Reference Database

YearReference
2020
Convalescent plasma therapy for B-cell depleted patients with protracted COVID-19 disease.
Hueso, Thomas
Pouderoux, Cécile
Péré, Hélène
Beaumont, Anne-Lise
Raillon, Laure-Anne
Ader, Florence
Chatenoud, Lucienne
Eshagh, Déborah
Szwebel, Tali-Anne
Martinot, Martin
Camou, Fabrice
Crickx, Etienne
Michel, Marc
Mahevas, Matthieu
Boutboul, David
Azoulay, Elie
Joseph, Adrien
Hermine, Olivier
Rouzaud, Claire
Faguer, Stanislas
Petua, Philippe
Pommeret, Fanny
Clerc, Sébastien
Planquette, Benjamin
Merabet, Fatiha
London, Jonathan
Zeller, Valérie
Ghez, David
Veyer, David
Ouedrani, Amani
Gallian, Pierre
Pacanowski, Jérôme
Mékinian, Arsène
Garnier, Marc
Pirenne, France
Tiberghien, Pierre
Lacombe, Karine
Blood 2020 Nov 12;136 (20): 2290-2295
Abstract

Anti-CD20 monoclonal antibodies are widely used for the treatment of hematological malignancies or autoimmune disease but may be responsible for a secondary humoral deficiency. In the context of COVID-19 infection, this may prevent the elicitation of a specific SARS-CoV-2-antibody response. We report a series of 17 consecutive patients with profound B-cell lymphopenia and prolonged COVID-19 symptoms, negative IgG-IgM SARS-CoV-2 serology and a positive RNAemia measured by digital PCR who were treated with four units of COVID-19 convalescent plasma. Within 48 hours following transfusion, all patients except one experienced an amelioration of their clinical symptoms. The inflammatory syndrome abated within a week. Only one patient who needed mechanical ventilation for severe COVID-19 disease died of bacterial pneumonia. SARS-CoV-2 RNAemia decreased to below the sensitivity threshold in 9 out of 9 evaluated patients. Analysis of virus-specific T-cell responses using T-cell enzyme linked immunoSpot (ELISPOT) assay was analyzed before convalescent plasma transfusion in 3 patients. All showed a conserved SARS-CoV-2 T-cell response and poor cross-response to other coronaviruses. No adverse event was reported. In COVID-19 patients unable to mount a specific humoral response to SARS-CoV-2, convalescent plasma with anti-SARS-CoV-2 antibodies appears to be a very promising approach in the context of protracted COVID-19 symptoms.

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