tetano
Editor, Senior Moderator
Blood
. 2020 Sep 21;blood.2020008423.
doi: 10.1182/blood.2020008423. Online ahead of print.
Convalescent plasma therapy for B-cell depleted patients with protracted COVID-19 disease
Thomas Hueso[SUP] 1 [/SUP], C?cile Pouderoux[SUP] 2 [/SUP], H?l?ne P?r?[SUP] 3 [/SUP], Anne-Lise Beaumont[SUP] 4 [/SUP], Laure-Anne Raillon[SUP] 2 [/SUP], Florence Ader[SUP] 5 [/SUP], Lucienne Chatenoud[SUP] 6 [/SUP], D?borah Eshagh[SUP] 7 [/SUP], Tali-Anne Szwebel[SUP] 8 [/SUP], Martin Martinot[SUP] 9 [/SUP], Fabrice Camou[SUP] 10 [/SUP], Etienne Crickx[SUP] 11 [/SUP], Marc Michel[SUP] 12 [/SUP], Matthieu Mahevas[SUP] 11 [/SUP], David Boutboul[SUP] 13 [/SUP], Elie Azoulay[SUP] 14 [/SUP], Adrien Joseph[SUP] 15 [/SUP], Olivier Hermine[SUP] 16 [/SUP], Claire Rouzaud[SUP] 17 [/SUP], Stanislas Faguer[SUP] 18 [/SUP], Philippe Petua[SUP] 19 [/SUP], Fanny Pommeret[SUP] 20 [/SUP], S?bastien Clerc[SUP] 21 [/SUP], Benjamin Planquette[SUP] 22 [/SUP], Fatiha Merabet[SUP] 23 [/SUP], Jonathan London[SUP] 24 [/SUP], Val?rie Zeller[SUP] 24 [/SUP], David Ghez[SUP] 25 [/SUP], David Veyer[SUP] 26 [/SUP], Amani Ouedrani[SUP] 27 [/SUP], Pierre Gallian[SUP] 28 [/SUP], J?r?me Pacanowski[SUP] 29 [/SUP], Ars?ne M?kinian[SUP] 30 [/SUP], Marc Garnier[SUP] 29 [/SUP], France Pirenne[SUP] 31 [/SUP], Pierre Tiberghien[SUP] 32 [/SUP], Karine Lacombe[SUP] 33 [/SUP]
Affiliations
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.
. 2020 Sep 21;blood.2020008423.
doi: 10.1182/blood.2020008423. Online ahead of print.
Convalescent plasma therapy for B-cell depleted patients with protracted COVID-19 disease
Thomas Hueso[SUP] 1 [/SUP], C?cile Pouderoux[SUP] 2 [/SUP], H?l?ne P?r?[SUP] 3 [/SUP], Anne-Lise Beaumont[SUP] 4 [/SUP], Laure-Anne Raillon[SUP] 2 [/SUP], Florence Ader[SUP] 5 [/SUP], Lucienne Chatenoud[SUP] 6 [/SUP], D?borah Eshagh[SUP] 7 [/SUP], Tali-Anne Szwebel[SUP] 8 [/SUP], Martin Martinot[SUP] 9 [/SUP], Fabrice Camou[SUP] 10 [/SUP], Etienne Crickx[SUP] 11 [/SUP], Marc Michel[SUP] 12 [/SUP], Matthieu Mahevas[SUP] 11 [/SUP], David Boutboul[SUP] 13 [/SUP], Elie Azoulay[SUP] 14 [/SUP], Adrien Joseph[SUP] 15 [/SUP], Olivier Hermine[SUP] 16 [/SUP], Claire Rouzaud[SUP] 17 [/SUP], Stanislas Faguer[SUP] 18 [/SUP], Philippe Petua[SUP] 19 [/SUP], Fanny Pommeret[SUP] 20 [/SUP], S?bastien Clerc[SUP] 21 [/SUP], Benjamin Planquette[SUP] 22 [/SUP], Fatiha Merabet[SUP] 23 [/SUP], Jonathan London[SUP] 24 [/SUP], Val?rie Zeller[SUP] 24 [/SUP], David Ghez[SUP] 25 [/SUP], David Veyer[SUP] 26 [/SUP], Amani Ouedrani[SUP] 27 [/SUP], Pierre Gallian[SUP] 28 [/SUP], J?r?me Pacanowski[SUP] 29 [/SUP], Ars?ne M?kinian[SUP] 30 [/SUP], Marc Garnier[SUP] 29 [/SUP], France Pirenne[SUP] 31 [/SUP], Pierre Tiberghien[SUP] 32 [/SUP], Karine Lacombe[SUP] 33 [/SUP]
Affiliations
- PMID: 32959052
- DOI: 10.1182/blood.2020008423
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.