi.org/10.3389/fimmu.2021.613502 Text en Copyright © 2021 Zimmerli, Monti, Fenwick, Eckerle, Beigelman-Aubry, Pellaton, Jaton, Dumas, Stamm, Infanti, Andreu-Ullrich, Germann, Mean, Vollenweider, Stadelmann, Prella, Comte, Guery, Gachoud and Rufer https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Immunology
Zimmerli, Aurelia
Monti, Matteo
Fenwick, Craig
Eckerle, Isabella
Beigelman-Aubry, Catherine
Pellaton, Céline
Jaton, Katia
Dumas, Dominique
Stamm, Gian-Marco
Infanti, Laura
Andreu-Ullrich, Heidrun
Germann, Daphné
Mean, Marie
Vollenweider, Peter
Stadelmann, Raphael
Prella, Maura
Comte, Denis
Guery, Benoit
Gachoud, David
Rufer, Nathalie
Case Report: Stepwise Anti-Inflammatory and Anti-SARS-CoV-2 Effects Following Convalescent Plasma Therapy With Full Clinical Recovery
title Case Report: Stepwise Anti-Inflammatory and Anti-SARS-CoV-2 Effects Following Convalescent Plasma Therapy With Full Clinical Recovery
title_full Case Report: Stepwise Anti-Inflammatory and Anti-SARS-CoV-2 Effects Following Convalescent Plasma Therapy With Full Clinical Recovery
title_fullStr Case Report: Stepwise Anti-Inflammatory and Anti-SARS-CoV-2 Effects Following Convalescent Plasma Therapy With Full Clinical Recovery
title_full_unstemmed Case Report: Stepwise Anti-Inflammatory and Anti-SARS-CoV-2 Effects Following Convalescent Plasma Therapy With Full Clinical Recovery
title_short Case Report: Stepwise Anti-Inflammatory and Anti-SARS-CoV-2 Effects Following Convalescent Plasma Therapy With Full Clinical Recovery
title_sort case report: stepwise anti-inflammatory and anti-sars-cov-2 effects following convalescent plasma therapy with full clinical recovery
topic Immunology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8097002/
https://www.ncbi.nlm.nih.gov/pubmed/33968017
http://dx.doi.org/10.3389/fimmu.2021.613502
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