Dataset Information

Convalescent plasma-mediated resolution of COVID-19 in a patient with humoral immunodeficiency.

ABSTRACT: Convalescent plasma (CP) is widely used to treat COVID-19, but without formal evidence of efficacy. Here, we report the beneficial effects of CP in a severely ill COVID-19 patient with prolonged pneumonia and advanced chronic lymphocytic leukemia (CLL), who was unable to generate an antiviral antibody response of her own. On day 33 after becoming symptomatic, the patient received CP containing high-titer (ID₅₀ > 5,000) neutralizing antibodies (NAbs), defervesced, and improved clinically within 48 h and was discharged on day 37. Hence, when present in sufficient quantities, NAbs to SARS-CoV-2 have clinical benefit even if administered relatively late in the disease course. However, analysis of additional CP units revealed widely varying NAb titers, with many recipients exhibiting endogenous NAb responses far exceeding those of the administered units. To obtain the full therapeutic benefits of CP immunotherapy, it will thus be important to determine the neutralizing activity in both CP units and transfusion candidates.

SUBMITTER: Honjo K

PROVIDER: S-EPMC7817775 | biostudies-literature | 2021 Jan

REPOSITORIES: biostudies-literature

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Convalescent plasma-mediated resolution of COVID-19 in a patient with humoral immunodeficiency.

Honjo Kazuhito K Russell Ronnie M RM Li Ran R Liu Weimin W Stoltz Regina R Tabengwa Edlue M EM Hua Yutao Y Prichard Lynn L Kornbrust Ashton N AN Sterrett Sarah S Marques Marisa B MB Lima Jose L JL Lough Chris M CM McCarty Todd P TP Ketas Thomas J TJ Hatziioannou Theodora T Bieniasz Paul D PD Redden David T DT Moore John P JP Goepfert Paul A PA Heath Sonya L SL Hahn Beatrice H BH Davis Randall S RS

Cell reports. Medicine 20201205 1

Convalescent plasma (CP) is widely used to treat COVID-19, but without formal evidence of efficacy. Here, we report the beneficial effects of CP in a severely ill COVID-19 patient with prolonged pneumonia and advanced chronic lymphocytic leukemia (CLL), who was unable to generate an antiviral antibody response of her own. On day 33 after becoming symptomatic, the patient received CP containing high-titer (ID<sub>50</sub> > 5,000) neutralizing antibodies (NAbs), defervesced, and improved clinical ...[more]

PMID: 33521696

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Project description:In SLE, underlying immune dysregulation and immunosuppression may increase the susceptibility to COVID-19 and impair the humoral and adaptive response. We aimed to characterize COVID-19 infection, identifying susceptibility and severity risk factors, assessing the presence of SARS-CoV-2 IgG antibodies and analyzing the cellular response. We established a prospective cohort of lupus patients to estimate the COVID-19 incidence compared to the reference general population. Data were collected via telephone interviews and medical record review. SARS-CoV-2 IgG antibodies were measured cross-sectionally as part of routine surveillance. Longitudinal changes in antibody titers and immunological profile from convalescent COVID-19 patients were evaluated at 6, 12 and 24 week after symptom onset. From immunological studies, PBMCs from convalescent patients were extracted and analyzed by flow cytometry and gene expression analysis. We included 725 patients, identifying 29 with PCR-confirmed COVID-19 infection and 16 with COVID-19-like symptoms without PCR-testing. Of the 29 confirmed cases, 7 had severe disease, 8 required hospital admission (27.6%), 4 intensive care, and 1 died. COVID-19 accumulated incidence was higher in lupus patients. Health care workers and anti-SSA/Ro52 antibody positivity were risk factors for COVID-19 susceptibility, and hypocomplementemia for severity. SARS-CoV-2 IgG antibodies were detected in 8.33% of patients. Three fourths of confirmed COVID-19 cases developed antibodies. High prednisone doses were associated with lack of antibody response. Antibody titers declined over time (39%). Convalescent patients at week 12 after symptom onset displayed a CD8+T cell reduction and predominant Th17 with a mild Th2 response, more pronounced in severe COVID-19 disease. Longitudinal immune response analysis showed a progressive sustained increase in CD8+ T and B memory cells with a decrease of Th17 signaling. Lupus patients are at higher risk of COVID-19 infection and new susceptibility and severity risk factors were identified. Lupus patients were able to mount humoral and cellular responses despite immunosuppressive therapy.

Dataset Information

Convalescent plasma-mediated resolution of COVID-19 in a patient with humoral immunodeficiency.

Publications

Convalescent plasma-mediated resolution of COVID-19 in a patient with humoral immunodeficiency.

Similar Datasets

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