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Efficacy of convalescent plasma therapy in immunocompromised patients with COVID-19: A case report
BACKGROUND: Management of immunocompromised COVID-19 patients is the object of current debate. Accumulating evidence suggest that treatment with high-titer COVID-19 convalescent plasma (CCP) may be effective in this characteristic clinical scenario. CASE REPORT: A 52-years old immunocompromised fema...
Autores principales: | , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
The Author(s). Published by Elsevier Ltd on behalf of British Infection Association.
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8408049/ https://www.ncbi.nlm.nih.gov/pubmed/34490417 http://dx.doi.org/10.1016/j.clinpr.2021.100096 |
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author | Casarola, Genni D'Abbondanza, Marco Curcio, Rosa Alcidi, Riccardo Campanella, Tommaso Rossi, Rachele Fusaro, Jessica Gandolfo, Vito Di Giuli, Cinzia Laoreti, Chiara Veca, Vito Leone, Maria Comasia Pucci, Giacomo Vaudo, Gaetano |
author_facet | Casarola, Genni D'Abbondanza, Marco Curcio, Rosa Alcidi, Riccardo Campanella, Tommaso Rossi, Rachele Fusaro, Jessica Gandolfo, Vito Di Giuli, Cinzia Laoreti, Chiara Veca, Vito Leone, Maria Comasia Pucci, Giacomo Vaudo, Gaetano |
author_sort | Casarola, Genni |
collection | PubMed |
description | BACKGROUND: Management of immunocompromised COVID-19 patients is the object of current debate. Accumulating evidence suggest that treatment with high-titer COVID-19 convalescent plasma (CCP) may be effective in this characteristic clinical scenario. CASE REPORT: A 52-years old immunocompromised female patient, previously treated with rituximab for low grade B-cell lymphoma, showed prolonged SARS-CoV-2 shedding and a long-term course of signs of severe COVID-19. A first cycle of treatment with remdesivir, a nucleotide analogue prodrug effective in inhibiting SARS-CoV-2 replication, did not provide fully and sustained clinical remission. A second hospitalization was deemed necessary after 10 days from the first hospital discharge due to recrudescence of symptoms of severe COVID-19 and the evidence of bilateral interstitial pneumonia at the chest-CT scan. Clinical and radiological findings completely disappeared after CCP administration. The viral culture confirmed the absence of SARS-CoV-2-related cytopathic effect. The clinical evaluation, performed two months after hospital discharge, was unremarkable. RESULTS: Findings from our case report suggest that the host T-cell specific response to SARS-CoV-2 is not sufficient to reduce viral load in the absence of neutralizing antibodies. Acquired immune antibodies and/or related components passively infused with CCP might help in boosting the plasma recipient response to the virus and promoting complete viral clearance. CONCLUSIONS: Independently from negative results in immunocompetent individuals, the potential effectiveness of CCP infusion in selected cohorts of patients with primary or secondary impaired immune response should be tested. Further research about mechanisms of host response in immunocompromised patients with SARS-CoV-2 infection is required. |
format | Online Article Text |
id | pubmed-8408049 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | The Author(s). Published by Elsevier Ltd on behalf of British Infection Association. |
record_format | MEDLINE/PubMed |
spelling | pubmed-84080492021-09-01 Efficacy of convalescent plasma therapy in immunocompromised patients with COVID-19: A case report Casarola, Genni D'Abbondanza, Marco Curcio, Rosa Alcidi, Riccardo Campanella, Tommaso Rossi, Rachele Fusaro, Jessica Gandolfo, Vito Di Giuli, Cinzia Laoreti, Chiara Veca, Vito Leone, Maria Comasia Pucci, Giacomo Vaudo, Gaetano Clin Infect Pract Case Reports and Series BACKGROUND: Management of immunocompromised COVID-19 patients is the object of current debate. Accumulating evidence suggest that treatment with high-titer COVID-19 convalescent plasma (CCP) may be effective in this characteristic clinical scenario. CASE REPORT: A 52-years old immunocompromised female patient, previously treated with rituximab for low grade B-cell lymphoma, showed prolonged SARS-CoV-2 shedding and a long-term course of signs of severe COVID-19. A first cycle of treatment with remdesivir, a nucleotide analogue prodrug effective in inhibiting SARS-CoV-2 replication, did not provide fully and sustained clinical remission. A second hospitalization was deemed necessary after 10 days from the first hospital discharge due to recrudescence of symptoms of severe COVID-19 and the evidence of bilateral interstitial pneumonia at the chest-CT scan. Clinical and radiological findings completely disappeared after CCP administration. The viral culture confirmed the absence of SARS-CoV-2-related cytopathic effect. The clinical evaluation, performed two months after hospital discharge, was unremarkable. RESULTS: Findings from our case report suggest that the host T-cell specific response to SARS-CoV-2 is not sufficient to reduce viral load in the absence of neutralizing antibodies. Acquired immune antibodies and/or related components passively infused with CCP might help in boosting the plasma recipient response to the virus and promoting complete viral clearance. CONCLUSIONS: Independently from negative results in immunocompetent individuals, the potential effectiveness of CCP infusion in selected cohorts of patients with primary or secondary impaired immune response should be tested. Further research about mechanisms of host response in immunocompromised patients with SARS-CoV-2 infection is required. The Author(s). Published by Elsevier Ltd on behalf of British Infection Association. 2021-11 2021-09-01 /pmc/articles/PMC8408049/ /pubmed/34490417 http://dx.doi.org/10.1016/j.clinpr.2021.100096 Text en © 2021 The Author(s) Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active. |
spellingShingle | Case Reports and Series Casarola, Genni D'Abbondanza, Marco Curcio, Rosa Alcidi, Riccardo Campanella, Tommaso Rossi, Rachele Fusaro, Jessica Gandolfo, Vito Di Giuli, Cinzia Laoreti, Chiara Veca, Vito Leone, Maria Comasia Pucci, Giacomo Vaudo, Gaetano Efficacy of convalescent plasma therapy in immunocompromised patients with COVID-19: A case report |
title | Efficacy of convalescent plasma therapy in immunocompromised patients with COVID-19: A case report |
title_full | Efficacy of convalescent plasma therapy in immunocompromised patients with COVID-19: A case report |
title_fullStr | Efficacy of convalescent plasma therapy in immunocompromised patients with COVID-19: A case report |
title_full_unstemmed | Efficacy of convalescent plasma therapy in immunocompromised patients with COVID-19: A case report |
title_short | Efficacy of convalescent plasma therapy in immunocompromised patients with COVID-19: A case report |
title_sort | efficacy of convalescent plasma therapy in immunocompromised patients with covid-19: a case report |
topic | Case Reports and Series |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8408049/ https://www.ncbi.nlm.nih.gov/pubmed/34490417 http://dx.doi.org/10.1016/j.clinpr.2021.100096 |
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