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Convalescent plasma therapy for B-cell-depleted patients with protracted COVID-19.
Blood. 2020 11 12; 136(20):2290-2295.Blood

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 immunoglobulin G (IgG)-IgM SARS-CoV-2 serology, and positive RNAemia measured by digital polymerase chain reaction who were treated with 4 units of COVID-19 convalescent plasma. Within 48 hours of transfusion, all but 1 patient experienced an improvement of clinical symptoms. The inflammatory syndrome abated within a week. Only 1 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 all 9 evaluated patients. In 3 patients, virus-specific T-cell responses were analyzed using T-cell enzyme-linked immunospot assay before convalescent plasma transfusion. All showed a maintained SARS-CoV-2 T-cell response and poor cross-response to other coronaviruses. No adverse event was reported. Convalescent plasma with anti-SARS-CoV-2 antibodies appears to be a very promising approach in the context of protracted COVID-19 symptoms in patients unable to mount a specific humoral response to SARS-CoV-2.

Authors+Show Affiliations

Hematology Department, Gustave Roussy, Villejuif, France. Paris-Sud University, Paris-Saclay University, Le Kremlin-Bicêtre, France.Infectious Diseases Department, Croix Rousse Hospital, Hospices Civils de Lyon, Lyon, France.Laboratoire de Virologie, Hôpital Européen Georges Pompidou, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France. Université de Paris, INSERM U970, Paris Cardiovascular Research Center, Paris, France.Infectious Diseases Department, Saint-Antoine Hospital, AP-HP, Paris, France.Infectious Diseases Department, Croix Rousse Hospital, Hospices Civils de Lyon, Lyon, France.Infectious Diseases Department, Croix Rousse Hospital, Hospices Civils de Lyon, Lyon, France. Université Claude Bernard Lyon 1, INSERM 1111, Centre International de Recherche en Infectiologie UCBL1, Lyon, France.Paris University, Institut Necker-Enfants Malades, CNRS UMR 8253 and INSERM UMR1151, Hôpital Necker-Enfants Malades, Paris, France. Laboratoire d'immunologie Biologique, Hôpital Necker-Enfants Malades, Paris, France.Internal Medicine Department, Cochin Hospital, AP-HP, Paris, France.Internal Medicine Department, Cochin Hospital, AP-HP, Paris, France.Infectious Diseases Department, Hôpitaux Civils de Colmar, Colmar, France.Intensive Care and Infectious Diseases Department, Saint-André Hospital, Bordeaux, France.Internal Medicine Department, Centre National de Référence des Cytopénies Auto-Immunes de l'Adulte, Centre Hospitalier Universitaire Henri-Mondor, AP-HP, Université Paris Est Créteil, Créteil, France.Internal Medicine Department, Centre National de Référence des Cytopénies Auto-Immunes de l'Adulte, Centre Hospitalier Universitaire Henri-Mondor, AP-HP, Université Paris Est Créteil, Créteil, France.Internal Medicine Department, Centre National de Référence des Cytopénies Auto-Immunes de l'Adulte, Centre Hospitalier Universitaire Henri-Mondor, AP-HP, Université Paris Est Créteil, Créteil, France.Department of Clinical Immunology, Hôpital Saint-Louis Hospital, AP-HP, Paris, France. Laboratory of Lymphocyte Activation and Susceptibility to EBV Infection, Imagine Institute, INSERM, Paris, France.Intensive Care Unit, Hôpital Saint-Louis, AP-HP, Paris Diderot Sorbonne University, Paris, France.Intensive Care Unit, Hôpital Saint-Louis, AP-HP, Paris Diderot Sorbonne University, Paris, France.Laboratory of Molecular Mechanisms of Hematologic Disorders and Therapeutic Implications, Imagine Institute, Paris, France. Department of Clinical Hematology, Hôpital Necker-Enfants-Malades, Paris, France.Infectious Diseases Department, Necker-Enfants Malades Hospital, AP-HP, Paris, France.Département de Néphrologie et Transplantation d'Organes, Centre de Référence des Maladies Rénales Rares, Centre Hospitalier Universitaire de Toulouse, Toulouse, France.Intensive Care Unit, Tarbes Hospital, Tarbes, France.Oncology Department, Gustave Roussy, Villejuif, France.Respiratory Diseases Intensive Care Unit, Hôpital Européen Georges Pompidou, AP-HP, Paris, France.Respiratory Diseases Intensive Care Unit, Hôpital Européen Georges Pompidou, AP-HP, Paris, France.Hematology Department, Versailles Hospital, Versailles, France.Department of Internal Medicine and Infectious Diseases, Hôpital Diaconesses Croix Saint-Simon, Paris, France.Department of Internal Medicine and Infectious Diseases, Hôpital Diaconesses Croix Saint-Simon, Paris, France.Hematology Department, Gustave Roussy, Villejuif, France.Infectious Diseases Department, Saint-Antoine Hospital, AP-HP, Paris, France. Université de Paris and Sorbonne Université, INSERM, Centre de Recherche des Cordeliers, Functional Genomics of Solid Tumors (FunGeST), Paris, France.Paris University, Institut Necker-Enfants Malades, CNRS UMR 8253 and INSERM UMR1151, Hôpital Necker-Enfants Malades, Paris, France. Laboratoire d'immunologie Biologique, Hôpital Necker-Enfants Malades, Paris, France.Unité des Virus Émergents (UVE) (Aix-Marseille Université-Institut de recherche pour le développement 190-INSERM 1207-IHU Méditerranée Infection), Marseille, France. Etablissement Français du Sang, La Plaine St-Denis, France.Infectious Diseases Department, Saint-Antoine Hospital, AP-HP, Paris, France.Sorbonne Université, Internal Medicine Department, Inflammation-Immunopathology-Biotherapy Department (DMU i3D), Saint-Antoine Hospital, AP-HP, Paris, France.Sorbonne University, GRC 29, AP-HP, DMU DREAM, Anesthesiology and Intensive Care Department, Saint-Antoine Hospital, AP-HP, Paris, France.Etablissement Français du Sang, La Plaine St-Denis, France. Institut Mondor de Recherche Biomédicale, Unité 955, Equipe 2: Transfusion et Maladies du Globule Rouge, INSERM, Etablissement Français du Sang, Université Paris-Est Créteil, Créteil, France.Etablissement Français du Sang, La Plaine St-Denis, France. UMR 1098 RIGHT INSERM Université de Franche-Comté Etablissement Français du Sang, Besançon, France; and.Infectious Diseases Department, Saint-Antoine Hospital, AP-HP, Paris, France. Sorbonne University, INSERM IPLESP, AP-HP, Paris, France.

Pub Type(s)

Journal Article
Multicenter Study
Observational Study
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

32959052

Citation

Hueso, Thomas, et al. "Convalescent Plasma Therapy for B-cell-depleted Patients With Protracted COVID-19." Blood, vol. 136, no. 20, 2020, pp. 2290-2295.
Hueso T, Pouderoux C, Péré H, et al. Convalescent plasma therapy for B-cell-depleted patients with protracted COVID-19. Blood. 2020;136(20):2290-2295.
Hueso, T., Pouderoux, C., Péré, H., Beaumont, A. L., Raillon, L. A., Ader, F., Chatenoud, L., Eshagh, D., Szwebel, T. A., Martinot, M., Camou, F., Crickx, E., Michel, M., Mahevas, M., Boutboul, D., Azoulay, E., Joseph, A., Hermine, O., Rouzaud, C., ... Lacombe, K. (2020). Convalescent plasma therapy for B-cell-depleted patients with protracted COVID-19. Blood, 136(20), 2290-2295. https://doi.org/10.1182/blood.2020008423
Hueso T, et al. Convalescent Plasma Therapy for B-cell-depleted Patients With Protracted COVID-19. Blood. 2020 11 12;136(20):2290-2295. PubMed PMID: 32959052.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Convalescent plasma therapy for B-cell-depleted patients with protracted COVID-19. AU - Hueso,Thomas, AU - Pouderoux,Cécile, AU - Péré,Hélène, AU - Beaumont,Anne-Lise, AU - Raillon,Laure-Anne, AU - Ader,Florence, AU - Chatenoud,Lucienne, AU - Eshagh,Déborah, AU - Szwebel,Tali-Anne, AU - Martinot,Martin, AU - Camou,Fabrice, AU - Crickx,Etienne, AU - Michel,Marc, AU - Mahevas,Matthieu, AU - Boutboul,David, AU - Azoulay,Elie, AU - Joseph,Adrien, AU - Hermine,Olivier, AU - Rouzaud,Claire, AU - Faguer,Stanislas, AU - Petua,Philippe, AU - Pommeret,Fanny, AU - Clerc,Sébastien, AU - Planquette,Benjamin, AU - Merabet,Fatiha, AU - London,Jonathan, AU - Zeller,Valérie, AU - Ghez,David, AU - Veyer,David, AU - Ouedrani,Amani, AU - Gallian,Pierre, AU - Pacanowski,Jérôme, AU - Mékinian,Arsène, AU - Garnier,Marc, AU - Pirenne,France, AU - Tiberghien,Pierre, AU - Lacombe,Karine, PY - 2020/07/29/received PY - 2020/08/25/accepted PY - 2020/9/23/pubmed PY - 2020/12/1/medline PY - 2020/9/22/entrez SP - 2290 EP - 2295 JF - Blood JO - Blood VL - 136 IS - 20 N2 - 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 immunoglobulin G (IgG)-IgM SARS-CoV-2 serology, and positive RNAemia measured by digital polymerase chain reaction who were treated with 4 units of COVID-19 convalescent plasma. Within 48 hours of transfusion, all but 1 patient experienced an improvement of clinical symptoms. The inflammatory syndrome abated within a week. Only 1 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 all 9 evaluated patients. In 3 patients, virus-specific T-cell responses were analyzed using T-cell enzyme-linked immunospot assay before convalescent plasma transfusion. All showed a maintained SARS-CoV-2 T-cell response and poor cross-response to other coronaviruses. No adverse event was reported. Convalescent plasma with anti-SARS-CoV-2 antibodies appears to be a very promising approach in the context of protracted COVID-19 symptoms in patients unable to mount a specific humoral response to SARS-CoV-2. SN - 1528-0020 UR - https://www.unboundmedicine.com/medline/citation/32959052/Convalescent_plasma_therapy_for_B_cell_depleted_patients_with_protracted_COVID_19_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0006-4971(20)79929-5 DB - PRIME DP - Unbound Medicine ER -